To the Editor: We were interested to learn from Drs. Ruini and Fava that a low prevalence of major depression has been found in a clinical study group of patients with panic disorder who were treated with cognitive behavior therapy. This observation is consistent with the association we reported of a lower incidence of major depression among individuals in an epidemiologic sample who received some form of treatment for panic. We are less impressed, however, with evidence linking the treatment of patients with panic disorder with antidepressants to a poorer outcome, specifically in terms of a greater risk of major depression. After a close reading of the literature, we have failed to find strong empirical support for the sensitizing effects of antidepressant medications. At least in the short term, there appears to be evidence that antidepressant medications are associated with a greater, rather than lower, incidence of depression among patients with panic disorder (1).