An earlier article by Alchin & Tranby resulted in 6 critical Letters to the Editor. All Letters point to the cost effectiveness & efficacy of the newer antidepressant drugs. They note that Alchin et al limited their study to looking at only direct acquisition costs. Alchin responds to the criticisms & notes that the point of their study was to ask: what are the consequences of escalating costs of antidepressant use while the number of prscriptions has not increased in the same period?