Most people on antidepressants are being duped

Con has tried to alter the terms of the debate to the point where it is unrecognizable. I reject every one of his changes and respectfully refer him back to the resolution:Most people on antidepressants are being dupedSpecifically:1. As the instigator, I have the BoP to defend the resolution. Con does not have the BoP.2. "Most people are being duped" means that some people do indeed benefit from taking antidepressants. This is not being contested.3. "Most people on antidepressants" means people taking antidepressants as they currently do in the real world. This includes: a) people taking antidepressants for any reason. Con has no justification for limiting the debate to people who take them "for the obvious purpose of being less depressed." SSRIs, for example, are prescribed for a range of reasons - predominantly related to depression and anxiety, but also, notoriously, as mood brighteners. b) people taking any dosage of antidepressants. There is nothing in the resolution that limits the debate to people adhering to a specific dosage regimen. 4. Anti-depressants may have benefits - most strikingly, the placebo effect - but they also have associated costs, psychological, physiological, financial and social. To win this debate, I will show that the costs balance or outweigh any benefits for most people currently taking anti-depressants.____the placebo effectThere is a very large placebo effect associated with drug intervention for depression (1).For mild and moderate depression, the placebo effect is not significantly different from the drug effect for most popular antidepressants (2). This means that although these patients do benefit significantly from taking antidepressants, they would benefit as much from taking a placebo. It is only for severely depressed patients that the drug effect exceeds the placebo effect. These patients do benefit from antidepressants. A recent US survey of antidepressant use found that only one third of people taking antidepressants had severe depression (3). Therefore, two thirds (most) of the people taking antidepressants are benefitting from the medication no more than they would from a placebo.Finally, the placebo effect associated with antidepressants has been increasing in the decades since they were introduced into our society (4). As antidepressants become more popular, and people believe more and more in the drug company rhetoric, they have more faith in the effects of the drug and the placebo effect is enhanced. This has consequences for society in general, which I may discuss further in the next round.If people are benefitting from antidepressants, who cares if the effect is a placebo effect or a pharmacological one? A benefit is a benefit, right? Yes, which is no doubt why general practitioners keep on writing those prescriptions. (In fact, four of every five prescriptions for anti-depressants in the US come from non-psychiatrists (5)). However, antidepressants:a) are more expensive than a simple placebo (over $10 billion dollars spent on them each year in the US (6)); and b) have serious side-effects. Side effects include nausea, insomnia, anxiety, decreased sex drive, weight gain, fatigue, and headaches. There is also the risk of increased depression and suicidal behavior, especially in young people. Older people have an increased risk of fractures and bone loss. There are also serious withdrawal symptoms associated with antidepressants (7). Therefore, most people on antidepressants are being duped. They would be better off with a simple chalk pill or even some paracetamol. (1) Kirsch & Sapirstein, 'Listening to Prozac but hearing placebo: A meta-analysis of antidepressant medication.' Prevention & Treatment, 1998 http://psychrights.org...(2) Kirsch et al., 'Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration' PLOS Medicine http://www.plosmedicine.org...Also see Fournier et al. 'Antidepressant Drug Effects and Depression Severity A Patient-Level Meta-analysis' JAMA 2010 http://jama.jamanetwork.com...(3) Pratt et al. 'Antidepressant Use in Persons Aged 12 and Over: United States, 2005–2008' NCHS Data Brief No.76, 2011 http://www.cdc.gov...(4) Walsh et al., 'Placebo Response in Studies of Major Depression: Variable, Substantial, and Growing'JAMA. 2002;287(14):1840-1847. http://jama.jamanetwork.com...(5) B.Smith 'Inappropriate prescribing' Monitor on Psychology APA. 2012 http://www.apa.org...(6) T. Insel, 'Antidepressants: A complicated picture' National Institute of Mental Health, 2011 http://www.nimh.nih.gov...(7) http://www.helpguide.org...