While the general point of this article is important, the details supporting it are not accurate and are misleading. For example, serotonin syndrome rarely, if ever occurs outside of use of overlapping MAOI drugs (rarely used) and SSRIs. I never saw a case in my career and neither have any of my colleagues. Also, the black box warning on antidepressants comes from a study which found "thoughts" about suicide more common in adolescents on antidepressants for two weeks. There were no attempts. If two overly stimulating meds were taken out of the mix, there was no such effect. Subsequent decreases in prescribing led to an increase in completed suicide among adolescents. Lastly, the lack of efficacy of antidepressant drugs comes from studies of highly refractory, disabled people (the only people they can get into studies these days). In practice they work just fine.
I agree that the use of more than one drug is highly excessive. Part of the problem here is allowing masters level people prescribe, but psychiatrists share the blame. However, once again society is blaming the messengers. Psychiatrists and other providers are asked to treat people with little time or help. Today insurance companies dictate care, not pharmaceutical companies and certainly not treaters. We have precious little time to perform miracles like getting a teen back to school and to stop hurting themselves.
For my final point I will point out that surveys of teens and other populations find increases in depression, etc whether they are in care or not. Mental illness is increasing in most industrialized countries. We in psychiatry are trying to treat it. Yes, we do not know how the brain works. Sorry. Neither do neurologists or neurosurgeons. No one does. But we have to deal with suffering people. (Btw, I had cancer in 2019. No one could tell what part of my body the tumor came from. Biology is hard.).
I have made the observation before that you should talk to someone in the field before making these comments. That suggestion stands here. These same highly misleading points have been made many times and yet people are flocking to mental health care asking for help. Might that mean something?
