Table 3.

Predefined criteria

	Criteria	Standards for scientific evidence
1	Effect	Effect estimated in meta-analyses of placebo-controlled trials should be correctly conveyed [12–14].
2	Relapse of depression	Withdrawal symptoms may be mistaken for relapse [15,16]; no good evidence for advising long-term treatment [17–19]; depression usually remits spontaneously [20].
3	Chemical imbalance	No evidence for a chemical imbalance as a cause of depression, or for drugs fixing or correcting an imbalance of chemicals in the brain [19,21–23].
4	Functioning/Quality of life	No evidence that drugs help people return to work, reduce sick leave and improve their social relationships [19].
5	Sexual function	The drugs cause sexual dysfunction in many people, e.g. lack of libido and impotence [24].
6	Emotional numbing	The drugs may blunt people’s emotions [25].
7	Suicidality	The drugs may increase the risk of suicidality, with no age limit [19,26–29].
8	Addiction	Objectively and subjectively, the drugs are addictive [30–32].
9	Withdrawal effects	The drugs may cause withdrawal effects, which may make it difficult for the patients to come off them [15,16,19,32].
10	Foetal harms	The drugs may cause neonatal abstinence syndrome [33]; it is less clear whether they may cause foetal malformations [34,35].
11	Duration of treatment	Randomised trials have only tested the drugs in the short term [19]. There is no evidence for their benefit in the long term [17,18].
12	Tapering	People must not stop the drugs suddenly [15]; a tapering is needed, often for a duration of many months [16,32,36].
13	Psychotherapy	Psychotherapy is effective [37,38] and may reduce the risk of suicide [39].
14	Off-label prescribing	The drugs are generally not approved for young people [40].