To the Editor: We read with interest the study by Dr. Wagner et al. We have a number of concerns about this study. In the Method section, it is not clear how the patients were recruited. One is also left in the dark about the method of random assignment and if the random assignment list was concealed. The authors also give no indication of how they arrived at the sample size and if a power calculation was done. Given the recent concerns about the risk of suicidal thoughts and behaviors in children treated with SSRIs, this study could have attempted to shed additional light on the subject. The authors called the analysis of data an intent-to-treat analysis, although four patients who were lost to follow-up were excluded. In a true intent-to-treat analysis, all patients are analyzed in the groups to which they were initially assigned, regardless of whether they received the treatment or not. We consider the use of the term "intent-to-treat" in this context misleading.