similar results were found by lerner et a the authors indicate that antidepressants might not be required for all employees with milder depression but when prescribed medication should start as soon as possible however it remains a fact that the positive employment effects are lower than the clinical effects frank and koss ie clinical improvement does not automatically nor fully translate into better work functioning measured with functioning scales and increased paid employment with substantial earnings or in getting off disability benefit rolls first symptom improvements do not always go handinhand with productivity improvement