AbstractAntidepressant drugs have unequivocally altered the short‐term outcome of depressive illness and reduced considerably the risk of morbidity. Their influence upon the chronic course of depression or upon the excess mortality associated with depressive illness is less easy to quantify. Nevertheless, the benefits of effectively treating depression far outweigh the considerable risks of leaving depressed patients inadequately, inappropriately or untreated. Most antidepressants currently available have broadly equal efficacy, although some drugs may be more appropriate in certain types of patient, when particular symptoms are prominent or when a particular side‐effect is undesirable.Antidepressants vary in their side‐effect profiles, and the newer non‐tricyclic drugs appear to offer a reduced risk of anticholinergic and cardiovascular effects. All of the newer drugs carry additional adverse effects, however, leading in the cases of zimeldine and nomifensin to withdrawal from the market and with mianserin to controls on prescription. Analysis of overdosage data indicates that the greatest risk of any antidepressant is fatality upon overdosage, the numbers of which far exceed fatalities from adverse effects. It is suggested that any assessment of the overall benefitsand risks of antidepressant drugs should include not only risks at therapeutic dosage but also the dangers of ove
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