Raising Questions about Antidepressants

Abstract

Antidepressant medication has apparently become the most popular treatment for depression in the USA. Several beliefs about the efficacy of antidepressant medications prevail among mental health professionals and the public. This paper explores relevant research data and raises questions about these beliefs. Many of the common beliefs about these medications are not adequately supported by scientific data. The following issues are raised: (1) industry-funded research studies which result in negative findings sometimes do not get published; (2) placebo washout procedures may bias results in some studies; (3) there are serious questions about the integrity of the double-blind procedure; (4) the ‘true’ antidepressant drug effect in adults appears to be relatively small; (5) there is minimal evidence of antidepressant efficacy in children; (6) side effects are fairly common even with the newer antidepressants; (7) combining medications raises the risk for more serious complications; (8) all antidepressants can cause withdrawal symptoms; (9) genetic influences on unipolar depression appear to be weaker than environmental influences; (10) biochemical theories of depression are as yet unproven; (11) biological markers specific for depression have been elusive; (12) dosage and plasma levels of antidepressants have been minimally related to treatment outcome; (13) preliminary evidence suggests that patients who improve with cognitive-behavioral psychotherapy show similar biological changes as those who respond to medication, and (14) the evidence suggests that psychological interventions are at least as effective as pharmacotherapy in treating depression, even if severe, especially when patient-rated measures are used and long-term follow-up is considered.

Neuroplasticity and Positive Psychology in Clinical Practice: A Review for Combined Benefits

“…Use of the internet for a random controlled trial has provided empirical validation of some positive psychology techniques that can increase happiness and decrease depression for as long as six months . Thus, CBT and other positive psychological interventions are especially significant because the potential damage of the chemistry of depression and stress might be avoided by psychotherapy which has been of similar effect but greater duration than pharmacotherapy (Antonuccio et al, 1999). Duration of depression has been found to be more powerful than age in predicting volume loss in the human hippocampus (Sheline et al, 1999).…”

Placebo Use in Depression Research: Some Ethical Considerations

“…(Enserink, 1999;Kirsch et al, 2008;Turner et al, 2008). Some authors state that the effects of antidepressants are not much higher than those of sophisticated placebos (Antonuccio et al, 1999;Kirsch & Sapirstein, 1998).…”

A Preliminary Analysis of the Effects of Coaching Feedback on Teacher Implementation Fidelity of First Step to Success

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