The Instigator
Pro (for)
8 Points
The Contender
Con (against)
0 Points

Antidepressants, and the antidepressant industry, do more harm than good

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Voting Style: Open Point System: 7 Point
Started: 2/12/2013 Category: Society
Updated: 3 years ago Status: Post Voting Period
Viewed: 1,712 times Debate No: 30166
Debate Rounds (4)
Comments (3)
Votes (2)




By antidepressants, I mean SSRIs, SNRIs, but it could be extended to mean any drug that a GP would normally prescribe for depression.

By the antidepressant industry, I mean all the marketing of antidepressants, and any effect directly related it.

The harm and good refers to society in general. I acknowledge that certain individuals may benefit from antidepressants, but that others are harmed and that overall the harm outweighs the good.

Burden of proof is shared.

I've put a filter on this debate because I've put up three debates in a row that were forfeited. But I'm happy to debate anyone who won't forfeit, so please put a comment on if you'd like to debate this and are filtered out.


Debate Round No. 1


Thank you for accepting the debate, Four Trouble.

Peter Kramer, a psychiatrist, describes one of his patients:

"A young woman comes to the office complaining she is boy-crazy. Last week, she found herself walking though a dangerous part of town at two in the morning in the cold and dark She had a crush on a certain young man, and she knew he liked a rock band that was playing a one-night stand at a small club...She says her focus on this young man and others like him - they are all dismissive of her and a bit wild - is disconnected from the way she ordinarily sees herself. She is a quiet and self-effacing young woman, dressed in a way that plays down her femininity, devoid in any manner of any hint of seductiveness." (1)

The psychiatrist concludes that she is "a young woman with a damaged self-image, a tendency to place men first, and a willingness to place herself at risk". She's an ivy league student. He puts her on therapy and then, because although she gets a more suitable boyfriend, she's too intense with him - on Prozac. It works, at least for a bit. She calms down.

This is case is absolutely typical of what I'm seeing everywhere. Women with inconvenient emotions are put on antidepressants. They calm down. Plenty of men are on antidepressants too, of course.

This year is the 50 year anniversary of Betty Friedan's The Feminine Mystique, the polemic against women being trapped in the house. Since then, there have been great advances in women's education and career opportunities for women. You can't help but wonder if all that would have happened if that generation of women had been on antidepressants.

Or, since I don't want this to be limited to feminism, writers such as Nelson Algren, and artists such as Frieda Kahlo, scientists who insist on perfect methodology, often seem dogged by strange urges and negative emotions. The new rhetoric about depression and mental illness, that it's a chemical imbalance that can be righted with a purchase from a drug company, has taken over our reactions to our own emotions. Maybe it's good for us to have emotions that make us uncomfortable and drive us to behave in ways we don't expect. A society of people who get good marks, marry nice clean boys and live comfortably in the suburbs is, surely, a society in decline.

The marketers of antidepressants have done a brilliant job convincing healthy people that they are sick and need to take antidepressants regularly. Most people on antidepressants would be better off without.

the placebo effect

There is a very large placebo effect associated with drug intervention for depression (1).

For mild and moderate depression, the placebo effect is not significantly different from the drug effect for most popular antidepressants (2). This means that although these patients do benefit significantly from taking antidepressants, they would benefit as much from taking a placebo. It is only for severely depressed patients that the drug effect exceeds the placebo effect. These patients do benefit from antidepressants.

A recent US survey of antidepressant use found that only one third of people taking antidepressants had severe depression (3). Therefore, two thirds (most) of the people taking antidepressants are benefitting from the medication no more than they would from a placebo.

Finally, the placebo effect associated with antidepressants has been increasing in the decades since they were introduced into our society (4). As antidepressants become more popular, and people believe more and more in the drug company rhetoric, they have more faith in the effects of the drug and the placebo effect is enhanced.

If people are benefitting from antidepressants, who cares if the effect is a placebo effect or a pharmacological one? A benefit is a benefit, right? Yes, which is no doubt why general practitioners keep on writing those prescriptions. (In fact, four of every five prescriptions for anti-depressants in the US come from non-psychiatrists (5)).

However, antidepressants:

a) are more expensive than a simple placebo (over $10 billion dollars spent on them each year in the US (6)); and

b) have serious side-effects. Side effects include nausea, insomnia, anxiety, decreased sex drive, weight gain, fatigue, and headaches. There is also the risk of increased depression and suicidal behavior, especially in young people. Older people have an increased risk of fractures and bone loss.

A recent study of GPs in the UK (7) showed that although most of them prescribed antidepressants (92%), the majority (60%) would have preferred to provide a different kind of therapy, but said that it was unavailable. Most GPs (57%) agreed that antidepressants are prescribed too often.


There are serious withdrawal symptoms associated with antidepressants (8). These withdrawal symptoms can include anxiety and depression, which can make people think they're having a relapse (9). The danger of this is that people can think they're unwell when they're not. They might think that they're the sort of person who needs to always be on antidepressants when, actually, they're just suffering from withdrawal symptoms.

I have been unable to find research to show how long people stay on antidepressants, but around here it's not uncommon to meet people who've been on them for years. However, depression left untreated rarely lasts beyond a year (10).



Thanks for the debate rross.

There are many people in the world with clinical depression (MDD) and it is a serious problem that is treated through the use of antidepressants. These people benefit immensely from taking antidepressants and therefore antidepressants do more good than harm. They allow people who are depressed to the point of being disabled to lead normal, healthy lives.

Pro has a problem with antidepressants because they are popular, as if somehow that makes them less effective or beneficial to society. It is a personal choice to take an antidepressant or not. If people feel that they are depressed and that taking an antidepressant can help them, it is their choice. Having the option available is a net good for society.

The Placebo Effect

I am not quite sure what the point of Pro's argument is regarding placebo. I want to note off the bat that Pro admits that the severely depressed gain no placebo benefit. The benefit they get from antidepressants is specific to the affect antidepressants have on brain chemistry.

That said, it is true that antidepressants have a placebo effect on people who are moderately depressed. This does not change the fact that antidepressants work. They do something that helps people who are moderately depressed. You cannot tell someone they are on a placebo or it stops working. The primary point here is that the placebo effect associated with antidepressants is a good thing.

I also want to note another point that Pro ignores: antidepressants have similar efficacy, independent of severity. In other words, placebo only helps those moderately depressed, but antidepressants show a 10% improvement over placebo for the moderately depressed, as well as showing the same degree of efficacy for the severely depressed, where the placebo effect is totally absent.

Pro says the placebo effect associated with antidepressants has increased as a result of "drug company rhetoric," which has given people greater faith that antidepressants work. This is an example of how the "antidepressant industry" is enhancing the effectiveness of antidepressants, through the use of rhetoric that boosts the placebo effect associated with their drugs.

SSRIs generally show a 10% improvement over placebo. Nonetheless, it is important to keep in mind that a placebo effect still counts as the medicine doing something. Pro claims the problem is pricing. I counter with an article in JAMA which demonstrated that the pricing of placebos makes a difference in their effectiveness. It was shown that a placebo priced at $2.50 was significantly more effective than a placebo priced at $0.10, which further shows that the "rhetoric" perpetuated by drug companies does more good than harm to the effectiveness of antidepressants and their associated placebo effect.

The idea here is similar to a study done on wine, which took the same wine poured into two glasses, labeled one $5 and the other $90, and the subjects thought the $90 wine tasted better. Thus, the price of antidepressants is part of the mechanism, as it also enhances the placebo effect.

Side Effects

Pro says antidepressants have "serious" side effects. This is false insofar as none of the side effects are serious. They range from things like nausea and insomnia to decreased sex drive. Compared to the pain and suffering that the clinically depressed experience on a daily basis, these side effects are nothing. People who are clinically depressed would much rather choose happiness with the side effect of nausea and insomnia than remain clinically depressed.

The point here, again, is that it is a choice that patients make. They recognize that their depression gets in the way of their being able to lead normal lives. Many depressed people cannot hold a job, and their depression often leads them down the path towards far more self-destructive patterns of behavior, drug addiction, etc. An antidepressant's side effects are a small price to pay for happiness.

As for Pro's claim that antidepressants lead to increased risk of suicidal behavior, this does not tell the whole story. Antidepressants eliminated suicidal thoughts in 74% of patients who had them. The rate of patients who are suicidal prior to taking antidepressants who then are able to lead normal lives is far higher than those who become suicidal. There is also no way to tell that depressed people become "more" suicidal as a result of taking an antidepressant. It could very well be that their depression itself is the cause of their increased suicidal thoughts.


If withdrawal is done under supervision of a good psychiatrist, patients should not have to suffer through serious withdrawal symptoms. Moreover, why would a severely depressed patient ever get off a drug that has helped them?

Pro's claim that untreated depression rarely lasts beyond a year is patently false. Pro simply blurs the line here between clinical depression, which requires clinical treatment, and non-clinical depression, which is usually temporary and not cause for taking an antidepressant. A good psychiatrist can tell the difference between the two and prescribes medication appropriately.
Debate Round No. 2


In the previous round I explained how antidepressants are being used as a mechanism for social control and to enforce conformity particularly in women, and how their use is likely to stifle not only social change but achievement in art and science. Con did not contest these points at all. Therefore, we can assume that he agrees that antidepressant use does indeed have these negative consequences. However, in his opinion, this is balanced by the fact that they can be used effectively against severe depression.

Con then made a large number of statements about antidepressants. Almost all his statements were unreferenced and false. In fact, he made so many false statements that it will be impossible for me, in this short space, to address them all. I will go through the most important ones.

Severe depression

Although antidepressants do work against severe depression, they only have a very small effect (1). People with major depression do not "benefit immensely" as Con claims. And, of course, as I said in the previous round, for most people on antidepressants there is no treatment difference between the drug and a placebo.

Con also said that severe depression "is a serious problem that is treated through the use of antidepressants". What he didn't mention is that there are therapies available - most notably cognitive-behavioral therapy (CBT) - that are more effective (2), cheaper, and do not carry the same side-effects as antidepressants.

Therefore, although antidepressants do benefit people with severe depression, the benefit is very small. Further, other effective treatment options are available. The slight benefits obtained by severely depressed patients do not come close to balancing the pernicious effect that antidepressants and the whole industry of antidepressants have on society in general.

Antidepressants as a choice people make

Con notes that antidepressants are popular and that they are an option that people have and that options are good. He is right that I have a "problem" with their popularity. In the same way, I have a "problem" with the popularity of domestic violence and racism. The more popular bad things are, the worse it is.

I am particularly concerned with the popularity of antidepressants because their marketing and their use encourage society towards the "take a pill" response to people's sadness. It has got to the point, almost, where contentment is a social duty in the same way as personal hygiene. That, if you are miserable or confused, you should go to a GP a fix yourself up.

Look at a message thread on the current site as an example (3). A 14-year-old has taken an online depression test which has given him a score that means mild to moderate depression and he asks the community for advice. He says he's surprised by the diagnosis but that "My parents keep a hold on these restrictions tighter than need be and I feel like I'm stuck in a cage." There's the usual mix of good and bad advice, the following comments among them:

"it's mostly a result of chemicals anyway."

"If you can't really pinpoint it to specific things...the answer is drugs."

"It sounds to me like you have an actual medical might be curable with meds."

That's right. A 14-year-old is frustrated by restrictions on his life. And three people say it's chemical and that he should take antidepressants. Talk about successful marketing.

Con also says that people have the choice to take antidepressants. On the other hand, most people follow their doctors' advice on these matters, especially if they have already been convinced that their sadness is a result of "brain chemistry". And, as I said in the previous round, most GPs don't feel that they do have options when treating patients with depression. That they are prescribing antidepressants against their own best judgement.

One of the side effects of antidepressants is increased suicidality

This is a well documented finding, especially for children, adolescents and adults under the age of 25 (4,5) , which is why antidepressants have been contraindicated for those populations in many countries. The US Food and Drug administration has the following comments on its website (6):

"In October 2004, FDA directed manufacturers to add a boxed warning to the labeling of all antidepressant medications to alert the public about the increased risk of suicidal thinking or suicide attempts by children and adolescents taking antidepressants.

A boxed warning is the most serious type of warning used on prescription drug labeling. In May 2007, FDA directed that the warning should be extended to include young adults up through age 24.

More detailed analysis by FDA of antidepressant clinical trials showed an increased risk of suicidality—suicidal thoughts or behavior. "There weren't more actual suicides, but more people under 24 were thinking or talking about it," explains Mathis. "This occurs most often within the first 30 days of an adolescent or young adult starting on an antidepressant.""

the placebo effect

Con did include one source (7). It is a "research letter" that looks at the connection between drug discounting and placebo effect. The full article is not accessible without a subscription. As a justification for the billions of dollars US patients spend each year on antidepressants, it is completely insufficient.

Anyway, it's appalling to suggest doctors should be giving people placebos. It's telling people that they're sick when they aren't, and it's a violation of the doctor-patient relationship.




FourTrouble forfeited this round.
Debate Round No. 3


Con forfeited. All arguments extended.


FourTrouble forfeited this round.
Debate Round No. 4
3 comments have been posted on this debate. Showing 1 through 3 records.
Posted by USN276 2 years ago
Psychiatric drugs cause mass shootings
Posted by rross 3 years ago
I've changed it to a week.
Posted by FourTrouble 3 years ago
Change the voting period to at least a week and I'll accept this.
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