There is very little evidence that depression is caused by chemical imbalance in the brain, it's something that big pharma have sold you so they can sell their drugs.
Great book on the topic, check out lost connections.
The problem with SSRI's, especially in my experience and from my understanding, is that they aim for "mildly beneficial with minimal side effects" and hit somewhere closer to, "mildly beneficial with understated side effects that many patients will be too embarrassed to report". This doesn't mean SSRI's are total junk, but it does mean that they're kind of mediocre.
Ketamine is more of a high-risk high-reward drug, similar to the use of CNS stimulants to treat ADD. There's no question that amphetamines help people focus. There's also, understandably, far more concern about giving people amphetamines in the first place.
Also, it's easier to convince patients to take a boring prescription drug than to sell them on, "I think the real solution to your problem is this really scary-sounding drug that people take at raves; trust me, I'm a psychiatrist."
A broken bone can be fixed by immobilizing it via a plaster cast. Did the bone break due to the lack of plaster?
Eczema can be fixed by applying topical steroids. Did eczema develop due to the lack of topical steroids?
Depression can be fixed by inducing changes in neurochemistry. Did depression arise due to an imbalance in neurochemistry?
> The results are reported after 8 weeks of treatment, so we don't know if they apply to long-term use of antidepressants.
I'm not sure why you would discount an improvement in symptoms over 8 weeks though. Many major depressive episodes will be resolved in that time ("The median duration of MDE was 3.0 months; 50% of participants recovered within 3 months"[1]), so even if they are not suitable, or less effective, for long term care, that can still be a improvement in quality of life.
[1] https://www.ncbi.nlm.nih.gov/pubmed/12204924
(FWIW, it was 21 antidepressants, not 21 studies: "The researchers found 522 studies covering 116,477 patients in total. This included 101 previously unpublished studies.")
I'm not, but I don't think anyone is arguing that SSRIs can't be effective for some people with severe depression when used in the short term. The issue is that that only represents a small percentage of patients.
He found they didn't work better than Placebo.
I looked up the first thing I found on Google.
https://www.psychologytoday.com/us/blog/psych-unseen/201802/...
This is written about Kirsh's study, and it's confusing. Kirsh interpolation of the raw data showed that antidepressants don't work, and work less so for extremely depressed patients.
This doctor claims the opposite?
Pesonally, I find the research on the efficacy of antidepressants very confusing.
To those whom are depressed, I can offer this, it does get better with age.