SSRIs in Perspective


Have They Lived up to Their Promise?

July/August 2014


The research literature on the effectiveness of antidepressants is filled with contradictions and controversy. Few have the scientific know-how and patience to wade into the Great SSRI Debate and make sense of it. An exception is neuropsychologist John Preston, author of Clinical Psychopharmacology Made Ridiculously Easy. While he’s a critic of the role of Big Pharma in the mental health field, in the interview below, he tells us how SSRIs may have unfairly gotten a bad rep.

Depression is probably the number-one condition for which people receive psychiatric medication. What’s the overall incidence of depression in the general population and, from a psychopharmacology viewpoint, what are the main distinctions among different kinds of depression?

John Preston: At any moment in the United States, 10 percent of people are in the midst of some kind of severe mood disorder. The lifetime prevalence for unipolar major depression is judged to be about 15 percent, and then about 5 percent of some people have some version of bipolar disorder. So we’re looking at somewhere between 15 and 20 percent of people.

Bipolar disorder, of course, presents with both depressions and either manias or hypomanias. But this isn’t just an academic question about the right diagnosis. It’s been clearly shown that if people who have bipolar disorder are treated with some of the standard antidepressant medications, the outcomes are not good.…

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