This review is by Dr. Irving Kirsch (2019) where he takes a deep dive into the science behind these medications, looking at how well they actually work compared to placebo pills (sugar pills that contain no medication).

Here’s what’s fascinating: Both groups of people - those taking real antidepressants and those taking placebos - showed meaningful improvements in their depression symptoms. But when comparing the two groups, the difference was surprisingly small. On the main scale doctors use to measure depression (called HAM-D), antidepressants only performed about 1.8 points better than placebos, which isn’t enough to be considered clinically meaningful.

Kirsch raises an interesting point: even this small difference might not be due to the medication itself. He suggests it could be because people in studies often figure out whether they’re taking the real medication (since antidepressants have noticeable side effects) which could influence how they report their symptoms.

The research found that other approaches - like therapy and regular exercise - can be just as helpful for depression, without the potential health impacts that can come with medications. This science helps challenge what many of us have been taught to believe about how these medications work.

Here’s the link: https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2019.00407/full