That all drugs are better than placebo is true. However, there is a VERY important element to state here. The degree that anti-depressants are better than placebo IS NOT STATISTICALLY SIGNIFICANT.
For the null hypothesis to be rejected (The hypothesis that placebo is the cause of more positive anti-depressant effects than anti-depressents themselves) the observed result have to be statistically significant. And this is not the case - at least in the recently publiched studies I have read.
One thing to consider from a statistical point of view (for chronic MDD patients) is the situation that medication X may only work for 1 out of 10 depression patients, and in the other 9 may cause e.g. a worsening of symptoms that would require the drug to be ceased. Looking at that drug X in isolation and just looking at the first 12 weeks of medication results per patient, it could appear as though it causes more harm than good at first glance.
But if we have 10 different medications that can work for 10 different aforementioned people, then they essentially would just need to be cycled through the meds until they each found their one. So a study of any one of those drugs could show that during the first 12 weeks, 9 patients had worsening symptoms/side effects/no improvement and only one person may have gotten better. Statistically, that looks horrible, until you look at the possible bigger picture, which is that each patient goes on to the next drug and the next until they find one that works for them. This includes alternative antidepressants such as Depakote as well.
Hopefully, each patient ends up being matched to an antidepressant, and thus what we really need is a meta analysis of our psychiatric/pharmacological methods of treating depression as a whole, rather than statistics on
individual meds
What I would like to know in the future is what medicines (food, training, what ever) anti-depressant can be combined with in order to result in a bigger positive effect. At least this will be important to research until potentially new anti-depressants emerge that works different from SSRI's and SNRI's and works on something that actually have a significant effect.
Some research has shown promise for Antalarmin (stress hormone blocker) combined with SSRIs, mindfulness I'm sure would pair very well with SSRIs as well and cardio is known to augment SSRIs effects. In the severe depression category, a drug called pindolol seems to augment SSRI response as well, but only for the severely depressed
CY