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Authors’ reply:

Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical Centre Utrecht, HP BO1.206, PO Box 85500, 3508 GA, Utrecht, The Netherlands.

W. A. Nolen

University Medical Centre Groningen, Department of Psychiatry, Groningen, The Netherlands

Correspondence: Email: j.wijkstra{at}azu.nl

EDITED BY KIRIAKOS XENITIDIS and COLIN CAMPBELL

It is correct that some patients with psychotic depression in the studies by Bruijn et al (1996) and van den Broek et al (2004) were given haloperidol as adjunctive treatment. However, as mentioned in our article, in our intention-to-treat analysis we counted these patients as having dropped out. So, additional treatment with haloperidol did not affect the validity of our findings regarding patients receiving antidepressant monotherapy.

We agree, as mentioned in our article, that the quality of the constituent studies and the small sample sizes does influence the outcome of our meta-analysis regarding the comparison of antidepressant monotherapy v. the combination of an antidepressant and an antipsychotic. But to say that these data favour the combination is statistically not true and surely is no sound basis for contemporary clinical practice to use the combination. Moreover, the data indicate that there is no evidence for the clinical belief that an antidepressant alone is ineffective. Thus, we maintain our conclusion that both antidepressant monotherapy and the combination of an antidepressant and an antipsychotic are appropriate options for patients with psychotic depression.

This Article Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Wijkstra, J. Articles by Nolen, W. A. Search for Related Content PubMed Articles by Wijkstra, J. Articles by Nolen, W. A.