Until such time, we hope that clinicians will bear in mind the findings summarized in our report. In our mega-analysis, based on four major studies that compared antidepressant medications and cognitive behavioral therapy in the acute treatment of severely depressed outpatients, we found equivalent performance of these two treatment modalities. As for Dr. Taylor’s specific concerns, first, especially with severe or melancholic depression, the evidence suggests that tricyclic antidepressants such as those used in the four studies reviewed are at least as potent as other classes of antidepressants, including selective serotonin reuptake inhibitors (1). Second, we understand that there are many ways to define severe depression. As our aim was to present data germane to existing treatment guidelines, we applied the criteria used in those guidelines. Moreover, despite the original investigators’ attempts to find interactions of treatment and subtype in the data sets of the four studies reviewed, there is virtually no empirical evidence for the presumed superiority of medication treatment over cognitive behavioral therapy in patients with melancholic depression or in any subgroup of depressed patients for that matter. As for the 60-plus-year-old man with classic melancholic symptoms, we have observed that many such patients benefit greatly from well-delivered cognitive behavioral therapy, just as they do from well-managed antidepressant medication regimes.