Antidepressants risky, may not be more effective than placebo

New research challenges the common practice of medicating patients diagnosed with clinical depression. A new study funded by the National Institute for Health and published in The British Medical Journal suggests that prescription antidepressants are only slightly more effective than a placebo and that alternative treatments often can be effective. Dr. Robert Lefever, a medical doctor who writes for the British newspaper the Daily Mail, recently argued that studies of merely supplementing antidepressant use with other forms of treatment have a fundamental flaw, that no additional treatment will be of much use “once antidepressants are locked into the mood centers of the brain.”

Dr. Lefever points out that the effectiveness of antidepressants has been shown to be only marginally better than treatment with a placebo (a plain tablet with no active ingredient). Researchers have found that treating depression patients with SSRI medications such as Zoloft and Paxil is barely more effective than treating them with a sugar pill. He attributes most of the effectiveness of antidepressants to the placebo effect: “People feel better on anti depressants largely because their problems are medicalized and they are free from responsibility for sorting out their own lives.”

He argues that antidepressants generally are addictive and cause emotional blankness:

“Doctors generally believe that antidepressants are not addictive. I fundamentally disagree. Patients do not usually crave for an increase in the dose but they have dreadful withdrawal effects. Coming off them has to be done very carefully and gradually over a period of weeks rather than days – and a behavioral program, such as The Twelve Steps, has to take their place.”

This is compounded by other SSRI side effects including the risk of birth defects and increased suicide rates. He argues that the prime purpose of prescribing antidepressants is to enable doctors to avoid being blamed for patients’ suicides:

“If doctors do not follow the herd in prescribing drugs and CBT, they risk being blamed by coroners or by the General Medical Council when patients kill themselves.  If they do follow conventional practice, they will not be blamed. They will be said to have done the best they could do.”

Instead, Dr. Lefever suggests treatment relying primarily on behavior modification programs including Cognitive Behavior Therapy. CBT is a psychotherapeutic approach that addresses dysfunctional emotions, behaviors, and cognitions through a goal-oriented, systematic process. “Cognitive Behavior Therapy is an excellent treatment for people who grapple with confusing issues but not for those with any significant emotional problem,” he says. This unconventional method of treating depression, he argues, is more effective and carries fewer side effects than the conventional medicalization of the disorder.

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