Raising questions about antidepressants

Antidepressant medication has apparently become the most popular treatment for depression in the USA. Several beliefs about the efficacy of antidepres sant 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 adequa tely supported by scientific data. The following issues are raised: (1) ind ustry-funded research studies which result in negative findings sometimes d o not get published; (2) placebo washout procedures may bias results in som e studies; (3) there are serious questions about the integrity of the doubl e-blind procedure; (4) the 'true' antidepressant drug effect in adults appe ars to be relatively small; (5) there is minimal evidence of antidepressant efficacy in children; (6) side effects are fairly common even with the new er antidepressants; (7) combining medications raises the risk for more seri ous complications; (8) all antidepressants can cause withdrawal symptoms; ( 9) genetic influences on unipolar depression appear to be weaker than envir onmental influences; (10) biochemical theories of depression are as yet unp roven; (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 ch anges as those who respond to medication, and (14) the evidence suggests th at psychological interventions are at least as effective as pharmacotherapy in treating depression, even if severe, especially when patient-rated meas ures are used and long-term follow-up is considered.