Shouldn't the default position be "we don't know"?
No that's a common misunderstanding. Science is the search for the best model/theory as such it's hard to rank something as better or worse than we don't know. Thus the default theory is "There is no relationship between X and Y". Even if not clinically useful there does appear to be a connection and as such you can replace the default theory.
After even more research the current theory is something like. "They appear to beat placebo's which have no side effects." Which again is far more useful than "We don't know." As it suggests comparing them to placebos that have side effects. Again not because they are going to help you treat patents directly, but because it tells you more about the disease and possible what research could be useful.
Science is the search for the best theory as such it's hard to rank something as better or worse than we don't know. Thus the default theory is "There is no relationship between X and Y".
For the purposes of this discussion, that's a distinction without a difference. (BTW I edited my comment before your reply showed up, and had deleted the bit you quoted.)
More significantly, your suggestion of comparing SSRIs to placebos with side effects strikes me as an excellent idea; it is what Kirsch's study would naturally seem to suggest. I wonder if such studies will ever be undertaken.
The more conservative estimates from the present analysis found that differences between antidepressants and active placebos were small. This suggests that unblinding effects may inflate the efficacy of antidepressants in trials using inert placebos. Further research into unblinding is warranted.
No that's a common misunderstanding. Science is the search for the best model/theory as such it's hard to rank something as better or worse than we don't know. Thus the default theory is "There is no relationship between X and Y". Even if not clinically useful there does appear to be a connection and as such you can replace the default theory.
After even more research the current theory is something like. "They appear to beat placebo's which have no side effects." Which again is far more useful than "We don't know." As it suggests comparing them to placebos that have side effects. Again not because they are going to help you treat patents directly, but because it tells you more about the disease and possible what research could be useful.