Why does the world have such a `down' on antidepressants?

Any newspaper or TV/radio listener in recent months will have heard reported that antidepressants are no better than placebo. This extravagant claim was fuelled by a press release about a article in JPLOS (Kirsch, et al., 2008), which reported a metaanalysis of antidepressant trials for four newer antidepressants. This has again raised criticisms of our current use of antidepressants and many journalists and even some professionals are suggesting that we should be considering using placebos instead! When added to other recent antidepressant scare stories such as their causing suicide, public confidence in what are highly effective and safe drugs is in danger of becoming undermined. This is a major concern to those treating mental illness for depression is one of the largest public health problems in Europe (Jacobi and Wittchen, 2005) and according to new data projecting, it will be the number one cause of disability in Europe by 2030. So, why do the media and some elements of the medico/scientific community seem to have such a down on antidepressants? In this editorial, we examine issues relating to the general misconceptions around antidepressant efficacy trials especially the issue of placebo comparisons and explore the other aspects of treatment effectiveness that are consistently ignored by those antagonistic to antidepressants.