I understand your point. It's just that article doesn't really make your point. Initial 6 to 8 week clinical trials for approval don't yell you much. Even if big pharma hid unsupportive trials from the FDA it is not really relevant. Especially since we now know it takes 6 to 8 weeks to even work. The article is all about a New England Journal study that looked at initial clinical trials and how big pharma cheated. That doesn't tell us anything about real world clinical use and effectiveness. We have had this argument and the best study to date says 60% of the time effective but that study had problems too. From everything I have read I would put it at 50/50 of finding one that works for you.

I don't think it is fair to compare them to ECT and lobotomies. In the big picture they are proven very safe. 30 years on the market with millions of people taking them. Some people have problems, there are side effects, possible withdrawal. I have taken them for twenty years with no adverse effects. I consider them very safe.

Why not point them to Harvard and what they say about the risks.

What are the real risks of antidepressants? - Harvard Health Publications

My only point is your article is not relevant.

I agree with you that other methods should be tried first or absolutely in conjunction with all other methods. Whatever works. They shouldn't be handed out like candy as they are. In a severe case I may prescribe one right away along with all the other things such as meditation, CBT, exercise, etc. I don't think in all cases everything should be tried first and an AD only as a last resort. And I agree medical issues should be ruled out and psychiatry doesn't look at that stuff. Family history, personal history, effect on your life, symptoms, all have to be taken into account by a psychiatrist. It should be case by case. A PTSD war veteran who was fine before he left is one case and may be best treated with trauma therapy. Someone sexually and physically abused as a child is another case. A long history of alcoholism and depression in the family history and personal history is another case. Someone who presents with schizophrenia at age 13 is another case. Some cases meds are a good option.

You point to Depression Success Stories a lot and talk about how many people have said how great meditation is. There are only four who talk about meditation in that section and some as part of the answer. There are 9 out of twenty that talk about medication and part of the answer. Only three or four talk about long term recovery.

http://forums.psychcentral.com/depre...s-stories.html

Someone recently posted that they have been in therapy for thirty years now and still want to kill themselves. If that were me I would damn sure be trying AD's.

You can find all kinds of individual doctors with differing opinions and some pretty extreme. This is why I stick to Harvard, Stanford, John Hopkins, NIMH, as much as I can. I put links to individual studies but they are reputable and any one study doesn't prove everything. it is just one piece of evidence. If you can find studies that say meditation is as good as antidepressants, post them.