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Response to commentary

We appreciate the thoughtful commentary by Weisburg, Hayden, and Pontes (WHP). The question of whether the apparent increased risk of suicidal thoughts or actions in children taking antidepressants is real or an artifact caused by entry criteria in clinical trials is extremely important, and we certainly did not mean to give the impression that we were dismissing the selection hypothesis. As WHP point out, that would be unwise, just as it would be unwise to dismiss the explanation that antidepressants really do cause suicidal thoughts and actions in children, regardless of risk. Our conclusion is only that the meta-analysis data do not favor the selection hypothesis over a constant relative treatment benefit hypothesis. This conclusion is based on the following.