Little blue pills of cheer.

July 6, 2008 7:53 PM

"The drug's effectiveness inspired an elegant theory, known as the chemical hypothesis: Sadness is simply a lack of chemical happiness. The little blue pills cheer us up because they give the brain what it has been missing. There's only one problem with this theory of depression: it's almost certainly wrong, or at the very least woefully incomplete."

How Prozac sent the science of depression in the wrong direction, from the Boston Globe.
posted by zardoz (56 comments total)

Here we go again.
posted by tkolar at 8:01 PM on July 6, 2008

This is going to get flamed, but thank you for posting it.
posted by Afroblanco at 8:04 PM on July 6, 2008

I think it's possible that the most exciting part of this article has been overlooked here:

The effectiveness of Prozac, these scientists say, has little to do with the amount of serotonin in the brain. Rather, the drug works because it helps heal our neurons, allowing them to grow and thrive again. [...] "The best way to think about depression is as a mild neurodegenerative disorder," says Ronald Duman, a professor of psychiatry and pharmacology at Yale. "Your brain cells atrophy, just like in other diseases [such as Alzheimer's and Parkinson's]. The only difference with depression is that it's reversible. The brain can recover."

I find that to be wonderfully positive news, personally.
posted by jokeefe at 8:11 PM on July 6, 2008 [24 favorites]

I would argue that SSRIs didn't send research in the wrong direction, just that they led to getting off at the wrong exit along the highway, leading it to stop at a gas station where the detour was corrected and coffee was had.

I don't mean this to be funny -- the newest thinking on the topic was (as stated in the article) "inspired" by the Prozac lag. For those SSRIs that (seem to) act more quickly, I would be interested to lean whether it perhaps speed the healing process theorized.

Thanks for the article.
posted by ltracey at 8:12 PM on July 6, 2008

"interested to learn whether it perhaps speeds"
posted by ltracey at 8:13 PM on July 6, 2008

jokeefe writes "I find that to be wonderfully positive news, personally."

Until you read the recent study suggesting that oestrogens do the same time, and that's why tofu and other soybean products increase dementia in the elderly. (In the old, presumably, new neuron growth is destabilizing, upsetting a more-or-less optimal-as-it's-going-to-get pattern in the brain.)
posted by orthogonality at 8:17 PM on July 6, 2008 [1 favorite]

Er, s/time/thing/. I guess I had too much tofu tonight.
posted by orthogonality at 8:17 PM on July 6, 2008

ortho, do you have any citations for that?
posted by greatgefilte at 8:20 PM on July 6, 2008

PepsiBluePills.
posted by jonmc at 8:22 PM on July 6, 2008

Lots of interesting research tidbits, in an otherwise stupid article with a pointlessly inflammatory (and incorrect) title.

While medical progress has been remarkable on the whole, our knowledge of the causes and treatments of mental diseases is still in the cupping and leeches stage. The linked article does once mention this, at least. Prior to Prozac, the drugs commonly prescribed for depression/OCD (eg Anafranil) were not very effective and had significant side effects. Compared to those, Prozac was a big forward step.

Another clue to the article's general irrelevance is the fact that it focuses only on Prozac. There are now several drugs that have been developed more recently that deliver better results, eg by combining SSRI and NSRI action. So Prozac is the cliche, but not the most current drug for depression/OCD.

Finally, one hates to disappoint all the budding scriptwriters out there, but taking Prozac or its cousins does not make one relaxed/happy/giddy/anxiety-free/cheery. Have your characters take ecstasy instead.
posted by Artful Codger at 8:31 PM on July 6, 2008 [5 favorites]

This TED talk is really excellent. It starts out about "love" but ends on the dangers of anti-depressants, and how the two are connected - change brain chemistry and it effects everything in unexpected ways.
posted by stbalbach at 8:32 PM on July 6, 2008 [2 favorites]

Experiments have since shown that lowering people's serotonin levels does not make them depressed, nor does it does not make them depressed, nor does it worsen their symptoms if they are already depressed.

This lack of copy-editing makes me depressed.
posted by blucevalo at 8:50 PM on July 6, 2008 [5 favorites]

stbalbach, I haven't listened to the talk you linked, but I just have to say that we change and tweak our brain chemistry constantly, starting with our coffee in the morning and our workout in the evening, and so on. Brain chemistry, as I understand it, is not static.
posted by jokeefe at 8:52 PM on July 6, 2008

This article isn't really that bad from the "OMG anti-depressants kills creativity!!1" angle.

It does however, talk vaguely about "scientists" and "experiments" while naming only a few names. The fact that there are no dissenting opinions cited leads me to disregard this completely. I have no clue if the people they're quoting are reputable. It reminds me a bit of those Intelligent Design books that manage to get a few quotes from guys with "phD" after their name on the back cover.
posted by drjimmy11 at 8:54 PM on July 6, 2008 [1 favorite]

It's known that some kinds of depression run in families. It's quite plausible that there's a genetic component to it.

One of the more interesting discoveries of the last few years is that autopsies of some people with bipolar disorder showed that their brains had far more receptors for the monoamine neurotransmitters than non-bipolars had. (The monoamine neutrotransmitters include serotonin, norepinephrine, and dopamine.) But no one knows why that matters.

It's always seemed to me that trying to treat depression by boosting the level of neurotransmitters is like trying to debug a computer program by adjusting the power supply voltage.

But it's undeniable that those drugs work for many people.
posted by Class Goat at 9:01 PM on July 6, 2008

Anecdotally, my working and short-term memory vastly improved about two months after I started SSRIs. So something about them is repairing neurons, for lack of a more precise term. Like ltracey says, maybe the trophic factors mentioned in the article only work in the proper concentration of serotonin.
posted by infinitewindow at 9:05 PM on July 6, 2008

drjimmy11, I wouldn't dismiss the article completely; it made a lot of good points, even if some of the language was hyperbolic and the copyediting was crappy. I can certainly vouch for Art Petronis's bona fides, not that he needs it, and judging by the others' publications records, they're no hacks either.
posted by greatgefilte at 9:06 PM on July 6, 2008

I've often thought that depression seemed like more of a symptom than a disease.
posted by empath at 9:16 PM on July 6, 2008 [2 favorites]

There's a pretty good layperson's-level chapter on the SSRI/neurogenesis stuff in this book.
posted by joannemerriam at 9:17 PM on July 6, 2008

FPP Title: Little blue bills of cheer.

Quote from Boston Globe article: "The little blue pills cheer us up because they give the brain what it has been missing."

Ummm ... Prozac pills are capsules: half green/half white (20 mg.) or green tablets (10 mg.).

Little blue pills cheer up one's pecker!
posted by ericb at 9:21 PM on July 6, 2008 [5 favorites]

*FPP Title: Little blue pills of cheer.*
posted by ericb at 9:39 PM on July 6, 2008

we change and tweak our brain chemistry constantly, starting with our coffee in the morning and our workout in the evening, and so on. Brain chemistry, as I understand it, is not static.

Normally yes, but actually when your on SSRI's, it's sort of like holding down the piano key and not letting up, it permanently suppresses dopamine and increases serotonin. One chemical goes up the other goes down, there is no free lunch, SSRI's are not like taking a serotonin pill that adds something that was missing, rather it triggers the brain to create multiple hormones in certain balances.

One thing I've noticed about people on SSRI's is a certain "flatness". They handle trauma really well never letting terrible things get them down, they don't seem down on otherwise down days (rainy cold monday, day after a terrible event, etc..) - this makes sense when you consider serotonin is being artificially boosted - on the other hand they have low dopamine levels and that sort of takes away a certain "passion" - not that they can't be passionate, but not the same level and depth with someone who has higher dopamine levels. This then has an effect on things like sex drive, romantic love and long term attachment. The TED talk goes into this supported by some MRI experiments.
posted by stbalbach at 9:41 PM on July 6, 2008

Uh, SSRIs don't increase or decrease the amount of serotonin in the brain. They prevent it from binding inappropriately, leaving more of it free as a neurotransmitter, but they don't change the amount at all.

There have been some interesting studies done on how the amount of serotonin in the brain affects perception, but that's off on a different axis from depression.
posted by tkolar at 9:51 PM on July 6, 2008

What SSRI's do is increase the amount of serotonin in synapses. It amounts to the same thing.
posted by Class Goat at 10:01 PM on July 6, 2008

greatgefilte writes "ortho, do you have any citations for that?"

Nope, but start here.
posted by orthogonality at 10:02 PM on July 6, 2008

"The drug's effectiveness inspired an elegant theory, known as the chemical hypothesis: Sadness is simply a lack of chemical happiness. The little blue pills cheer us up because they give the brain what it has been missing."

--- aaaaaand that's where I stopped reading. The editors should have tossed such a blatant straw-man right in the circular file the second it crossed their desk. Every physician, shrink and counselor will tell you the same thing... Medicine with therapy. Pharmaceuticals only get you so far without the cognitive. I don't know of a singe credible care-giver or scientist in the field who pretends otherwise.

That's what the science says, that's what the science said when MAOI's were the only pills out there, and that's where the research is headed now that we have SNRIs on the shelves now and electromagnetic field therapy on the horizon. Full stop, end of story.

But, no, I'm sure the story will go on, and be full of luddite moralizing against the dreaded "happy pill," and at least a few more straw-men to topple. It will just go on without me.

(Plus, that's not even how SSRI's work! The fail on this one is beyond epic.)
posted by Slap*Happy at 10:25 PM on July 6, 2008 [8 favorites]

Slap*Happy, of the dozen or so people I know who take SSRIs only one also goes to therapy. The one-two combo of drugs-therapy may be the intention but by no stretch of the imagination is it the practice. How these pills are supposed to be prescribed (with therapy, you seem to be saying) is not how they're marketed. If you don't think it's important or necessary to address the science of the meds the way they're used in the real world... well, then it's a good thing the discussion is going on without you.
posted by dobbs at 10:43 PM on July 6, 2008

Slap*Happy, of the dozen or so people I know who take SSRIs only one also goes to therapy.

Presumably, that would be because the SSRI's are working sufficiently for them without the additional cognitive adjunct?

The pills might only get you so far, but for many people, so far is apparently far enough.
posted by PeterMcDermott at 11:01 PM on July 6, 2008

The pills might only get you so far, but for many people, so far is apparently far enough.

Therapy is also an enormous amount of work. The temptation to just take the pills and hope that's enough is tremendous.
posted by tkolar at 11:11 PM on July 6, 2008

Marketing is science? Is this a science piece or a piece on unethical marketing? Or is it a piece on medical practice not matching the science?

It's none of the above, it's merely another hatchet job, shoddily researched by someone with a pre-written conclusion.
posted by Slap*Happy at 11:27 PM on July 6, 2008 [1 favorite]

SSRI's are not like taking a serotonin pill that adds something that was missing, rather it triggers the brain to create multiple hormones in certain balances.

Neurotransmitters are not hormones! Neurotransmitters are used in synapses to communicate between neurons, usually on a very short time scale. The concept of "neurotransmitter levels" is very badly reported in the general press. It has nothing to do with hormone levels, like blood steroid levels where changes in the level can effect the whole body. Neurotransmitter levels are only important in the context of specific synapses, and with many new drugs specific receptors in specific synapses. For example, the olfactory system is regulated by dopamine, but when you take a anti depressant that "lowers dopamine levels," it doesn't effect your smell, because the drug specifically targets a different area of the brain. Basically the concept of "brain neurotransmitter levels" is meaningless.

Though the drug companies don't like to admit it, we still don't have a strong grasp on what causes depression. SSRIs do work, but we don't know why. "Serotonin levels" probably became such a popular explanation probably because the drug companies knew it was easy to understand and it makes treating depression as easy as changing the oil in your car.
posted by afu at 11:46 PM on July 6, 2008

Therapy is also an enormous amount of work.

Well, some of it is. But my understanding is that the type of therapy generally recommended for mild to moderate depression -- the type generally treated by SSRI's -- is a relatively brief course of CBT, which doesn't really seem like a huge amount of work to me.

In fact, I recall reading recently that the NHS is using computer programmes to provide the CBT aspect of treatment for depression, because for most people, its the kind of intervention that lends itself to this kind of systemization.
posted by PeterMcDermott at 11:55 PM on July 6, 2008

stbalbach: One thing I've noticed about people on SSRI's is a certain "flatness". They handle trauma really well never letting terrible things get them down, they don't seem down on otherwise down days (rainy cold monday, day after a terrible event, etc..)

Really? I've been on an SSRI for over 10 years, and that is completely, utterly untrue of my life experience. Maybe it's a "you have to live it" thing.

As for therapy, yes, anti-depressants + therapy is the best way to go, but as has been pointed out here, therapy is a lot of hard work. Another thing is that, just like any medication that is life-changing for those who truly need it, within a year or two it becomes massively over-prescribed. Being depressed (emotion) is not the same as having depression (illness). Since nobody likes being unhappy, and hey, I hear there are pills for that now, of course Prozac (read: anti-depressants in general) gets a bad rap.

This article is a prime example of why the general public remains woefully misinformed when it comes to mental illness and the purposes and effects of its various medications.
posted by tzikeh at 12:00 AM on July 7, 2008 [2 favorites]

I'm so depressed about this, I can't bring myself to read the article.
posted by ZachsMind at 12:46 AM on July 7, 2008

Slap*Happy, while the article may not be very good, its a bit unfair to accuse the author of not discussing "medicine with therapy" until you've read the whole thing...

"While antidepressants help brain cells recover their vigor and form new connections, Castren says that patients must still work to cement these connections in place, perhaps with therapy. He compares antidepressants with anabolic steroids, which increase muscle mass only when subjects also go to the gym.

"If you just sit on your couch, then steroids aren't going to be very effective," he says. "Antidepressants are the same way: if you want the drug to work for you, then you have to work for the drug.""
posted by Kirjava at 1:16 AM on July 7, 2008

In this sense, Prozac is simply a bottled version of other activities that have a similar effect, such as physical exercise.

Yeah, anti-depressants have the same effect as exercise, that's surely been my experience. It just didn't seem that way, maybe, for fucking decades, as I ran/swam/biked/fucked/hopped/skipped/jumped/wrestled/whirled/twirled/etc through every type of exercise and/or therapy I could find, desperately seeking relief, release, surcease the roar of acheful hurt in my poor dumb soul.

"The best way to think about depression is as a mild neurodegenerative disorder," says Ronald Duman, a professor of psychiatry and pharmacology at Yale.

Way to go, Ronald Duman! Thank you so much -- you are godlike, I so want to have your baby -- thank you for telling us all that depression is a mild neurodegenerative disorder. Hows about I cut off your arm, Ronald Duman, hack the son of a bitch off with a girl scout hatchet -- will you feel mild pain? Jerkoff.

This cat is a psychopharmacologist and he sees depression as a mild disorder. Makes me all happy. How'd you like him for your shrink? Gawd.

Thank you, drjimmy, for you usual clear-eyed perspective. You rock.

Truth be told, an interesting article, but so, so flawed.

Thanx for posting.

Peace.
posted by dancestoblue at 1:30 AM on July 7, 2008 [1 favorite]

Thanks for the link, I enjoyed it. Unfortunately, the writer thinks that disproving one theory about depression is proof that all the rival theories are true, even if they contradict each other.
posted by w0mbat at 1:46 AM on July 7, 2008

The drug's effectiveness inspired an elegant theory, known as the chemical hypothesis: Sadness is simply a lack of chemical happiness. The little blue pills cheer us up because they give the brain what it has been missing.

Bzzzt. Try again. The chemical hypothesis (which started out as the catecholamine hypothesis and later incorporated serotonin), has been around since the mid sixties. By comparison, the development of Prozac began in the seventies. So the idea that Prozac suddenly made people go "Oh! It's chemicals!" is not only stunningly wrong, it doesn't stand up to even a tiny amount of fact-checking.

But hey, it's health journalism, so expecting, y'know, a connection to reality is way too high an expectation.
posted by xchmp at 2:37 AM on July 7, 2008

@dancestoblue:
I believe Duman was speaking of depression from a physical, neuronal point of view. When looking at it that way, Alzheimer and Parkinson's are kinda harsh, and depression rather mild.

Come to think of it, the comparison holds even when looking at the effects it has on patients.

I don't think Duman was out to "get" anyone, nor do I find his comment disrespectful. I must have some mild form of neurodegeneration!

@xchmp:
True, but in the public eye, Prozac did have this effect - aligning depression with chemistry. And it's the public eye connected to the public wallet that had a pretty big impact on the planet.
posted by krilli at 4:19 AM on July 7, 2008

Dear Dancestoblue:

Yes, from personal experience, the crushing numbness of untreated depression is something I'd rather deal with than Alzheimers. The former could be fatal and the latter will be fatal. I agree that depression sucks in an epic, soul destroying way, but you also have to rember that their are degrees of depression from 'Can't ever feel happy' to 'Body shut down and stop eating'.

In my case, CBT and reactivating my brain via keeping busy with study worked, while medication didn't, so while you may be in the medicatable range of the disorder, when I had the problem I had to fight hard to avoid being medicated to the gills.
posted by Phalene at 5:02 AM on July 7, 2008

There seems to be a "medicine with therapy" myth running around. Again and again we've heard this myth propounded, only to see that it really is "medicine forever" disguised as "I'm trying to get better but I need a little helper". [Insert personal testimonial that is not statistically supported here.]

As far as medicated life styles goes, SSRIs are probably better than booze and pot, but given they don't have a "clinically significant effect" for most people, they are an expensive placebo fueled by a myth.

SSRI treated depression is such an insidious problem for consumers: The ability to continue earning while not actually getting better. When consumers face problems that keep them from earning we generally get both better science and actual cures.
posted by ewkpates at 5:07 AM on July 7, 2008 [1 favorite]

dancestoblue: This cat is a psychopharmacologist and he sees depression as a mild disorder. Makes me all happy. How'd you like him for your shrink? Gawd.

He did not say it was a "mild disorder." What he did say was that recent research is focusing on thinking about depression as a neurodegenerative disease, an idea that has not had a lot of scientific currency until recently. In that frame of thought, depression is mild among the full spectrum of neurodegenerative diseases. As Phalene said, when you compare it to Alzheimer's, Parkinson's, CJD, or any form of cerebellar degeneration, it is mild, because it is usually treatable and often reversible.

IMHO, this framework doesn't get us very far outside of the new research, because depression, unlike the other disorders and diseases in that category, often responds well to non-pharmacological levers, like CBT or other psychological therapy, exercise, light therapy, etc.
posted by bafflegab at 5:42 AM on July 7, 2008

Normally yes, but actually when your on SSRI's, it's sort of like holding down the piano key and not letting up, it permanently suppresses dopamine and increases serotonin.

Oh, the joys of argument by metaphor!

Neurotransmitters are not hormones! Neurotransmitters are used in synapses to communicate between neurons, usually on a very short time scale.

Some neurons do emit hormones.

Anyway, lots of people want to treat the treatment depression as some kind of moral position, for some reason. As if emotional suffering were some kind of virtue and that depriving people of it is somehow wrong. It's all very bizarre.
posted by delmoi at 6:33 AM on July 7, 2008 [1 favorite]

OK...no one's taking anyone's pills away - so can we all stop freaking out now? The article isn't saying that depression doesn't exist, nor is it saying that Prozac doesn't work. What it is saying (albeit not very well) is that Prozac works as advertised and then some. The advertised effect (raising serotonin) may not be what is relieving depression - it may be that the main ingredient of Prozac, fluoxetine, increases factors needed in the brain to stimulate neuron production, along with raising serotonin, and THIS is what is alleviating depression.

So, to recap: They are saying Prozac works, more study is needed, depression is a real illness, they are learning more and more about brain function every day.

Why is everyone pissed off?
posted by The Light Fantastic at 7:26 AM on July 7, 2008 [2 favorites]

Science reporting in this country makes me depressed.
posted by ozomatli at 9:50 AM on July 7, 2008

Why is everyone pissed off?

... because it's one more in a series of BAD articles about Prozac and depression in the popular press.

The title alone ("Head fake: How Prozac sent the science of depression in the wrong direction") is divisive, over the top, not substantiated by the article, and just plain wrong. And the article contains inaccuracies. And so on as you've seen here. Yes it's the Boston Globe, not the New England Journal of Medicine, but even the general public deserve a better written and more accurate article.

ewkpates: they are an expensive placebo fueled by a myth
You're a fool for buying into THAT myth. Placebos have been around for centuries; why does THIS "placebo" work better than the others? Better myth?

delmoi: Anyway, lots of people want to treat the treatment depression as some kind of moral position, for some reason. As if emotional suffering were some kind of virtue and that depriving people of it is somehow wrong. It's all very bizarre.

Totally agree. Which is why misinformation on the subject, with attendant moral implications, is so enraging.
posted by Artful Codger at 10:32 AM on July 7, 2008 [1 favorite]

Yes...on the one side we have those who believe Prozac and its ilk are overprescribed crutches for people who can't handle reality. On the other are those who believe their own diagnosed depression makes them such experts on the subject that they can sneer at the ignorance and arrogance of Ph.D. neuroscientists.
No wonder these threads always go so well.
posted by rocket88 at 10:55 AM on July 7, 2008 [1 favorite]

rocket88 , you left out the opinionated non-expert who, after reading "I am Joe's Depression" in Readers Digest, and maybe 2/3 of one article in Psychology Today, thinks they have the ability to accurately sum up the debate and the right to generalize both sides to caricatures. thanks for coming out.
posted by Artful Codger at 11:19 AM on July 7, 2008

The temptation to false dichotomy is inescapable here for many people.

It isn't "depression is a serious disease and SSRI's are a powerful tool for fighting it" against the "SSRI's are an over prescribed placebo for the weak minded."

The frequently ignored argument is "We don't understand depression, we don't have a cure, SSRI's help people, but does this help come at the cost of better treatments and research? Is the current rate of SSRI use ethical? Are drug companies via the medical establishment praying on the vulnerable by giving them a habit which doesn't lead to a cure?"

In this light, the question of prozac's role in public perception and the developing science of neurochemistry is an important one.

But feel free to enjoy your false dichotomy.
posted by ewkpates at 11:48 AM on July 7, 2008 [1 favorite]

AC: ewkpates: "they are an expensive placebo fueled by a myth"
You're a fool for buying into THAT myth. Placebos have been around for centuries; why does THIS "placebo" work better than the others? Better myth?

Previously. And: Prozac, used by 40m people, does not work say scientists | Society | The Guardian and
Psychology Today: Another view: Talking back to Prozac .
posted by psyche7 at 11:52 AM on July 7, 2008

Why is everyone pissed off?

Because you're taking my pills away! I want my Prozac, damn it!
posted by rand at 12:03 PM on July 7, 2008

ewkpates: I wasn't creating a dichotomy. The two extremes I outlined are invariably represented in all SSRI threads here, and mostly reponsible for the derails and general shittiness of the discussions. The alternative viewpoint you brought up is valid, and one which I personally share. I found the article informative and enlightening, and was disappointed that most of the discussion was dominated by those whose minds are firmly made up, one way or the other, on all issues SSRI related; or by those who feel their personal anecdotal evidence can refute years of controlled scientific research.
*wishes Eli Lilly would invent "lighten up" pill*
posted by rocket88 at 12:35 PM on July 7, 2008

Hey psyche7, I was waiting for someone to surface that. Can I assume you read the study, not just the headlines or the articles in the popular press that it spawned?

Quoting from that study:

In order to generalize the findings of the clinical trial to a larger patient population, FDA reviewers sought a completion rate of 70% or better for these typically 6-wk trials. Only four of the trials reported reaching this objective, and completion rates were not reported for two trials. Attrition rates were comparable between drug and placebo groups. Of those trials for which these rates were reported, 60% of the placebo patients and 63% of the study drug patients completed a 4-, 5-, 6-, or 8-wk trial. Thirty-three trials were of 6-wk duration, six trials were 4 wk, two were 5 wk, and six were 8 wk. Patients were evaluated on a weekly basis. For this meta-analysis, the data were taken from the last visit prior to trial termination.

Note that no trial analysed for this study lasted longer than 8 weeks. 8 fucking weeks.

Some people struggle with depression for months and years before seeking help, it often takes several visits (and doctors) before a diagnosis of clinical depression is made, and again it usually takes months or years, even, to confirm significant, lasting improvement in the patient.

Still want to make that study the cornerstone of your argument? This is another example of how an opinion is formed based on a public article's bad interpretation of a limited study.

BTW, I hate being in the present position of defending the efficacy of Prozac. First, because as I mentioned initially, our knowledge of mental illnesses is still in the dark ages. The active ingredient in Prozac was discovered by accident to have anti-depressant qualities, it wasn't initially designed as an anti-depressant. Second, there is a whole new array of SSRI/SNRI drugs that have since been produced, with better performance (so enough about Prozac, already).

(Also, the Psych Today article is um 14 years old)

ewkpates:

The frequently ignored argument is "We don't understand depression, we don't have a cure, SSRI's help people, but does this help come at the cost of better treatments and research? Is the current rate of SSRI use ethical? Are drug companies via the medical establishment praying on the vulnerable by giving them a habit which doesn't lead to a cure?"

In this light, the question of prozac's role in public perception and the developing science of neurochemistry is an important one.

Your "ignored" point is the core of my main point - we don't know enough. Which is why it's fruitless and harmful for popular articles to misrepresent the facts or present them poorly, and for this to be debated in the public sphere, based only on snatches of misinformation.
posted by Artful Codger at 1:06 PM on July 7, 2008

Actually the most interesting part of the "Science proves anti-depressants are placebos" meme is that there are a total of five peer reviewed papers making that claim -- and the same author's name is on all five of them.

Dr. Irving Kirsch has made a good career as a contrarian in the anti-depressant arena but he is, frankly, one guy on a mission. It would be a mistake to believe that his dissenting opinion represents a large rift in the research community. He writes meta-papers that make for good controversy, but he's certainly not changing the minds of people who do the actual research.
posted by tkolar at 3:17 PM on July 7, 2008 [1 favorite]

Metafilter : Big Blue Pill Of Cheer
(unless it is about crappy articles
that sensationalize mental illness,
it's therapies and discontents)
posted by liza at 5:08 PM on July 7, 2008

This article was written by Jonah Lehrer, who’s basically the Brian Greene of neurobiology, all talking about fascinating new ideas as if they were accepted scientific theories. If you’ve ever listened to Radio Lab, it’s pretty clear that his influence pervades it, and, to me at least, makes it unbearable. Then again, popular scientific journalism has never been all that great.
posted by tepidmonkey at 5:26 PM on July 7, 2008