Marketing depression and making medicines work Charles Medawar

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The Antidepressant Web

Marketing depression and making medicines work

Charles Medawar

Social Audit Ltd, P.O. Box 111, London NW1 8XE, UK
This version downloaded from http:\\

and posted on the Internet by kind permission of the Publishers:

IOS Press, Van Diemenstraat 94, 1013 CN Amsterdam, The

Netherlands (FAX: +33 20 620 34 19; email:


Medawar C: The Antidepressant Web - Marketing depression and making medicines work, International Journal of Risk & Safety in Medicine, 1997, 10, 2, 75-126.

1. Abstract and introduction

This paper was conceived as chapters two and three of a still unwritten book, and as a basis for discussion on a website and elsewhere. From early 1998, revised and expanded versions of this text, plus feedback, will be posted on the Internet; hence the numbered section headings, each denoting a separate thread.

These chapters examine hard evidence relating to a wholly rhetorical and hypothetical question, “Do antidepressants work?” The reason for asking this ostensibly silly question is to provide the broadest possible framework for looking at the meaning and values of medicine. Implicitly, the question also asks: what is better than nothing, and how much better are antidepressant drugs than the placebos they are compared with in clinical trials?

Between the lines of the paper lie basic questions about the ethics, activities, performance and impact of the three main centres of power in medicine   government, professionals and the pharmaceutical industry. The underlying issue is whether people who are miserably unfulfilled, sad, anguished or depressed are in hands as safe as they might imagine or need.

There are no conclusions in this paper, but something of a hypothesis emerges from it: “depression” is fast developing as an iatrogenic disease and that, however much they are part of the solution, antidepressant drugs seem much more implicated in the problem of depression than is supposed. Moreover, the public’s opinion that antidepressants are drugs of dependence seems much closer to the reality than the exactly opposite orthodox view.

Similar scenarios go back a long way; they have repeatedly shown public concern to be justified and seen the medical establishment caught unawares. Past experience in this field links risk of dependence to unaccountable power. Is the same not true today?

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