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[Correspondence] Network meta-analysis of antidepressants – Authors’ reply

We agree with Kirsch and Jakobsen that the standardised mean difference (SMD) of antidepressants is, on average, 0·30. Many other medical interventions have similar effect sizes.1 Indeed, the minimal important change for 17-item Hamilton Depression Rating Scale (HAMD-17) is between 4 and 10.2 However, the minimal important change, a within-person index, should not be confused with the smallest worthwhile difference,3 a between-intervention measure that is intervention-specific and can be much smaller.

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