Imagine, as a psychiatrist, hearing this story from a beloved friend or relative:

“I’ve been terribly depressed for the last month–can’t focus, can’t get out of bed, and I’m barely eating. Nothing really gives me pleasure anymore. I haven’t showered in 2 weeks. Sometimes I think I’d be better off dead. I asked my family doctor if an antidepressant might help. She said I’d do just as well taking a sugar pill, and it’s a lot cheaper!”

I hope you would be both alarmed and outraged by this doctor’s dismissive attitude. Yet if the doctor–or your loved one–had read the article on antidepressants in the February 8 Newsweek (The Depressing News About Antidepressants), she might well have concluded that antidepressants are largely worthless.

Let’s credit Newsweek and the usually careful science writer, Sharon Begley, with bringing the problem of clinical depression before a wide audience. The clever cover of the magazine allows one to read either “Antidepressants Don’t Work” or “Antidepressants Do Work,” depending on which title is on top. Sadly, the article itself is a bit topsy-turvy, and may do less to educate the general public than to confuse or alarm it. (A nice rebuttal by psychiatrist Robert Klitzman, MD follows the Begley article).

Essentially, after a superficial analysis of 2 recent studies, Begley concludes that antidepressants are “basically expensive Tic Tacs” (sugar pills). Begley then struggles with whether it might be “a kindness” to keep patients “in the dark about the ineffectiveness of antidepressants, which for many are their only hope…”

The studies in question–by Kirsch and colleagues1 and Fournier and colleagues2–found that antidepressants were not substantially more effective than placebo, except for the most severe types of depression. The lay press promptly proclaimed–sometimes with barely suppressed glee–“Antidepressants No Better than Sugar Pill!”

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