Mainstream psychiatry seems motivated to rely on unsatisfactory data to undermine the significance of antidepressant withdrawal. This is because it finds it difficult to accept that antidepressants are not effective and, therefore, wants to minimise any potential problems caused by the vast amount of antidepressant prescribing that takes place. It is very difficult for psychiatry to accept that it has made so many people dependent on antidepressants.
Personally I'm not convinced the evidence of antidepressant dependence indicates physical dependence, even brain damage, in the sense that the body, rather than the person, has been made dependent on antidepressants. There is evidence that neuroleptic medication can cause brain damage, as with tardive dyskinesia, but, although the brain of course needs to readapt after antidepressant discontinuation, I know of no evidence there is permanent brain damage from antidepressants. Of course withdrawal symptoms can be prolonged but the mechanism requires further elucidation. I have always emphasised the role of psychological factors. It concerns me that people who make the case for physical dependence tend not to give enough priority to psychological factors, which cannot be denied. It’s not surprising that a drug that is thought to improve mood can be habit forming, considering especially that it may have been started when people are feeling desperate. Undoing what can be an identity altering experience of taking antidepressants may well not be easy.
