The part that really bothers me is this “Informed Consent” you write about. I would really like to know how many psychiatrists, from the start of therapy, tell their patients that there is a significant chance the first antidepressant I give you will not be effective, and while the second one I prescribe will likely do the trick (or at least it does for some people). How many practitioners go even further to say that many people feel their medicine stops working, and have to start a new class of meds with debilitating side effects that the first class didn’t have. I saw several psychiatrists since I was 17 and they only had these conversations with me once I presented the symptoms of this so called “refractory depression.” People are saying here that the author’s post is doom and gloom, which is it, but I think doctor’s should be just as candid about the antidepressant from day 1 of giving the nice samples from the pharmaceutical company. But, I guess, if everyone got better, or patients weren’t given AD the minute they walked through a door you wouldn’t be able to secure new patients and make money and get spiffs or incentives for prescribing medication that the pharma rep gives to you. If you lost all the AD patients who didn’t really need them, you probably wouldn’t have a business.