The Myth of the Antidepressant: An Historical Analysis

Abstract

Intense marketing of antidepressants over recent decades has resulted in a dramatic rise in their use, and in the widespread social acceptance of the idea that depression is caused by a ‘chemical imbalance’ that can be rectified by drugs. In 2002 eleven per cent of women and over 5 per cent of men in the United States were taking antidepressants (Stagnitti, 2005). This situation led Nikolas Rose to conclude that a large proportion of people have come to ‘recode their moods and their ills in terms of their brain chemicals’ (Rose, 2004: 28). Although there has been some criticism of levels of prescribing of antidepressants, and recent guidelines recommend that their use is restricted to people with more severe conditions (NICE, 2004), the idea that an antidepressant drug can reverse depression has not seriously been challenged. In this chapter I describe evidence that suggests that the very concept of ‘an antidepressant’, rather than emerging from scientific data, was constructed to fulfil the pre-existing desire of the psychiatric profession, allied with the pharmaceutical industry, to present psychiatric interventions as specific treatments. At the time the concept was invented there was little evidence to support the idea that drugs could exert a specific ‘antidepressant’ action, and there remains little such evidence to this day.