Unfortunately I don't think most of us have access to that particular journal, d/t the controversey behind its founder to name one of many other reasons. From their website, here's their description of themselves:
Ethical Human Psychology and Psychiatry (EHPP) is a peer-reviewed journal that publishes original research reports, reviews, essays, book reviews, commentaries, and case reports examining all the ramifications of the idea that emotional distress is due to an underlying organic disease that is best treated with pharmacological therapy. This oversimplified view of human nature permeates virtually every area of our society including medicine, business, law, education, politics, and the media.
Now I think a journal with this goal in mind is itself biased at its face towards a certain extreme, which is fine. We need varying voices for quality discussions. But somehow I suspect that this journal is filled primarily with editorials/letters exploring the philosophical issues with medicating the public, rather than clear critiques of the science behind it. That's fine and dandy, but let's not dismiss published research with opinion pieces. At least show the articles specifically showing problems in the analysis of well-designed unbiased studies. Give me some of those references, or send out some pdf's. The problem in my opinion with the extremist anti-psychiatry front is that they believe we're trying to control people's mind with medications, as if we have some grander agenda to subvert the world's population. Or that the whole system is driven by drug companies for a profit. Don't get me wrong, there's a lot of money involved and clear selective analyses in some papers, as well as the direct-to-consumer advertising, but that doesn't make psychiatrists the cause of this, nor the field of psychiatry. We need drug companies to research drugs, or else we'd still be giving arsenic to psychotics.
The keen SCIENTISTS and Physicians will know how to properly analyze publications and see through shoddy conclusions drawn from poor efficacy. I try with my colleagues to do that all the time, especially when a slick pharma sales rep is trying to pass on their conclusions from articles they don't fully understand. Show me that equal level of understanding. Show me an analysis of the unbiased studies (the ones funded by NIMH where's there's no investment or bias for one drug or another- STAR-D, CATIE, etc.). Please go read those studies, then come back with clear critiques and we'll continue our discussion.
As for the washout period issue, that pre-supposes that everyone enrolling in a study were on a medication beforehand necessitating a need for a washout, which is on the whole VERY untrue.
Furthermore, while there is such a phenomenon with withdrawl from some antidepressants (SSRI discontinuation syndrome, paxil being the most notorious d/t the short half-life), this doesn't mean that everyone experiences withdrawl symptoms. And show me the literature showing that this withdrawl that you're referring to is even in the criteria analyzed in these studies. Most withdrawl symptoms recognized in SSRI discontinuation syndrome include anxiety and flu-like symptoms, rather than direct measures of mood such as measured in the Beck Depression inventory (though there is some measure of irritability). These symptoms are also particular for discontinuation of short half-life medications, rather than a categorical aspect of all anti-depressants.
Now while I think there is a schism in psychiatry with one part extremist towards biologic reductionism, it is by no means the majority. Correlation doesn't mean causation, and most of us know that. Altered brain chemistry is not the cause of mental illness, happening independently of many other things, but the chemistry itself is instead a manifestation, and in changing it some part of the illness is also changed. We use medications as tools, often to make someone functional enough to survive and then actually take advantage of therapy without losing their jobs, homes, families, friends, other support systems.
Once again, if you want to go fix all of western society including the nuclear family, centralized government with underfunding of many public resources, mass media propagation of unhealthy body image and idealization of greed and materialism, pollution, obesity, wireless technology with lack of personal boundaries/space/unplugged time, child abuse/neglect, desensitization to violence, no money, high stress, lack of sleep, to name just a few, then go ahead. Those are all real problems that help to make people mentally ill. But many of us live just fine in this world despite all these issues, and when we don't then one must conclude that to whatever degree some internal part of a person isn't functioning right, and that changing that person may help them to cope better, whether that be with teaching relaxation techniques, or giving them a little ativan so they don't have a full blown panic attack and drive into a telephone pole.
