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Sir: The article by Stein et al.1 on placebo response may, due to the data available, be missing much of the "forest" in the United States. Larger issues include the following:

1. There are many fewer untreated depressed patients in the community today than even 5 to 10 years ago, thanks to reduced stigma regarding depression, widespread prescribing by family practitioners and other physicians of the newer antidepressants (which are so relatively safe and easy to use), and the low cost of generic antidepressants.’ ‹’ ‹