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Anti-depressants do work: reply to Stegenga

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In a piece at Aeon linked to at Daily Nous, philosopher of science Jacob Stegenga (University of Cambridge) contends that "we simply have no good evidence that antidepressants help sufferers to improve." I don't think the evidence available supports Stegenga's argument, and I made a comment to that effect in the comments section over at Aeon (which Stegenga replied to). Because I think this is a very important issue--one that could potentially affect people's choices and public attitudes regarding anti-depressants--I want to address Stegenga's argument here at the Cocoon. I want to begin by noting two things. First, this issue is very personal to me. Mental illness not only runs in my family, affecting multiple people I am close to - it has also affected friends of mine. Second, I have experience working in the mental health field. As an undergraduate, I interned for a year in an out-patient day program utilized by dozens of individuals with serious mental illnesses: schizophrenia, bipolar disorder, depression, borderline personality disorder, and so on. Then, after graduation, I was Assistant Director of a group home that housed around a dozen residents with serious mental disorders. Among many other things, I was responsible on a day to day basis for dispensing medications, including importantly changes to patients' medications.   Bearing this in mind, let us turn to Stegenga's basic argument that "we simply have no good evidence that antidepressants help sufferers to improve." He contends, first, that "the best evidence about the effectiveness of antidepressants comes from randomised trials and meta-analyses of these trials." I will explain below why--on methodological grounds--I believe this to be false. Stegenga's argument then is that randomized trials and meta-analyses, observed mean effect sizes are tiny: In meta-analyses that include as much of the evidence as possible, the severity of. . .

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News source: The Philosophers' Cocoon

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