Handbook of Critical Psychiatry, Chapter 8: Depression and Mania (Affective Disorders) (Part Two)

From Mad in Brasil: Now that we know that depression pills have no clinically relevant effects on depression, we can turn to textbooks. They don’t tell us anything about the above. A teaching manual stated that an improvement can already be seen with the use of fluoxetine after a few days. This is complete nonsense. Whether patients are treated with a depression pill or a placebo, it takes about 3 weeks before improvement is seen, corresponding to the minimum clinically relevant effect of 5-6 points on the Hamilton Depression Rating scale. The last manual was completely dishonest about the benefits of pills. He stated that psychomotor speed, sleep pattern, appetite and mood normalize, and that depressive thoughts about guilt, inferiority and suicide disappear. Nothing normalizes during pill treatment, and pills double the risk of suicide (as I will discuss later).

Read the full article here and English translation here.