NEI Podcast E273 - Busting Myths About Antidepressants with Dr. Jeffrey Strawn
Jan 14, 2026
Join Dr. Jeffrey Strawn, a leading expert in psychiatry and pharmacology, as he busts common myths surrounding antidepressants. He and Dr. Andy Cutler delve into the efficacy of these medications compared to placebos and clarify the risk of suicidality. They discuss when to initiate treatment, the importance of balancing medication with therapy, and how to effectively communicate side effects to patients. Strawn also tackles the misconception of antidepressants altering personality, emphasizing their role in symptom relief. A must-listen for anyone curious about mental health treatment!
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Antidepressants Show Real Efficacy
- Major depressive disorder and OCD are pharmacologically responsive and show benefits beyond placebo in trials like STAR*D and CO-MED.
- Heterogeneity of illness, comorbidity, dosing, and trial design explain many perceived failures of antidepressants.
Persist And Sequence Treatments
- Treat depression as a journey and try sequential strategies rather than giving up after one failed medication.
- Adjust dose and switch agents thoughtfully because remission accumulates across trials (STAR*D lessons).
Pharmacogenetics: Helpful but Limited
- Pharmacogenetic testing gives useful pharmacokinetic clues but cannot reliably pick the right antidepressant for pharmacodynamic response.
- The test's paper report can increase buy-in even if its predictive power is limited.