From Gordon Davies
The article by James Kingsland raises serious issues about the use of antidepressants but not necessarily the issues he implies (3 July, p 36).
When I was training in psychiatry in the late 1960s, it was well accepted that all antidepressants could cause agitation in the early stages of treatment and the standard practice was to prescribe them along with some form of tranquilliser. Indeed there were several antidepressant preparations that included a tranquilliser, such as Mutabon and Parstelin.
This old strategy has largely fallen into disuse in recent years, probably because with the newer antidepressants agitation has been less of a problem in practical terms. There is unlikely to be any opportunity now to undertake controlled trials in this, but doctors should reconsider the old strategy, even though academics have generally discouraged polypharmacy.
Wollongong, New South Wales, Australia
