Medical Organizations Turn Blind Eye to Harms of Maternal Antidepressant Use: A Conversation With Adam Urato and Joanna Moncrieff

Welcome, my name is Robert Whitaker, and today I have the pleasure of speaking with Adam Urato and Joanna Moncrieff. But before I introduce them, I’d like to provide the context for our discussion.

On July 21st, the FDA convened a hearing on maternal use of antidepressants during pregnancy and the impact this use has on fetal development. Around 400,000 children in the United States are born each year whose mothers took antidepressants while pregnant, and so it’s easy to see the societal importance of this topic. What are the risks to the fetus, the newborn, and the long-term development of that child? Adam Urato and Joanna Moncrieff were members of that FDA panel, and so too were several others well-known to MIA readers, including David Healy and Joseph Witt-Doerring.

The purpose of the panel was to assess whether the FDA needed to put a warning on antidepressants related to their use in pregnancy, and most on the panel spoke of research that told of the need to do so. However, after the panel concluded, the American Psychiatric Association and other medical associations, most notably the American College of Obstetricians and Gynecologists, responded with what can only be described as howls of outrage, issuing press releases and telling the public that the panel was biased and that the real risk during pregnancy was untreated mental illness.

These medical organizations asserted that the increased risk of adverse outcomes for children born to depressed mothers is due to the illness and not the drug, and that there was plenty of evidence that antidepressants were a helpful and even life-saving treatment for maternal depression.

Here is where we are today. That FDA hearing put two narratives on public display, and most media reports embraced the narrative put forth by the medical organizations. What we will do today is review the evidence that exists on this topic and the response by the medical guilds to a public airing of that evidence.

Dr. Adam Urato is Chief of Maternal and Fetal Medicine at the Metro West Medical Center in Framingham, Massachusetts, and he has been speaking and writing about the risk of medications used during pregnancy for years. Dr. Joanna Moncrieff is a UK psychiatrist and researcher who was a co-founder of the Critical Psychiatry Network and is well known for her research on the safety and efficacy of psychiatric drugs.

The transcript below has been edited for length and clarity. Listen to the audio of the interview here.

Robert Whitaker. Thank you both for joining us today.

Joanna Moncrieff: Thank you. Nice to be here.

Adam Urato: It’s great to join both of you.

Whitaker: Adam, I’m going to start with you. Do you know how the FDA panel came to be?

Urato: I think several things are going on that have prompted this. One, just as far as antidepressants go, there are rising rates of antidepressant use, particularly antidepressant use during pregnancy. I think concurrently with this, the research evidence has continued to roll out, over the last four decades, of harms to the developing baby and pregnancy complications. I think that certain individuals in the current administration at HHS are interested in this area, and so they had wanted to put some focus attention on this topic, which, from my standpoint, was sorely needed.

Whitaker: Joanna, how about the view from the UK? Is this a topic of concern?

Moncrieff: The mainstream view in the UK is very much the same as the American Psychiatric Association’s opinion that came out after the FDA hearing, that women shouldn’t be frightened of using antidepressants during pregnancy and that depression should be treated just as robustly as in people who are not pregnant. But as I’m sure has been happening in the US, increasing questions have been arising in the public’s mind about the increasing use of antidepressants, partly because of the huge numbers that are now using them. Almost a fifth of the UK population is taking an antidepressant.

Of course, Irving Kirsch’s work has been raising questions about whether they have any benefit over and above their placebo effect for quite a few years now. Then we published our paper on the serotonin theory of depression and the evidence for that, suggesting that the evidence didn’t support that idea, which I think caused a lot of people to ask the question, why on earth are we using these drugs, and what the hell are they doing to us?

Whitaker: It’s obviously a topic of incredible societal importance. If you have evidence of harm done, of increased risk, that’s an extraordinary story. Evolution over a long period of time obviously created this miracle, where you go from a fertilized egg to a human baby in nine months. Interfering with that process with a drug is a big thing.

Moncrieff: We know from experience that that’s true, don’t we? After thalidomide, we had become extremely cautious about prescribing drugs to pregnant women.

Urato: This is quite a complex area of discussion, but I try to keep it simple, that these [antidepressants] are chemicals. They’re synthetic chemical compounds being manufactured in a chemical manufacturing facility. Then they’re going into the mom, crossing over to the placenta, they’re going into the baby, and they’re having chemical effects, and so that’s what pregnant women really need to understand.

Serotonin plays a crucial role in fetal development. These SSRI chemicals disrupt the serotonin system. We would expect to find complications with them and impacts on fetal development. That’s exactly what the studies are now showing.

Right now, the warnings are not good from the FDA on the label and also certainly from the professional medical societies. If you listen to the follow up to that meeting, there’s very little warning. They’re essentially saying that these drugs are without risk, maybe some minor newborn complications, and that they’ve got these great benefits.

Along with this chemical aspect that I’m trying to get people to focus on, I’d also like to draw attention to the fact that what we’re hearing after the meeting, a lot of it is more sales pitch than actual reality of what the evidence is actually showing.

Whitaker: Let’s talk about the impact of a serotonergic drug on fetal brain development, which was part of the panel discussion. We heard about basic research on how the fetal brain organizes itself and how serotonin plays a signaling role in guiding the organization. Then there was animal research showing that in-utero exposure altered brain organization. There is evidence in humans that that is true. Can you talk about how incredibly important it is to understand that?

Urato: These drugs absolutely impact and disrupt fetal brain development. From a basic science standpoint, we can see the impact of SSRIs when we look at individual neurons. Neurons are supposed to arborize or send off neurites; that’s how they communicate with each other. There are studies out there, one in particular with Celexa (citalopram), where if you expose these neurons to increasing doses of citalopram, 20, 40, and 60 mg, you can see a reduction in the neurites. They look like they’re not like a beautiful, branching tree, the way it should be. They look stunted.

Then you go to the animal models, and the animal models are showing disruption of brain development. We’re seeing this from studies where they expose pregnant mice, rats, or sheep to the antidepressants and then look at the outcomes in the babies and their behavior. We’re seeing alterations. We’re seeing pregnancy complications, but we’re also seeing brain developmental alterations. When those animals grow up into adulthood, they behave differently. They have altered social interactions.

Then you move to the human studies, and they are showing an impact on the developing fetal brain. Mulder in 2011 and Salisbury in 2024 looked at SSRI exposure to fetuses in utero. And they are moving differently. They’re showing more jittery behavior, more agitation, less quiescence. Babies developing in utero should have quiescent periods and active periods. The babies exposed to the SSRIs aren’t having the normal quiescent periods. This is what we’re seeing on the ultrasound studies.

There are other studies on the immediate newborns or in the children, and these are MRI studies. The MRI is looking at the structure of the brain and then looking at functional connectivity. I made this point at the FDA. There have now been 12 consecutive MRI studies showing the impact from these medications on the brain. There are also EEG studies, three of them now, that have been done in babies or children exposed to SSRIs in utero, showing different brainwave patterns and different connectivity.

Then, when we study these children growing up as children and into adolescence, we’re finding changes. We’re seeing impacts on speech and language development. We’re seeing mood disorders, including depression and anxiety. We’re finding neurobehavioral problems like autism and ADHD. The whole model basically fits together incredibly well to show that these SSRI chemicals are disrupting brain development.

Whitaker: I would think that every potential mother and father would like to know this information.

Moncrieff: People need to know it when they’re considering starting an antidepressant, don’t they? I mean, a young woman in her twenties may have no idea about having a baby in the foreseeable future, but 10 years down the line, she might well be thinking of that, and she might still be on that antidepressant and then really struggle to get off it.

Whitaker: This is part of the societal problem with the widespread use of antidepressants, and should be part of the informed consent process. Joanna, you’ve studied adults who go on these drugs, and you see brain changes, right? Are you surprised that it’s happening in the fetal brain during that time?

Moncrieff: MRIs have enabled us to see quite subtle changes in the brain, and we can detect them when people are on antipsychotics. There are one or two studies suggesting there might be similar changes with antidepressants. I think the data is less conclusive on that. But the principle is that yes, these drugs can alter brain structure in a way that we can visualize, so that suggests they’re doing lots of other things that we can’t immediately see. It’s extremely likely that they are having similar modifying effects on the developing fetus.

I think Adam’s idea that these are chemicals having chemical effects is really important to get across to people, not only in relation to pregnancy and the effects on the fetus, but also in relation to just what they might be doing to your brain. We’ve been fed this myth, haven’t we, for years, that your SSRI is correcting your serotonin deficiency and that’s what they’re doing. We know now that that’s not supported by science. That was always just a marketing myth, so what are we doing? We’re actually putting chemicals into the brain whose effects we do not properly understand. We shouldn’t be surprised if we see harmful consequences down the line.

Whitaker: We do know that these drugs perturb normal serotonergic function. You might think that the fetal exposure is permanently altering the serotonergic function in children exposed in utero to antidepressants.

Moncrieff: Those animal studies showing that the offspring of animals that are given antidepressants show reduced sexual activity when they become adolescents or adults. They’re quite consistent. They were done a long time ago now, and they’ve been well-replicated and are consistent with the increasing evidence for this post-SSRI sexual dysfunction that adults report. People are also reporting that they have ongoing emotional numbing, which is basically part and parcel of the sexual dysfunction. I think that we can see that these effects on the fetus may have long-term effects on sexual functioning, but also on emotional experience.

Urato: Jay Gingrich, who was on the panel, has spent a career researching this, and the study from his group just came out this year, 2025, and the lead author is Giulia Zanni. It is a phenomenal study because it’s both the animal and human studies being run together, and it’s a terrific paper showing that exposure to SSRIs during development leads to these alterations in the brain. You can see that reflected in changes in the brain on MRI and changes in response to fear.

It’s a complex study, but they exposed mice to SSRIs during development, and then they looked at their fear response. I think they used mountain lion urine because mice are afraid of mountain lions. They use the fear response, and they found that it was altered in the mice that had been exposed to SSRIs in utero. Then they did the human study in a similar fashion and looked at fear response as well as MRIs, and they found similarities. It’s really a dramatic presentation of the chemical impact of these drugs on brain development as seen in animals and in humans. But what makes it phenomenal is that it’s pulled into one study.

Whitaker: I read that paper, and what is amazing is that this is a compilation of evidence that has gone on for years. It’s a paper that brings it all together and shows how consistent the evidence is. Can you both address the concern that when the baby is born, they go through abrupt withdrawal from the drug?

Urato: What’s really concerning about this to me is that this has been downplayed. What we’re seeing is increasing rates of what’s called newborn behavioral syndrome, or poor neonatal adaptation or neonatal withdrawal syndrome. We’re seeing these symptoms like jitteriness, agitation, hypertonia, sometimes difficulty in feeding, constant crying, temperature dysregulation, and these babies have increased rates of admission to the NICU. They can also have lung issues and difficulty breathing.

It’s often been dismissed or downplayed by a lot of the folks who have been speaking about this after the meeting. But it’s a concerning condition in and of itself. ACOG in their own document puts the rates of symptoms up to 85%. That sounds like an exaggerated claim if I just said that alone, but no, this is ACOG saying that the rates of symptoms in exposed fetuses are as high as 85%. We see this in a lot of the kids. The babies come out, and they’re not doing well. It’s a problem for the baby. It’s a problem for the mom and the parents now that they’ve got the baby who’s having this difficulty.

The other reason I think it’s important is what it says about the chemical impact of the SSRIs on the brain. On the FDA label, it says it may be withdrawal, but it also may be direct toxicity. In fact, the ultrasound studies would suggest that it’s direct toxicity because we’re seeing these agitated, or jittery movements.

Then the question is, does newborn behavioral syndrome or withdrawal syndrome have longer-term impacts? There are some studies suggesting that those babies do have more problems in the future.

Whitaker: Joanna, you’ve been involved with people tapering from antidepressants. You’ve seen these withdrawal symptoms, which of course are downplayed in adults as well. Can you give a sense of what we are doing to a newborn in their first weeks of life?

Moncrieff: I hear a lot of stories about how awful antidepressant withdrawal is, particularly when people are discontinued abruptly from something that they’ve been on for a while, and the thought of a newborn baby having to endure the extreme discomfort that people describe—it can be extreme restlessness, dizziness, sickness, headaches, and brain fog. I don’t know what that feels like for a newborn, but people describe extreme discomfort. So, you would think that the extreme discomfort that a newborn baby feels is going to be even more extreme than that which an adult feels on withdrawal. It’s interesting listening to Adam’s point about whether this is toxicity or withdrawal. I mean, maybe it’s a combination of the two.

Whitaker: From my layman’s point of view, the minute the baby is born, they’re starting to respond to their environments, right? That’s what the human being is built to do. You’re starting to form connections and it seems outrageous that we are exposing the newborn to this early misery.

Urato: That’s the time for things like bonding, initiation of breastfeeding, things like that, and to be going through that during withdrawal is concerning. I’m not a psychiatrist, I’m a maternal-fetal medicine specialist, but what I’m hearing is more discussion about brain injury or brain toxicity, that we’re seeing is maybe a brain injury. I’m wondering, Joanna, what you think about that?

Moncrieff: I think that’s a very reasonable view because these are symptoms that persist long after the drug has left the body. So, we have to conjecture that the drug has persistently altered something in the brain, which is then causing these symptoms, which then may slowly, over time, normalize.

Whitaker: And it’s not just in the brain. Maybe you’re injuring the nervous system at large.

Moncrieff: Absolutely, and probably other biological systems. There is a lot of serotonin in the gut, so you might have implications for gut function too.

Urato: I just tweeted out a new paper that came out showing increased fracture risk in women who initiate SSRIs between the ages of 42 and 52, so we know they also have an impact on bone. I make this argument with the fetus that it’s affecting the bone. It’s affecting the brain. It’s affecting the gut. It’s affecting the blood system. It’s affecting platelets as well, which is very important because that’s a major factor in stopping bleeding and not hemorrhaging. We do, in fact, see increased rates of maternal hemorrhage and postpartum hemorrhage in moms using SSRIs during pregnancy. So, I think the point you both just made on this affecting multiple systems, is exactly right.

Whitaker: I think one reason you were invited to the panel, Joanna, was to answer this question: are antidepressants an effective treatment for the mother?

Moncrieff: This is the key question. The justification for giving these drugs to women is the idea that they are an effective treatment for depression. The evidence which I know well shows that, at best, they are minimally different from a placebo. So, the very best view of them is that they might improve your depression experience or symptoms very slightly more than taking a placebo.

Whitaker: To play a little bit of devil’s advocate here, how about trials in pregnant women who are depressed? Is there evidence of efficacy? Maybe it’s different for some reason in women who are pregnant.

Moncrieff: Absolutely not, because we don’t have randomized control trials of pregnant women. You’re not allowed to do trials on pregnant women of substances like antidepressants. So no, we don’t have any evidence at all. We also don’t have evidence that there is any particular group that does relatively better with antidepressants than others. All we have is this very small average difference between antidepressants and placebo, which, to my mind, cannot possibly justify the risks that you are running, even if these risks remain uncertain. I think most women do have this view that they don’t want to put their baby at risk, even if we’re not completely sure of the nature or extent of the risk, and they particularly wouldn’t want to if they knew how absolutely minimal the potential benefits are.

Whitaker: There are alternatives to drugs for depression. Why aren’t we doing that?

Moncrieff: I’m sure people are offered these other treatments if they become depressed during pregnancy. I don’t know what it’s like in the US, but I would think that generally in the UK, you would initially be offered therapy, and then if that didn’t work, antidepressants might be considered, or if the woman had a preference for antidepressants, it might be considered. But another problem is that I would imagine the vast majority of women who take antidepressants during pregnancy were already taking them when they got pregnant. It’s not a case of saying, there is an alternative. It’s a case of saying, how can we get you off this medication, and then you’ve got all the difficulties with withdrawal effects.

Whitaker: Adam, how do you counsel women who are already taking an antidepressant when they become pregnant?

Urato: I try to point out that there are two separate issues to deal with. They’re related, but separate. One question is, do the SSRI chemicals impact pregnancy? Do they cause pregnancy complications? Do they alter fetal brain development? Should pregnant women in public be warned about this? Those are scientific questions, and I think the answer to those questions is yes, and that’s what I spend a lot of time talking about.

The separate, but related question, isn’t the scientific question, but the patient care question. That’s what I do basically in my office throughout the day, counseling women about medication use in pregnancy. That’s much more variable depending on the woman, and it’s much more complex depending on her own personal history, her own personal psychiatric history, her own personal medication history. I tell patients all the time, there’s no one-size-fits-all answer to this.

Typically, what I’ll do is try to get their history and figure out how long they’ve been on the medication and whether they’ve tried stopping it before. Also, how the medication is working for them, and then it really comes down to weighing the risks, the benefits, and the alternatives.

If a woman’s been on the drug, for example, for 15 years and she’s tried to come off before unsuccessfully and had a horrible time, and now she sees me, and she’s maybe 20 weeks pregnant, I would say when I do that 20-week counseling, it’s probably 80% or 90% continue. Whereas when I see patients before they’re pregnant, which is really the time that the counseling should take place, we still have that same kind of conversation, but it’s different because they’re not in the pregnancy, they’re planning for it. I would say rates in that scenario are probably closer to 50% in terms of staying on versus coming off the drug.

I think a major issue is that it can be very difficult to come off these medications for some women. She may have had other attempts where she’s tried to come off the drug, and it’s been unsuccessful, and she’s had awful withdrawal symptoms. And the idea of trying to face that during her pregnancy may steer her towards staying on the medications.

My big take-home message to my patients is, I’m going to try to counsel you as well as I possibly can, and then support the individual decision that you make.

Whitaker: When women have been on antidepressants, and now they’re pregnant, and now you counsel them about the risks associated with antidepressants in pregnancy, do they ever feel like, oh my goodness, I’m in a trap, because I don’t want to face withdrawal, but I also don’t want to expose my fetus to these risks?

Urato: Absolutely, Bob. You’re hitting the nail on the head there. I think that that’s why it’s so important that this message gets out to the public, the general public, and to providers who take care of women of childbearing age, because it’s really something that needs to be discussed with a young woman of childbearing age prior to starting the medication. It does create a real conundrum for the patient to then be pregnant and not have been counseled about this, and then to learn about these things at the time of pregnancy.

Whitaker: What I’d like to do now is read a couple of the responses to the panel and then get you both to respond. I’m going to read first from the American College of Obstetricians and Gynecologists because, honestly, I was a little surprised by this one.

So, Adam, you’re an expert in this field. What do you make of that?

Urato: The first thing I noticed is this focus on depression rather than on the medications. I try to make the point that depression is important. Human suffering, people going through depression, it can be an awful thing. And nothing that I say in trying to raise attention about the effects of the drugs has anything to do with trying to make people feel guilty about being depressed or feel bad or pill-shaming or any of that. Depression is important.

But you can’t answer the question about the drugs by talking at length about depression. When I see a mom in the office, she’ll often ask me, what are the risks of these medications in pregnancy? I have to answer that question. That’s what the FDA needs to answer, and then have the labels changed appropriately. What are the risks of the drugs, and what is the evidence of the effectiveness of the drugs?

The second thing that jumps out at me is the statement that there’s robust evidence that the drugs are safe. I actually don’t like to use the term safe or unsafe because it’s an inexact scientific term.

Whitaker: But Adam, they said that they “prevent” all these issues. This organization, which is supposed to be responsible for improving maternal health and maternal outcomes, said, in fact, that giving antidepressants to pregnant women prevents all these adverse risks—preeclampsia, etc. That’s not just saying that they’re safe. They’re saying they’re curative, they’re preventive, they lower the risk. To be honest, you know this, there’s no evidence of that—zero. So why do they say it? Why do we have a medical guild saying that this treatment not only helps the mother, but also prevents all these adverse outcomes?

Urato: That’s the sales pitch that I was saying at the start. It changes the mom’s brain chemistry, corrects the chemical imbalance, makes her feel better, and then the pregnancy outcomes are better. They’re actually, ACOG, putting that out there, but that’s not what the science is showing.

Moncrieff: The logic of their position is that there are these studies which show that there are associations between being depressed and adverse pregnancy outcomes. If you click on one of the studies that they use to support their notion that depression causes adverse pregnancy outcomes, you will see that this study has not even considered whether or not people were taking antidepressants. They have just assumed that the adverse pregnancy outcomes are due to depression.

But no one has any mechanism for how an emotional state is going to affect a baby. We know that depression is associated with all sorts of things that are very likely to affect fetal development, particularly socioeconomic deprivation, alcohol use, smoking, and other sorts of behaviors that are going to impact the fetus. Some of these studies control for some of those things, but almost certainly they haven’t adequately controlled out all those factors. So the idea that depression causes adverse pregnancy outcomes, in my view, has not been adequately established.

Then the logic is that you’ve got this association, and then you take the antidepressant, and because we all know that antidepressants are so effective, the antidepressants will prevent these consequences of depression. Well, none of those things add up. We don’t have the evidence to show that depression is actually causing these adverse outcomes, and we certainly don’t have evidence that antidepressants can prevent them.

Another thing we haven’t mentioned is the fact that taking antidepressants is associated with fetal malformations. The association between some antidepressants, like paroxetine, and fetal malformations, again, is not disputed. I was absolutely shocked to see that statement that they are safe, because I don’t think anyone who knows that they’re going to increase your risk of having a major fetal malformation would consider that to be safe.

Whitaker: I’m going to read now something from the American Psychiatric Association.

Joanna, what do you think of that from your profession?

Moncrieff: Well, it’s like Adam says, isn’t it? This is a marketing pitch to make sure that people keep taking the drugs, don’t question them too much, and glosses over all the risks.

Whitaker: But do the professions believe this stuff? Do they know the evidence, or do they believe what they’re saying?

Moncrieff: Certainly, many in the profession do believe it. I know them. I know that that’s what they think. They think that the risks of antidepressants have been exaggerated. I suppose as a psychiatrist, you convince yourself that depression is a real biological condition and it’s really harmful and needs medical intervention. Psychiatrists who don’t accept that are constantly having to deal with a certain amount of cognitive dissonance because that is the mainstream view.

Whitaker: Both of those statements are asserting that this is the evidence base. Theoretically, a medical guild should know the evidence base. You expect them to be honest communicators about the evidence base. But these statements are so at odds with the evidence base that they are best described as dishonest. And I’m asking you both, as members in these professions, do these professional societies believe this, or do they know they’re lying?

Moncrieff: There’s a knee-jerk reaction to defend the status quo, to defend current practice. And I think raising this question and really highlighting the evidence of, as Adam says, the chemical effects on developing brains that are produced by antidepressants, is one of those really scary topics that the profession wants to shut down so that current practice, which is doling out these drugs without anyone worrying about them too much, can continue.

Urato: I agree with that. I don’t want to speak poorly of my colleagues, but I think that professional medical associations, by and large, currently in our society function more as a branch of the pharmaceutical industry than they do in their actual role to protect and defend and inform the public.

You’ve got a book on this, Bob, about the guild interests, and I think that, unfortunately, that’s how these professional medical associations function. They’re funded by pharma almost across the board. But I talk about this a lot, where in an ideal world, I think you’ve got patients here, you’ve got drug makers here, and the drug makers are trying to sell drugs to the patients, but you’ve got these layers of protection between them. Those layers are your professional medical societies, your physicians, your researchers, your FDA or European Medical Association, your CDC, your media. You’ve got all of these in between, actually protecting, defending, and informing the public. That would be your ideal society.

But in reality, that group is essentially working for the pharmaceutical industry to promote the increased use of drugs, to increase sales and profits for pharma. I do think that we need to be aware of this and that the listeners to this podcast need to get that word out and understand that those groups that are supposed to be defending and informing actually in the large part, are working to some extent as a branch of the pharmaceutical industry.

Just to finish on that point, this idea that there’s no birth defect risk, which the APA put out, is just really beyond the pale. We know serotonin plays a crucial role in the formation of the heart and the formation of the brain. We know the drugs are disrupting serotonin. The likelihood of them causing birth defects is significant. Then we see it in animal studies. We see it in human studies. For a professional medical association like APA to be saying, well, we’ve got a meta-analysis that basically takes that issue off the board, it’s more of a sales pitch. It’s more promotional than it is actually informing the public.

Moncrieff: I think the profession in the UK is less captured than it is in the US. But the attitude to the use of antidepressants in pregnancy is exactly the same. And the Royal College of Psychiatrists, I don’t think, receives a lot of money from the pharmaceutical industry, certainly not from antidepressant manufacturers, because most commonly used antidepressants are off patent now. I think this whole idea that depression is a medical condition and that medical treatments are the right way to go has become crucially important to the identity of psychiatry. It’s really, really challenged by things that question it. Our paper on the serotonin theory of depression questioned it. This discussion of the effects of antidepressants in pregnancy also really questioned it.

Whitaker: I have to say from my perspective, Mad in America is really focused on the sense that the public has been fed a false narrative around psychiatric diagnoses and treatments. And it’s a betrayal of the psychiatric profession to not be honest communicators of their own research, because the research is there, and they’re not honest in their presentation of that to the public. And somehow this particular case of not being honest communicators of what the evidence has shown I find particularly dispiriting, because if you have a newborn who’s not meeting their potential or suffering from some disability because of this exposure, that’s a lifelong cost to that human being that’s coming into this world.

As a society, one of the fundamental things we should be doing is trying to maximize the potential of those children who are born. And here we are not doing that. And then when I read those statements by these medical professionals, and then the media just echoing them like a bunch of parrots, I was so discouraged by the sense of how can we as a society organize our thinking and care, starting with the newborns, around honest science? So it was a really discouraging, dispiriting moment for me. And maybe last words from both of you? What is your emotional reaction to the responses to the panel?

Urato: I agree with you wholeheartedly about the honest communicator aspect of this. That has perhaps been my biggest frustration in the coverage after the meeting. What was really frustrating is that the honest communicators on this topic were being cast as providing misinformation. It was awful.

It’s not just that these professional medical associations and the SSRI advocates are not being honest communicators, which they’re not, but it’s that they’re accusing people who are actually trying to inform the public of misinformation. That’s been a huge source of frustration. I think, as a closing note for me, again, would be just to get back to trying to get people to realize that medications are chemicals, and these chemicals are going to have chemical effects. Chemicals have consequences. To keep that in mind and to really look into whatever you’re taking and putting into your body, and during pregnancy, that are going into the fetus.

Moncrieff: Like you, I was really dispirited by the reaction, and it reminded me very much of the reaction to our serotonin paper, particularly in the sense that it appeared to be trying to shut down debate to keep the public away from the people who are actually showcasing the evidence that exists. Don’t listen to them. It’s all fine. Just keep taking the drugs and don’t worry about anything.

I thought Adam put it very well. Ideally, physicians should be in that middle point, acting as a barrier between pharmaceutical company propaganda and the patient. They should be able to provide the prospective patient with an informed and balanced view of the evidence. And as a profession, we have utterly, utterly failed to do that, and as Adam says, acted as just a branch of the pharmaceutical companies’ propaganda departments. That’s really tragic to me. It was so clearly brought home in that response to the FDA panel and the response to our serotonin paper that the profession doesn’t want the public to have an unbiased view of the nature of antidepressants, depression, and mental health problems.

Whitaker: Or even an open debate about it. I have to say, of course, my profession, science journalism, is not doing itself proud either. They certainly embarrassed themselves with how they just uncritically took these statements. Then I thought they even piled on. They added their own sort of disparagement of the panels.

Moncrieff: There’s an ideology out there, isn’t there, that depression is a medical condition, that medical treatments like antidepressants are inherently benign and effective. It’s heresy to question this. It’s stigmatizing and hurtful to people if you dare to suggest that things might actually be different. It’s not just the medical professional, the pharmaceutical industry, lots and lots of people have jumped on this bandwagon and are promoting this view.

Whitaker: I thank you both for joining us here today. I commend your bravery in doing so, Hopefully, this can be a little bit of note, out there in the world of information, that provides a counter to that conventional narrative.

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