Antidepressants are ineffective in fully 50% of the people who take them.   It is clearly early 20th century medicine, where you keep trying things and hope something happens while pharmaceutical companies who impress doctors the most make the most money.

With so much research and money spent on depression studies, how is it possible that it is only as effective as doing nothing at all?  

1)  The cause of depression has been oversimplified.  A study from the laboratory of  depression researcher Eva Redei presented at the Neuroscience 2009 conference in Chicago this week addresses some strongly held beliefs about depression.
Prenatal sex-based biological differences extend to genetic expression in cerebral cortices and the differences in question are probably associated with later divergences in how our brains develop, according to a new study by Uppsala University researchers Elena Jazin and Björn Reinius in Molecular Psychiatry.

Professor Elena Jazin and doctoral student Björn Reinius at the Department of Physiology and Developmental Biology previously say they have demonstrated that genetic expression in the cerebral cortices of human beings and other primates exhibits certain sex-based differences. It is presumed that these differences are very old and have survived the evolutionary process.