Drugs, not hugs: antidepressant medication trials and suicidality in children—a case history in the philosophy of science as an argument for the need for improved technology in psychiatry

Abstract

Abstract Technology has played a central role in the development of science. Who cannot be moved at imagining Galileo looking through the telescope he invented and built as he first viewed the moons of Jupiter? Shapin and Schaffer (1985) have described in detail the vacuum-creating machine built by Boyle, Boyle's development of the experimental method in science, and the disputations that arose between him and Hobbes from this technology. It was part of Boyle's genius to appreciate the value of a machine to tell us about the world as it is. The development of new technologies makes it possible for contemporary science to enhance our understanding ‘of the real world as it really is’ (Klee 1997).I shall consider the technology of the double-blind psychopharmacological clinical trial by examining some of the methodological issues raised by a series of public hearings about the safety and efficacy of selective serotonin reuptake inhibitors (for example, fluoxetine (Prozac), and sertraline (Zoloft)) and other antidepressants in children and adolescents. I will show that some aspects of the technology used by psychiatry to study psychopharmacological agents are simple and error prone. This argues that psychiatry is greatly in need of more and improved technology, not less, as I believe some of my colleagues suggest in this book.