Antidepressants, and the antidepressant industry, do more harm than good

Thanks for the debate rross. There are many people in the world with clinical depression (MDD) and it is a serious problem that is treated through the use of antidepressants. These people benefit immensely from taking antidepressants and therefore antidepressants do more good than harm. They allow people who are depressed to the point of being disabled to lead normal, healthy lives. Pro has a problem with antidepressants because they are popular, as if somehow that makes them less effective or beneficial to society. It is a personal choice to take an antidepressant or not. If people feel that they are depressed and that taking an antidepressant can help them, it is their choice. Having the option available is a net good for society. The Placebo Effect I am not quite sure what the point of Pro's argument is regarding placebo. I want to note off the bat that Pro admits that the severely depressed gain no placebo benefit. The benefit they get from antidepressants is specific to the affect antidepressants have on brain chemistry. That said, it is true that antidepressants have a placebo effect on people who are moderately depressed. This does not change the fact that antidepressants work. They do something that helps people who are moderately depressed. You cannot tell someone they are on a placebo or it stops working. The primary point here is that the placebo effect associated with antidepressants is a good thing. I also want to note another point that Pro ignores: antidepressants have similar efficacy, independent of severity. In other words, placebo only helps those moderately depressed, but antidepressants show a 10% improvement over placebo for the moderately depressed, as well as showing the same degree of efficacy for the severely depressed, where the placebo effect is totally absent. Pro says the placebo effect associated with antidepressants has increased as a result of "drug company rhetoric," which has given people greater faith that antidepressants work. This is an example of how the "antidepressant industry" is enhancing the effectiveness of antidepressants, through the use of rhetoric that boosts the placebo effect associated with their drugs. SSRIs generally show a 10% improvement over placebo. Nonetheless, it is important to keep in mind that a placebo effect still counts as the medicine doing something. Pro claims the problem is pricing. I counter with an article in JAMA which demonstrated that the pricing of placebos makes a difference in their effectiveness. It was shown that a placebo priced at $2.50 was significantly more effective than a placebo priced at $0.10, which further shows that the "rhetoric" perpetuated by drug companies does more good than harm to the effectiveness of antidepressants and their associated placebo effect. http://jama.jamanetwork.com... The idea here is similar to a study done on wine, which took the same wine poured into two glasses, labeled one $5 and the other $90, and the subjects thought the $90 wine tasted better. Thus, the price of antidepressants is part of the mechanism, as it also enhances the placebo effect. Side Effects Pro says antidepressants have "serious" side effects. This is false insofar as none of the side effects are serious. They range from things like nausea and insomnia to decreased sex drive. Compared to the pain and suffering that the clinically depressed experience on a daily basis, these side effects are nothing. People who are clinically depressed would much rather choose happiness with the side effect of nausea and insomnia than remain clinically depressed. The point here, again, is that it is a choice that patients make. They recognize that their depression gets in the way of their being able to lead normal lives. Many depressed people cannot hold a job, and their depression often leads them down the path towards far more self-destructive patterns of behavior, drug addiction, etc. An antidepressant's side effects are a small price to pay for happiness. As for Pro's claim that antidepressants lead to increased risk of suicidal behavior, this does not tell the whole story. Antidepressants eliminated suicidal thoughts in 74% of patients who had them. The rate of patients who are suicidal prior to taking antidepressants who then are able to lead normal lives is far higher than those who become suicidal. There is also no way to tell that depressed people become "more" suicidal as a result of taking an antidepressant. It could very well be that their depression itself is the cause of their increased suicidal thoughts. Dependency If withdrawal is done under supervision of a good psychiatrist, patients should not have to suffer through serious withdrawal symptoms. Moreover, why would a severely depressed patient ever get off a drug that has helped them? Pro's claim that untreated depression rarely lasts beyond a year is patently false. Pro simply blurs the line here between clinical depression, which requires clinical treatment, and non-clinical depression, which is usually temporary and not cause for taking an antidepressant. A good psychiatrist can tell the difference between the two and prescribes medication appropriately.