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.