Conflict Arises Among Leading Psychiatrists Over the Proper Treatment of Depression and the Role of Antidepressants

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A new commentary titled “Do Antidepressants Really Work?” by two physicians posted on reinforces society’s philosophy of “one pill for every ill” and the faulty logic employed by many physicians in their attempt to successfully treat depression and other chronic illnesses. Relying on drugs, rather than properly assessing the six metabolic systems contributing to the syndrome of depression, is the wrong medical approach to treating the depression epidemic according to Dr. Robert J. Hedaya, founder of The National Center of Whole Psychiatry.

The National Center of Whole Psychiatry is located in Chevy Chase, Maryland.

“Dr. Steven Paul and Dr. William Potter have a case of what I call ‘neurocentric psychiatry,’” said Dr. Robert J. Hedaya.

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A new commentary titled “Do Antidepressants Really Work?” written by two physicians and posted on reflects the outdated approach to illness of “one pill for every ill” and highlights the medical community’s misguided approach to treating depression. As a certified psychopharmacologist, founder of The National Center of Whole Psychiatry, and Clinical Professor of Psychiatry at Georgetown University Medical Center, Robert J. Hedaya, M.D., D.F.A.P.A., states that while antidepressants have a role in clinical practice, they are grossly over-utilized. The question of whether antidepressants really work is disturbing, and illustrates just how far off base the medical community is when it comes to treating depression. Dr. Hedaya sees the solution in a systems-based approach: assess the metabolic factors which lead to the syndrome of depression. This approach is supported by much basic science and clinical research, but is ignored by the pharmaceutical and insurance industries.

Dr. Hedaya asserts the medical and research communities rely too heavily on drugs rather than deal with the root causes of depression. The medications generally are not as effective as society would be led to believe by the pharmaceutical companies’ ads and research (publicly acknowledged as distorted in peer reviewed journals such as The New England Journal of Medicine in an article titled “Selective Publication of Antidepressant Trials and Its Influence on Apparent Efficacy” published January 2008 by former FDA psychiatrist Erick H. Turner, M.D). Nor are these medications without financial costs and side effect burdens. The solution Dr. Paul and Dr. Potter suggest is to devote more research time and dollars to develop lab tests to predict who will respond to medications for depression. That is a reasonable idea, but given this era of tight budgets, it seems like too little bang for the buck.

“Dr. Steven Paul and Dr. William Potter have a case of what I call ‘neurocentric psychiatry,’” said Dr. Robert J. Hedaya. “The narrow model Dr. Paul and Dr. Potter use is based on the assumption that the biological answers to depression reside within the brain. The head and brain are connected to the body by something called the neck. There is a great deal of basic science and a good deal of clinical science indicating the very significant role played in subjective and objective mental health by at least six metabolic systems: nutrition, gastrointestinal physiology, immune/inflammatory/infectious processes, methylation processes, oxidative stress, and all hormonal systems. Also to be considered before treating depression are circulatory problems, physical-structural problems, age, gender, and lifestyle,” concluded Dr. Hedaya.

Assessing metabolic systems, their antecedents, triggers, and mediators and re-establishing multi-system reserves not only helps treat depression with less medication, it reduces medication side effects and reduces the incidence of known co-morbidities (e.g., diabetes, cardiovascular disease, osteoporosis, sexual dysfunction). To read Dr. Hedaya’s response, join Whole Psychiatry on Facebook at

Visit for more information on Dr. Robert J. Hedaya and The National Center of Whole Psychiatry. Join Whole Psychiatry on Twitter at!/wholepsychiatry

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