D.O. Antonuccio, W.G. Danton,
G.Y. DeNelsky, R.P. Greenberg, J. S. Gordon, Raising Questions
about Antidepressants, Psychotherapy and Psychosomatics 1999, 68:1, 3-14.
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."
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