ABSTRACT
It is very difficult to know when to refer a patient for psychoactive medication because a good part of the data base for psycho-pharmacological research has been so distorted by the medico-pharmacological-advertising complex that reliable data is difficult to come by (see for example Marcia Angell, 2009). The best non-partisan data I have found suggests that most anti-depressants may perhaps be slightly more efficacious than placebo, but not significantly so, and that the frequent side effects, including depersonalization, render them of dubious clinical efficacy for many patients. Nevertheless, I have seen occasional patients who seem to have been helped by anti-depressants and others who feel that they have been helped, and I support this without hesitation if the patient desires them.
