The discussion regarding antidepressant efficacy is known for being heated and ideology-driven. With every scientific publication, a familiar skirmish follows with both proponents and opponents of antidepressant use giving their opinion and interpretation. In the meantime, patients remain somewhat confused: who should they believe? Unfortunately, the debate is often not governed by balanced facts about both advantages and disadvantages. I believe that there are good reasons not to use antidepressants but equally there are also good reasons to use them. An antidepressant is neither a magic pill nor a illness-inducing placebo, and certainly not a quick fix. The evidence about antidepressant efficacy should be critically assessed of course, but we should be happy that they are available. In the field of antidepressants are other pressing challenges: how do we find out which patients respond to antidepressants, and how do we ensure that suitable mental health care is available for the third of all depressed Dutch people who receive no treatment at all?