> while methodologically you are correct re double blind, I suppose I was more meaning that surely decisions are made more on a triangulation base ... qual and quant research studies, observation ... etc

yeah. randomised double blind control trials are often hailed as the (current) epitome of 'evidence based medicine'. 'evidence based medicine' has become something of a catchphrase, however. if you are against evidence based medicine does that mean you think medicine should be based on... divine command? evidence based medicine / randomised double blind control trials are often downplayed in psychology because it is hard to deliver psychotherapy (for example) under those conditions. what methodology is the best does indeed depend on what it is that you want to know. with respect to measuring the efficacy / effects of medication, the methodology is pretty good, however (when adhered to).

> c) I gathered psisci was also critiquing the research ...

yeah. i'd like to have a good discussion with psisci :-)

> ...You essentially say he's making his decisions based on potentially incorrect information. I would just have thought that someone so well versed in psychopharmacology would have also considered the issues you are raising in this thread, and be basing his drug decisions on his own conclusions.

ah... i see what you mean here.

i was questioning the scientific studies, yup. i guess i'm not suggesting that the studies are 'incorrect' so much as not generalisable the way they have been taken to be. that the findings might be generalisable in ways that were originally unforseen (e.g., with respect to children and adolescents).

it comes down to time constraints. if one is spending a lot of ones time seeing / prescribing for patients then there are only so many hours in the day left for researching and drawing ones own conclusions. one simply can't do everything. if i were to see a doctor... i'd be happy and impressed if they were basing their treatment decisions from the latest research in the leading journals. very happy indeed. i most certainly wouldn't expect them to be thoroughly reading them and thinking critically about them, however. that is a job for the researchers. that is supposed to be the point of the peer review process.

like i said i'm NOT saying that the doctors should have found this out about the SSRI's. the scientific community, the researchers, those involved in the peer review process, those are the people who jolly well should have seen this well before now.

what is a doctor supposed to do??????

this most certainly is NOT anything personal about psipsy.

this is mostly about the APA treatment reccomendations for depression and in particular what they are going to do about them now.

it is also about... informed consumers.

when the APA reccomends (and when psychiatrists 'heavily encourage') people to take medication... in spite of side effects that people report... against their will in some instances... you have to wonder how much this is about political agenda. in particular... who will sponser their journal / fund their conference / buy their luncheon / provide their stationary / justify their being a branch of medicine...