Sir, Major depression kills thousands of people in this country each year and many more around the world by suicide (reports, May 14 ). The difficulty that primary care doctors have is in distinguishing minor depression and mood swings (comparable to the common cold) from major depression (comparable to old-fashioned pneumonia). Like the common cold and pneumonia one sometimes develops into the other.

The risks of taking antidepressants are small compared with their success. I have not had a case of addiction in 40 years of practice. To discourage doctors from prescribing antidepressants or seriously ill people from taking them would be disastrous.

JOHN COPELAND Emeritus Professor of Psychiatry, University of Liverpool

Sir, As a GP over the past 25 years I have witnessed and have been an unwilling instigator of a horrifying acceleration in all classes of drug prescribing.

GPs are not the instigators of all antidepressant prescribing. Nowadays we have a wealth of other health advisers such as specialist nurses, counsellors and psychiatric colleagues who tell our patients that they need medication such as antidepressants. Once any of them has advised such a treatment then there is no going back. There is also a very powerful pharmaceutical industry which is very effectively promoting its products.

Unhappiness is now an official illness for which medication is readily available. It is wrong to blame solely the prescriber for this. We are all to blame.

DR COLIN GUTHRIE Glasgow

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