- Public doubt about antidepressants has grown despite increasingly settled scientific agreement on their efficacy.
- Figures in critical psychiatry have amplified scepticism, notably misreading the 2022 serotonin review as evidence antidepressants do not work.
- Some philosophical commitments generate manufactured doubt, and rigid critiques can obscure scientific consensus and risk undermining psychiatric care.
Med Hist. 2026 Oct 16:1-21. doi: 10.1017/mdh.2026.10090. Online ahead of print.
ABSTRACT
Public doubt about the usefulness of antidepressants appears to have grown, even as scientific agreement about their efficacy has become more settled. This paper examines the role that figures associated with critical psychiatry have had in promoting this doubt. It traces the long entanglement of antidepressants and their critics over the last eighty years, culminating in a 2022 review of the serotonin hypothesis, which, though it made no claims about efficacy, was widely interpreted as showing that antidepressants do not work. Drawing on Oreskes and Conway’s concept of ‘manufactured doubt’, the paper explores how certain philosophical commitments have shaped these actors’ views, at times impeding their engagement with new evidence. In doing so, it marks a distinction between productive and unproductive doubt. Whilst external scrutiny has played a significant role in shaping psychiatry, some positions are held so rigidly that the resulting critiques obscure the scientific consensus and risk undermining psychiatric care.
PMID:42885742 | DOI:10.1017/mdh.2026.10090
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