alt Hacker NewsI suppose it can be moralizing, and probably is in the parent comment.
For me I still feel the surprise because I've followed the evidence carefully for well over a decade, and the methodological problems and lack of evidence for meaningful effectiveness have always been clear. I.e. it is clear standardized effect sizes are meaningless, and you need to determine important differences, as this is just basic science, but only a tiny handful of papers ever bothered.
So it feels very much like "how can we have normalized something so incredibly scientifically shaky", i.e. for me the moralizing is not "drugs are bad, how are we normalizing drugs" it is "how can an entire medical field and society so recklessly adopt something so obviously weakly supported". I.e. my dismay is more about the weak epistemic standards of society than it is about drugs.
The downsides to these drugs are pretty well understood and not generally that bad, right? Can we really say it's "reckless" to attempt to treat people with something that's fairly safe and see if it helps them?
This is what really rubs me the wrong way and makes me call it moralizing. There's this implicit foundation of "drugs bad" that's basically straight out of D.A.R.E. You're supposed to avoid drugs, but we might make an exception if they treat a serious problem and there are no alternatives.
Once in a while I'll take Tylenol or ibuprofen for a headache. Do they actually help? Hell if I know. Is it "reckless" to do this when I don't know if it actually does anything? Absolutely not. Antidepressants aren't as safe as those are, but at least some of them seem like they're safe enough to say, let's give this a try and see how it goes.