The Antidepressant Web

Abstract

This paper was conceived as chapters two and three of the still unwritten book, and as a basis for discussion on an Internet website and elsewhere. These chapters examine hard evidence relating to a wholly rhetorical and hypothetical question, "Do antidepressants work?" The question provides the broadest possible framework for looking at the meaning and values of medicine. Implicitly, the question also asks: what is better than nothing, and how much better are antidepressant drugs than the placebos they are compared with in clinical trials? Between the lines of the paper lie basic questions about the ethics, activities, performance and impact of the three main centres of power in medicine - government, professionals and the pharmaceutical industry. The underlying issue is whether people who are miserably unfulfilled, sad, anguished or depressed are in hands as safe as they might imagine or need.