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

In the previous round I explained how antidepressants are being used as a mechanism for social control and to enforce conformity particularly in women, and how their use is likely to stifle not only social change but achievement in art and science. Con did not contest these points at all. Therefore, we can assume that he agrees that antidepressant use does indeed have these negative consequences. However, in his opinion, this is balanced by the fact that they can be used effectively against severe depression.Con then made a large number of statements about antidepressants. Almost all his statements were unreferenced and false. In fact, he made so many false statements that it will be impossible for me, in this short space, to address them all. I will go through the most important ones.Severe depressionAlthough antidepressants do work against severe depression, they only have a very small effect (1). People with major depression do not "benefit immensely" as Con claims. And, of course, as I said in the previous round, for most people on antidepressants there is no treatment difference between the drug and a placebo.Con also said that severe depression "is a serious problem that is treated through the use of antidepressants". What he didn't mention is that there are therapies available - most notably cognitive-behavioral therapy (CBT) - that are more effective (2), cheaper, and do not carry the same side-effects as antidepressants.Therefore, although antidepressants do benefit people with severe depression, the benefit is very small. Further, other effective treatment options are available. The slight benefits obtained by severely depressed patients do not come close to balancing the pernicious effect that antidepressants and the whole industry of antidepressants have on society in general.Antidepressants as a choice people makeCon notes that antidepressants are popular and that they are an option that people have and that options are good. He is right that I have a "problem" with their popularity. In the same way, I have a "problem" with the popularity of domestic violence and racism. The more popular bad things are, the worse it is. I am particularly concerned with the popularity of antidepressants because their marketing and their use encourage society towards the "take a pill" response to people's sadness. It has got to the point, almost, where contentment is a social duty in the same way as personal hygiene. That, if you are miserable or confused, you should go to a GP a fix yourself up. Look at a message thread on the current site as an example (3). A 14-year-old has taken an online depression test which has given him a score that means mild to moderate depression and he asks the community for advice. He says he's surprised by the diagnosis but that "My parents keep a hold on these restrictions tighter than need be and I feel like I'm stuck in a cage." There's the usual mix of good and bad advice, the following comments among them:"it's mostly a result of chemicals anyway.""If you can't really pinpoint it to specific things...the answer is drugs.""It sounds to me like you have an actual medical problem...it might be curable with meds."That's right. A 14-year-old is frustrated by restrictions on his life. And three people say it's chemical and that he should take antidepressants. Talk about successful marketing.Con also says that people have the choice to take antidepressants. On the other hand, most people follow their doctors' advice on these matters, especially if they have already been convinced that their sadness is a result of "brain chemistry". And, as I said in the previous round, most GPs don't feel that they do have options when treating patients with depression. That they are prescribing antidepressants against their own best judgement.One of the side effects of antidepressants is increased suicidalityThis is a well documented finding, especially for children, adolescents and adults under the age of 25 (4,5) , which is why antidepressants have been contraindicated for those populations in many countries. The US Food and Drug administration has the following comments on its website (6):"In October 2004, FDA directed manufacturers to add a boxed warning to the labeling of all antidepressant medications to alert the public about the increased risk of suicidal thinking or suicide attempts by children and adolescents taking antidepressants. A boxed warning is the most serious type of warning used on prescription drug labeling. In May 2007, FDA directed that the warning should be extended to include young adults up through age 24. More detailed analysis by FDA of antidepressant clinical trials showed an increased risk of suicidality—suicidal thoughts or behavior. "There weren't more actual suicides, but more people under 24 were thinking or talking about it," explains Mathis. "This occurs most often within the first 30 days of an adolescent or young adult starting on an antidepressant."" the placebo effectCon did include one source (7). It is a "research letter" that looks at the connection between drug discounting and placebo effect. The full article is not accessible without a subscription. As a justification for the billions of dollars US patients spend each year on antidepressants, it is completely insufficient.Anyway, it's appalling to suggest doctors should be giving people placebos. It's telling people that they're sick when they aren't, and it's a violation of the doctor-patient relationship.(1) http://www.plosmedicine.org...(2) http://www.sciencedirect.com...(3) http://www.debate.org...(4) http://www.bmj.com...(5) http://www.medpagetoday.com...(6) http://www.fda.gov...(7) http://jama.jamanetwork.com......