Antidepressants are a safe and effective treatment for depression in patients with a chronic physical illness, a NICE systematic review and meta-analysis has concluded. There are several reasons for not prescribing antidepressants to patients with chronic conditions who present with mild to moderate depression of recent onset:antidepressants are little better than placebo;the physical illness may increase susceptibility to side effects; there is an increased risk of drug interactions;patients may be reluctant to take them. NICE recommends that they should only be prescribed if low-intensity psychosocial interventions are ineffective, or if there is a previous history of moderate or severe depression, or if the depression complicates the care of the chronic condition. If an antidepressant is to be prescribed, SSRIs are the drug group of first choice as they may be better tolerated and have been shown to improve quality of life. NICE recommends sertraline and citalopram as they are less likely than other SSRIs to interact with other medication and appear to be safe in heart disease.