David Antonuccio, a close friend for 20 years since we met around the issue of antidepressants and suicide, and now an emeritus Professor of Psychology at the University of Nevada, organized a Skills and Pills for Depression meeting in Reno on October 4 2025.
The recordings of the talks are available now. The quality is not perfect, even after a clean-up operation, but there is enough to get a sense of the interactions.
The meeting kicked off with a talk by David A on Skills for Depression making the case that cognitive and other psychotherapies that aim at imparting skills to manage depression should be considered equal to pills as first-line treatments for depression.
I have posted David’s talk on my You Tube channel and you can see the ratings for his talk below, which are stellar. It comprehensively covers the evidence supporting the idea we should have a choice about getting psychotherapy rather than pills. David is passionate about the comparative lack of access to therapy – the lack of choice people have when they need help.
David’s talk is not embedded here as embedding is not my strong point and I’m worried the site might crash if there is too much material embedded in one post.
David’s talk was followed by one from me on Pills for Depression. A version of the talk, recorded two days later, features in the Health, Care and Science post. The original at this meeting version, but with terrible quality, is on my You Tube channel.
The two lectures were followed by a Panel that featured Kim Witczak, who has been a Consumer Representative on FDA Psychopharmacologic Drug Advisory Committees from 2016 to 2025, along with David A and David H. This was chaired by Deacon Schoenberger.
My hope going into the meeting was that the 220+ attendees would be angry, confused, and either want to give out to the panellists or be inspired to offer thoughts on possible ways out of the quagmire in which we are now in and being sucked deeper and deeper. We need rescuing but it was unlikely I guess that anyone hearing about these problems for the first time was going to have a lightbulb moment and throw us a lifeline.
The format didn’t suit getting lifelines for a few reasons. The camera and audio set up was never going to be able to pick up audience input directly. So at the break after the talks anyone with questions was invited to write them down to be read out by Moderators – Faraaz Merchant, a psychiatrist, and Dean Hinitz, a psychologist.
This worked passably well but lacked the emotional heft that comes with a direct interaction. The Panel is embedded here.
It’s worth watching this before reading any further. In addition to the questions asked and perhaps not answered here there were several other questions which there was no time to ask or answer/not answer, which are listed below. They also feature in the first set of comments on this post where I will provide some answers/non-answers.
The Panel made me slightly uncomfortable because more of the questions seemed one’s for me to answer rather than Kim or David but also because one of the questions below points to some non-answering – which was the case and partly my fault as it was me answering on non-answering on the point made.
Questions
S stands for Student. P for Psychologist. L for lay person. A for anonymous. If no A present, people gave their names and emails
S What part of research do you think should be expanded when discussing SSRIs?
P The participants’ question asking about the balance between negative side effects and meds and increased mental health symptoms with withdrawal was not addressed…rather the panel devolved into a discussion about PSSD…not addressing their concerns. As an observer this seemed to play out the panels own expressed frustrations with providers not listening to the concerns of the client.
L Can you speak more about AI and “total propaganda”?
MFT-Intern What about drugs for things such as bipolar/schizophrenia?
S Stigma around mental health is still a major barrier on college campuses. How can students help shift the conversation to informed choice and empowered advocacy?
Looking to the future, what emerging treatment approach for depression gives you the most hope and why?
S Do you think depression along with other mental disorders are over or under diagnosed in today’s society? Why?
S Best approach to start a conversation about depression with a close friend and offer help?
S Why didn’t the FDA analyze the results of the positively spun drug tests before approving its publication? If they had, were they in a position to prevent its publication? Are there more suicide attempts for those under intensive social work over CBT because the social work adds stress to the patients?
Is there a correlation between suicide attempts in patients and the type of treatment those patients were undergoing? Do pharmaceutical companies prefer using drugs over psychological treatment? If they do, why? If someone has a hard time concentrating on learning a new skill because of a mental disability, what techniques should they use to concentrate better? Should doctors be held more accountable for patients who committed drug-induced suicide/homicide or other crimes?
A How well do improvements on depression rating scales reflect improvements in a person’s actual quality of life?
A P How can research data be suppressed-ethically? Are these non-psychologists? Suppressing data or “spinning” data is against our ethical standards and against everything science represents. This harms people-so even if it is non-psychologists doing the research, falsely representing data violates the “do no harm” mandate of medicine. Are the researchers held accountable in any way for this? No wonder the general public shows such doubt in science.
BackDrop
The meeting required me to state that I would be adhering to Evidence Based Medicine (EBM) but in fact my talk was a direct assault on what is usually thought of as EBM and I knew beforehand it would be. I’ve never given one like it before. Kim and Woody Witczak featured all the way through but Kim had no more than a hint she might feature at some point.
There were 220 attendees, among them students were possibly the majority, but there was a large contingent of psychologists, some members of the public and 4 doctors.
I had pushed for letting Democrat and Republican Senators and Representatives know about the meeting with an invitation to them or members of their teams or any experts they might wish to send to come. Who knows maybe some were there but likely not – at least in part because I don’t think the mission to let them know was all that thorough if it happened at all.
The only bit I know for sure did happen was a letter I sent to the American Psychiatric Association letting them know about the meeting and inviting them to attend and/or advise me on how best to frame the issues.
Ratings
Most meetings these days – like everything from buying a bar of chocolate to getting a visa to travel to the US – comes with emails asking you to rate how we did today. This happens automatically, even when the US government has ceased to function in the case of visa applications.
It was the same with this meeting, but of the 220 or so people it looks like only 43 responded. This is not a complaint on my part – I would have been one of 177 others.
Of the 43, 33 were mental health professionals, 6 were students and 4 didn’t state their ‘gender’.
In terms of learning objectives met, 46% gave a top rating of 5, 25% rated 4, 20% rated 3 and the remaining 9% rated 2 or 1 (poor).
David Antonuccio got a 73% 5 rating with no one rating 1 or 2.
I got a 38% 5 rating with 15% rating 2 and 6% rating 1. Whatever else you make of this it can’t be put down to medical hostility with only 4 doctors there, most of whom were semi-complimentary.
The Panel session wasn’t rated.
S What part of research do you think should be expanded when discussing SSRIs?
A – I don;t think it’s research that is needed first of all. We need a vision about what SSRIs are actually doing if they are not correcting a serotonin defect. Then we need to see how peoples experience on these drugs maps onto that vision. This is research but it’s not chopping up rat brains., or brain scans or clinical trials, measuring anything.
P The participants’ question asking about the balance between negative side effects and meds and increased mental health symptoms with withdrawal was not addressed…rather the panel devolved into a discussion about PSSD…not addressing their concerns. As an observer this seemed to play out the panels own expressed frustrations with providers not listening to the concerns of the client.
You are right and that was partly my fault for raising PSSD. The problem is there is just too much to tell people and one of the points I was trying to make but didn’t make clearly enough was that besides withdrawal there is damage which may never recover. .
The Reno meeting helped me get some of these ducks lined up and I’ve sent two articles for review on the issues raised by Q 1 and by your question here. I guess this means watch this space
L Can you speak more about AI and “total propaganda”?
There is a post from a few weeks ago on this site called The Miracles of Artificial Intelligence which picks up the issue of Chat GPT etc and its role in advising young parents on whether they should get an RSV vaccine for their child when it is still in the womb or give their child an injection of a monoclonal antibody at birth – or neither of these.
This will be supplement in the next two weeks or so by a post here looking at the interaction between Chat GPT and related AIs and Electroconvulsive Therapy and also Transgender issues.
These both feature the Total Propaganda issue. Certain points of view that suit certain interests get assimilated into AI as ‘evidence’ – even though they may defy common sense and as a result we risk losing common sense and perhaps the ability of anyone who is a little bit older to pass on any perspectives (I hesitate to call it wisdom) to Gen Z or others.
But there is another aspect to all this that I think is missing. Full AI as opposed to the AI we now have if put to the test might well endorse Relationship Based Medicine rather than Evidence Based Medicine – as by extension I guess Relationship Based Living. The forthcoming ECT and AI post will bring this point out
MFT-Intern What about drugs for things such as bipolar/schizophrenia?
This got answered in the panel. The rates of suicide on these drugs at least in clinical trials are even higher than for antidepressants in antidepressant trials. In real life the rates of suicide and homicide are equally high on antipsychotics as they are on antidepressants. While manic-depressive illness always had a high suicide rates most depressions don’t and schizophrenia suicide rates were even lower than mild depression rates before we started using antidepressant drugs
In addition as with antidepressants, no-one gets to see the data from antipsychotic trials – not even FDA – and you can assume pretty well the articles on these meds are ghostwritten – soon to be written by AI
MFT-Intern What about drugs for things such as bipolar/schizophrenia?
The rates of suicide on these drugs at least in clinical trials are even higher than for antidepressants in antidepressant trials. In real life the rates of suicide and homicide are equally high on antipsychotics as they are on antidepressants. While manic-depressive illness always had a high suicide rates most depressions don’t and schizophrenia suicide rates were even lower than mild depression rates before we started using antidepressant drugs
In addition as with antidepressants, no-one gets to see the data from antipsychotic trials – not even FDA – and you can assume pretty well the articles on these meds are ghostwritten – soon to be written by AI
S Stigma around mental health is still a major barrier on college campuses. How can students help shift the conversation to informed choice and empowered advocacy?
Looking to the future, what emerging treatment approach for depression gives you the most hope and why?
Looking to the future, I think getting people out of mental health systems and indeed out of health systems if possible is the best bet. An increasing proportion of people in our systems are not ill. They are seeking help in the wrong places or are being seduced into taking things for disorders they don’t have.
Pharmaceutical companies, therapists, counsellors and lifestyle coaches are making money out of a wellness industry that trades more on appeals to something closer to beauty rather than health. I guess we are all susceptible to this because its a competitive world
S Do you think depression along with other mental disorders are over or under diagnosed in today’s society? Why?
Vastly over-diagnosed. Because our doctors have to give us Depression in order to give us Pills and they’ve sold the idea these meds are sacraments and magical. Its all rather like the Catholic Church use to support being a daily Mass goer and communicant – once you have salvation in your hands it’s very hard to stop drawing people into what you are offering – and very hard for us to shun these options without feeling we might be doing something wrong
S Best approach to start a conversation about depression with a close friend and offer help?
Yes Except maybe make that a few close friends – you probably need a range of views and also need some way to avoid Tik Toxicity – where influencers talk you into doing things that ain’t going to help – as wit the recent Wall St Journal article which will feature in a post on RxISK.org in a few days time
S Why didn’t the FDA analyze the results of the positively spun drug tests before approving its publication? If they had, were they in a position to prevent its publication? Are there more suicide attempts for those under intensive social work over CBT because the social work adds stress to the patients?
Is there a correlation between suicide attempts in patients and the type o treatment those patients wer undergoing? Do pharmaceutical companies prefer using drugs over psychological treatment? If they do, why? If someone has a hard time concentrating on learning a new skill because of a mental disability, what techniques should they use to concentrate better? Should doctors be held more accountable for patients who committed drug-induced suicide/homicide or other crimes?
There are too many questions here to answer all of them.
First – Companies often publish negative studies as positive and then submit the study to FDA and tell FDA that it is negative. FDA do nothing about this. Why not? It’s not FDA’s job. They are a bureaucracy not a detective agency or a police force.
Journal editors like the editors of the New England Journal of Medicine in particular know these studies are false in important respects as well the Covid vaccine trials but they accept and publish the article. Why – they make money out of it. In the case of vaccines – it may be more complicated
Re what can people do when they can’t concentrate to get projects done. We have lost the ability to recognise we can’t be good at everything. We all have certain strong points and less strong point and success in life often depends on finding the right niche and the right partner etc. We need to be able to recognize what jobs/roles and company suit us and not use meds or therapy to try to get ourselves to fit into situations we are just not suited to
A How well do improvements on depression rating scales reflect improvements in a person’s actual quality of life?
For SSRI antidepressants they don’t. Hamilton Depression Rating scales get a doctor to rate if the illness is improving. Quality of Life Scales ask very similar questions and it is often us who are being given the meds who do the rating.
No SSRI or related antidepressant has ever been shown to work on Quality of Life Scales
A P How can research data be suppressed-ethically? Are these non-psychologists? Suppressing data or “spinning” data is against our ethical standards and against everything science represents. This harms people-so even if it is non-psychologists doing the research, falsely representing data violates the “do no harm” mandate of medicine. Are the researchers held accountable in any way for this? No wonder the general public shows such doubt in science.
It’s not research data that is being suppressed. The so called randomized controlled trials are not trial designed to inform clinical care. They are randomized and controlled but are assay systems designed to get a license to make a claim about a drug.
They are not Evidence. They are Hearsay. They should not be built into Standards of Care or Guidelines etc.
Email me if you want a fuller article going into all this in detail
But if you are saying psychologists can cast a stone because they don’t sin – well I can’t agree with that