Abstract Randomised clinical trials with the same study design for granting a marketing authorisation are used to draw up depression guidelines. These randomised clinical trials have several limitations. These include that depression of the participants in these randomised clinical trials is heterogeneous to varying degrees and the natural resilience mechanism is insufficiently controlled. It is preferable to base antidepressant treatment guidelines on the results of pragmatic trials by a fixed group of primary and secondary care reporters in drug treatment-naive patients.
A.J.M. Loonen (Tue,) studied this question.