Scientific debate instead of beef; challenging misleading arguments about the efficacy of antidepressants

Abstract

In a recent commentary with the polemic title 'Antidepressants; what's the beef?', Goodwin and Nutt argued that the benefit-risk ratio of antidepressants had been questioned inappropriately (Goodwin & Nutt, 2019). Personally I think it is a great achievement that our medical system can offer pharmacological treatments to people who suffer from serious clinical depression, and like Goodwin and Nutt I accept that antidepressants may be useful in some patients (Hengartner & Plöderl, 2018). Nevertheless, and this is where my position deviates from Goodwin and Nutt, I am also concerned about the overestimation of efficacy and the minimisation of harm (Hengartner, 2017). There are many misrepresentations in the commentary by Goodwin and Nutt, all of which systematically inflate the apparent benefits of antidepressants, and in this letter, I will discuss five of them.

Keywords: SSRI; antidepressants; bias; efficacy; selective reporting.