Placebo is just as good.  The power of the mind.  Power of feeling that someone understands us and that will help us to get out of depression is probably the most important point here.  The best medicine will be a support team that puts you on track with proper food and exercise.  

On a broader yet critical note regarding Gotzsche's work, what's essential to see is that Gotzsche has not just exposed the corrupt pharma industry but orthodox medicine in general with their various non-drug interventions and treatments.

For example, Gotzsche has been an extremely prolific opponent of mammography. Gotzsche's book "Mammography Screening: Truth, Lies and Controversy",  along with the book "The Mammogram Myth" by Rolf Hefti (author's outline at themammogrammyth dot com),  are the only two really extensive, independent works on the deep fraud of mammography.

As such Gotzsche really exposes the business of conventional allopathic medicine and its government cronies as highly criminal. Which is backed by his ejection from Cochrane and the hospital he worked for many years, of course, for purely political reasons....

Great write up on an important topic. There are several meta-level issues lurking in the background here, namely, the emphasis on publishing positive findings (the flipside being negative, or lack of effect, findings are ignored) and the standard approach to care these days which is chronically medicating. Ionnadis saying, "Based on the above considerations, antidepressants are probably indicated only in select patients with major depression, probably preferentially in those who have severe symptoms and have not responded to anything else," is a much more conservative and calculated approach as opposed to the widespread use of antidepressants in less severe cases. Given the side effects, this approach is wise.

Furthermore, I would like to see more research spent in determining the causes of depression in modern society and then strategies that can be put in place to *prevent* depression in the first place. Prevention, as a rule of thumb, is generally preferable to treatment. Depression and other mental disorders are clearly not going anywhere on their own.

Thank you Professor Gotzsche for putting this in your article, "many school shootings where the killers were on depression pills".

The ugly truth.  

We are not in the habit of peacefully living with our emotional selves, nor are we part of a society where my emotional self, really has a safe place for it's expression.  

Don't deal with the multi-generational emotional burden, medicate it.  Add to that an emotional irresponsibility that spans many generations and the whole pill idea looks good.

Until we re-read:  "many school shootings where the killers were on depression pills".

If one were to read from Dr. Kelly Brogan: 

https://kellybroganmd.com/rising-rates-of-suicide-are-pills-the-problem/?utm_source=Kelly+Brogan+MD+Newsletter&utm_campaign=c580f1f1cc-Rising+Rates+of+Suicide&utm_medium=email&utm_term=0_d0f977a8c5-c580f1f1cc-122115837

Or from Dr. Natasha Campbell McBride:  

http://www.doctor-natasha.com/gaps-book.php

The truth is out there.  

Will you look at it?

The problem Ioannidis draws attention to here may have effects that stretch far beyond the antidepressant literature, and speak to the core of the concept of evidence-based medicine.

When a clinician or an academic argues they are following the evidence in their recommendations, that implies they believe the evidence available to them is an accurate reflection of the evidence that exists regarding a particular condition, drug, therapy, etc. What Ioannidis describes is an area in which the published literature fails to even address the majority of the evidence available - that is, most of the evidence has never actually been published. Simultaneously, the evidence that HAS been published is systematically and predictably biased in ways that would lead to better mean results in clinical trials than in subsequent clinical practice.

Before Turner 2008 and other papers on antidepressants, it would have been difficult for any clinician or researcher to assess whether these forms of bias existed simply by looking at the published literature. Surely the same problems exist elsewhere and we are just not aware of them, or their extent.

YES!!!

This is a great article and it takes some real guts to spell out the truth on this topic. 

You guys have not only done a great job in expressing a genuine crime on the peoples effected by this but have done it in a way that is easily understood and accessible. 

Prescription drug use is OUT OF CONTROL. The quick fix / Magic Pill solution has resulted in the Big Pharma producing addictive drugs, that cause horrible side effects, long term damage to the health of our bodies and in most cases amplify the underlying problem. 

In addition to this being a problem of huge proportion for adults,  its now adolescent children that are being put on these heavy drugs. Did you now that there are over 600,000 children aged 0-5 that are on depression pills in the US alone? Look it up! The data is out there.

I hope that CrossFit.com produces more articles on this topic and uses its voice to create more dialog on this topic. 

Brilliant work guys!  It is a serious shame what is going on in America right now... Big Pharma is seriously doing us wrong.

I see a woman in distress. Maybe the film is Schindler's List or 12 Years a Slave. I found both movies distressful. 

I for one am very grateful that CrossFit Health and Greg Glassman have decided to address the system errors that plague our current medical system leading to a rise in all sorts of chronic disease including mental illness. As Nima stated the motto of CrossFit Health is “Let’s Start With The Truth”.

The truth is that mental illness and suicides are on the rise in this country. If pharmacotherapy was effective this should not be the case. Taking an antidepressant on a long term basis will not address the root cause of the depression anymore that injecting insulin will remove the effects of excess carbohydrate consumption. 

Every member of society needs to be a skeptic and learn to constantly question the status quo. The unfortunate reality is that most people do not know what kind of studies were performed to get a medication approved. In the modern era true scientific rigor has been neglected. Most studies are funded by the pharmaceutical industry, negative findings are not published and the leaders in the field are on the payroll of pharmaceutical companies. 

Dr. Gotzsche has dedicated his career to working to find the truth in medicine and has suffered personally for his dedication. 

It is never easy when our beliefs are called into question. However, it is important to keep an open mind and examine the arguments against the status quo that are being presented. The truth is that our current approach to treating most chronic diseases are failing. Medications address symptoms, not root cause, often with significant side effects and minimal effectiveness.  

I am a CrossFitter. I am an Affiliate Owner. I have my CF-L2. I also happen to be a Family Physician and Psychiatrist.
No one is arguing the validity or existence of mental illness, nor the burdens associated with mental illness.  Dr Gí¸tzsche is a well respected and well pedigreed professional. This article is airing one of the dirty secrets within Medicine — that antidepressants really do not work. We have known this going back to 2008 (see Effectiveness of antidepressants: an evidence myth constructed from a thousand randomized trials? by John PA Ioannidis available at https://peh-med.biomedcentral.com/articles/10.1186/1747-5341-3-14). Antidepressants separate out from Placebo (sugar pills) only in the most severe cases of Depression — yet they are the first line treatment in family practice, pediatrics, and mental health offices for everyone that walks in. The proof that they work is thin. And even in the most severe depressed patient, is not that antidepressants are more effective — it is that the statistical significance in the studies come from the placebo becoming LESS effective.
Leaving the international scene alone, we currently have approximately one in nine Americans on an antidepressant (approximately 40 million people) — the original FDA studies for Fluoxetine (Prozac, the first “antidepressant”) which granted approval for Prozac as a safe and effective treatment for depression were based on 5 studies totaling 817 patients. Leaving unpublished negative studies, unregistered trails, p hacking, and the host of other manipulative things Pharma does to make profits (not cure disease) — the truth of the matter is we overestimate how well antidepressants work. We overestimate the efficacy of prescription antidepressants, increasing the profit of pharmaceutical companies — to the detriment of therapy and other modalities that have become overshadowed by the advertising campaigns of big pharma.
Feel free to read up on Pharma and their adulteration of results to the detriment of public health. Start with https://en.wikipedia.org/wiki/Study_329 about Paxil (paroxetine).

Again, CrossFit has never been about posting “polarized” articles as click bait. It goes back to the basic message CrossFit Headquarters has been working to promote “Let’s start with the truth”.

As a Doctor, I agree wholeheartedly with Mr Glassman’s statement that “there’s something profoundly wrong with medicine… and it’s not going to get better until we acknowledge that reality.” Stop hiding the truth, as uncomfortable and shocking as it may turn out to be, as complicit as we Physicians end up being in that charade - and let us work to make medicine better for everyone.

I frequently have patients (all kids) who come to me for emotional concerns. Some are depressed. I have to address the underlying causes. The stressors in these kids lives- the academic pressure, the lack of sleep, social pressures, overscheduling, nutrition, constant iPhone use, JUULing (a whole other modern day disaster), social media, and more. Starting a 15 year old who sleeps 6 hours a night, spends 4 hours on social media, and eats carbs all day on an antidepressant is bad practice. But kids are started on antidepressants everyday. Because it’s something we can do. Write a prescription. It’s easier for the doctor and patient. Maybe. 

Dog Prozac is on the rise. It’s seems less insensitive and more obvious to discuss SSRI’s for dogs. Dog Prozac is ridiculous. Dogs need a lawn and some love. They don’t need to be pigeon holed into a crate all day and then be medicated. 

There’s a major problem here. And the solution is not a pill. 

One factor affecting mental illness is nutrition. The common consumption of carbs and processed foods is excessive. There is long standing research and evidence that low fat/high carb diets affect mental well-being. Dr Michael Norden in Beyond Prozac discusses the direct relationship of the low fat/high carb diet to mental illness. Studies demonstrate the impact of sugar on depression. 
https://www.ncbi.nlm.nih.gov/m/pubmed/26109579/

We also have to evaluate the efficacy and side effects of any drug. Which Dr Gotzsche (and references) presents well in this article. 

While there may be a role for medical treatment in the acute stabilization of patients with severe depression, they have to be part of a multimodal plan which emphasizes lifestyle changes.

It’s time to take a step back and take a better look. 

The comments to the article so far are disappointing. Dr. Gí¸tzsche is one of the most well known members of the evidence-based medicine community. He is a co-founder of the Cochrane Collaboration - the scientific group that evaluates the efficacy and safety of medical treatments. Everything he states is supported strongly by the available scientific evidence. If you follow his references and read many of the books and papers listed, you will read some of the best scientific information available on this subject.

The majority of people who take antidepressants will not be seriously harmed by them. In fact, as Dr. Gí¸tzsche notes, the majority of people will recover within some reasonable period of time. When they do so, they will almost without exception attribute their recovery to the antidepressant, even though the scientific data tells us this is not the case. Because depression can be such a difficult and trying experience in life, many of these people can develop very strong positive feelings about antidepressants that are not warranted, but nevertheless real. This human tendency is very much a part of the marketing of these drugs. The scientific data says they are on average harmful, yet the people who are unharmed often become emotionally invested in the myth around these drugs. They often see an attack on the drugs as an attack on their mental health, since they so strongly believe the drugs help them.

I encourage anyone who reads this to follow the references and really dig into the science around antidepressants. These drugs have powerful effects on the brain. Their main effects are a result of causing dysfunction in the serotonin systems they interact with. Emotional numbing and sexual dysfunction are two of the most prominent characteristics, along with the risk of suicidal thinking - often manifested in a bizarre, compulsive manner. Some patients enjoy being emotionally numb - at least temporarily - but it does not cure or help depression. Rather, it makes you indifferent to your depression.

The scientific data tells us one thing: that even if you believe the studies on antidepressants, they have shockingly low efficacy. But Dr. Gí¸tzsche gives some excellent reasons why we should not believe even these studies. The results are driven by biased ratings filled out by doctors who are proponents of the drugs. In the few cases where this bias has been peeled away, the (small) efficacy of these drugs disappears.

The woman leaning against the wall is contemplative. The staircase stands open, giving her the choice to climb or stay. We know what’s below, the masses, the theater where everyone else sits. What’s above? Something more? Maybe we are being called up to think higher thoughts, to live higher lives than what we see on display in the masses. 

Or maybe it’s just a nice painting. 

Boo CrossFit! Please don’t post polarized fear based articles about mental health. We as a community need to be able to have open conversations about our wellness. This article marginalizes and isolates people with depression, anxiety and other mental health conditions. It can be read and interpreted as ‘not only is something wrong with you, you’ve also made a bad choice is using antidepressants’

In the last 4-5 years that I’ve either been taking or teaching Crossfit, and in that same amount of time also reading the articles sent daily to my email, this is the first time I’ve ever truly felt compelled and somewhat disappointed with Crossfit for posting an article.  I’m sure there are more that I’ve probably skimmed over in the past that are similar, but for some reason today this one just hit a chord within me in a very negative way. 
While I appreciate and can understand the importance of researching the differences in antidepressants vs. placebos, the side effects of some if not all of these pills, I think that it’s more harmful to post an article like this one because of both Crossfit’s Popularity and the article’s subtle implications that ALL antidepressants are “as effective for depression as antibiotics are for infections.”  It really angers me that Crossfit would actually allow a post like this be associated with its brand, as someone who has battled with mental illness my entire life and has not only thrived by having an avid exercise regiment, but also taking an antidepressant daily for the last two years consistently due to depression along with PTSD/anxiety.
To loop all antidepressants into a singular category of all being harmful to any given individual taking them is basically continuing to stigmatize those who are on these medications and thriving, and perpetuating the stigma on mental illness/health.  Further more, for some individuals who follow the Crossfit prescriptions and recommendations to a T, how would Crossfit feel if, hypothetically, a bunch of athletes decide that, based on this article and ones before it, they no longer need their medication because they’ll “get better over time” without it?  Ok.  Maybe they will... but what if they don’t?  What if they truly do need that medication due to their particular chemical makeup and imbalance?  What happens if their mental illness gets worse?
Again, I appreciate and support research for all of its results and information that it can provide us.  But I encourage Crossfit to be better than this article; today you guys made me feel like it was my fault I’m “sick” because I’m continuing to take my medication.  Fortunately, I’m wise enough to know that, while I may not always need it, I do for right now and that’s ok.  If the author’s suggestions in this article have been misinterpreted, I do apologize.  Perhaps next time think about what you’re writing a little bit more before publishing.  Either way, this particular article is truly a disappointment to see being posted in my email.