Thanks for the comments on this piece. I guess I wasn’t clear enough about the statement “safe and effective.” In no way do I agree with Dr. Friedman’s terminology here. When I saw his statement in the New York Times it sounded to me, and others, like someone was talking about a drug like aspirin – there are not many side effects and it’s pretty clear it works. The term safe and effective really doesn’t mean much when talking about a drug, but especially about such strong medications as the atypicals. Patients and doctors want to know “how safe? and “how effective?” The phrase “safe and effective” might have been appropriate to use about the atypicals when they were just starting to come on the market and we didn’t know much about them, but there is way too much history behind us to use this term now. For at least ten years the side effects of these drugs were minimized. To simply state that they are “safe” is somewhat insulting to all the people harmed by the drugs. I contemplated adding a paragraph in the original post about all the problematic side effects including the increased suicides in the clinical trials, but figured that just the fact of so many dollars being paid out by the companies is evidence of how oversimplistic the statement is. It is quite clear that the national discussion of the atypicals has gone way beyond statements about them being safe and effective. Sorry about being too vague in the original post about this.