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> 2) this is in part explained by the analysis of when antidepressants start to worsen the course of the illness (which is ~2 years for neuroleptics...unsure about antidepressants)

Neuroleptics are an entirely different class of drugs - you absolutely cannot lump them together. They have varyingly opposing effects (e.g. blocking dopamine instead of increasing it). And just FYI, only old doctors call them neuroleptics anymore in practice - we just say antipsychotics. And there are two very distinct classes of antipsychotics that can't really be lumped together for most purposes - simply, first generation and second generation. The first generation (chlorpromazine, fluphenazine, thioridazine, haloperidol, prochlorperazine, etc) is much more likely to cause depression, whereas some agents in the second generation are actually indicated to treat depression (e.g. olanzapine, aripiprazole).

Looking at the page you linked, I have several comments: 1) As far as chronicity, depressed patients are likely to have multiple episodes throughout their lives. If they suffer an episode while on an antidepressant, it doesn't mean the antidepressant caused it. If they weren't on the antidepressant, they would likely be having even more episodes. Also, only one citation? From 1973? That doesn't stand in evidence-based medicine today.

2)"British researchers found that 50% of drug-withdrawn patients relapsed within six months." That would indicate that the drugs were working, don't you think? They can't relapse unless they first leave depression. Equally, this would imply that after stopping antidepressant therapy, 50% of patients /didn't/ relapse.

Replace depression with another disease state and think about it this way: 50% of patients with high blood pressure who stopped taking their medication (which lowered their blood pressure) had high blood pressure 18 months after stopping the drug. Is there anything surprising about this? No. The problem is the stigma associate with depression.

3) Patients with mental illnesses are more likely to suffer from chronic illnesses (if you wish, I will fetch citations for you). Therefore, quite logically, patients who take antidepressants suffer from more chronic illnesses becaues they have depression than patients who have never had a mental illness. Again, there is nothing surprising about this.

4) Cherry-picked journal articles. I know very few people read medical journals regularly, but you can find an article to prove anything. There are reputable journals, and disreputable journals. Standards are a big deal, and just because something got published doesn't mean it's accurate or true. For a nice ranking of journals, you can check out http://www.scimagojr.com/

Is this the entire bibliography for the book? Honestly, 8 page journal articles have more than this (I'm serious. Look up NEJM and pull any five articles over two pages. And then keep in mind that there is a citation /limit/ to get published in the journal).

If you would like to discuss any of the literature more thoroughly, I would be more than happy to.




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