This study examines anti-depressant response after 6 months of treatment in 75 depressed patients in a community mental health clinic. Symptomatic and functional outcome measures were administered. A pharmacotherapy algorithm was followed. Many patients presented with chronic depressive disorders complicated by psychosocial problems and co-morbidity with substance use and other psychiatric and medical conditions. Level of functioning was seriously impaired. Attrition rate after 6 months was high (49%). Response rate after 6 months of treatment was 24%. Conclusions: Research studies cannot predict the response potential in the real world because of numerous complicating factors in the presentation and treatment, of depression in the community.