Is burnout depression?
Since COVID, France has become the world champion of antidepressants with 14% of the population using them. Long presented as “the happy pills”, these serotonin reuptake inhibitor drugs are far from being a panacea and do not work for all patients. 2 recent studies have rekindled the debate: one questioning the biological mechanism of the disease, and the other tackling the effectiveness of drugs. The first, published in July in Molecular Psychiatry(1), calls into question the central role of a serotonin deficiency in the origin of burnout. 
It is in fact a multifactorial condition, in which the neurobiological causes are mixed with contextual or sociological factors that must be taken into account. Prescribing an antidepressant for someone experiencing professional burnout who remains exposed to harassment in the workplace makes no sense if we do not address the source.
In 85% of people, antidepressants are barely more effective than a placebo,
in the event of a mild or moderate illness. On the other hand, their effectiveness is beyond doubt in severe forms of depression, according to the second study, published on the British Medical Journal website. 
In mild forms, patients are exposed to the adverse effects of medications. In the mildest disorders, psychotherapy associated with physical activity and dietary modifications (diet or supplements) is recommended as first-line treatment.
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(1) The serotonin theory of depression: a systematic umbrella review of the evidence, Joanna Moncrieff1,2, Ruth E. Cooper3, Tom Stockmann4, Simone Amendola5, Michael P. Hengartner6 and Mark A. Horowitz1,2
(2) Response to acute monotherapy for major depressive disorder in randomized, placebo controlled trials submitted to the US Food and Drug Administration: individual participant data analysis BMJ 2022; 378 doi: https://doi.org/10.1136/bmj-2021-067606 (Published 02 August 2022)Cite this as: BMJ 2022;378:e067606
