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V_V comments on Rationality, Transhumanism, and Mental Health - Less Wrong Discussion
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For any given antidepressant there are a few studies that show that they work. Even for homeopathy there are studies that it works.
You said that it's off-label to use the drug as antidepressant. That probably means that the FDA thinks that the studies that exist don't provide enough evidence for it being a good antidepressant.
How do you know that rebuilding the specific synaptic connections they studied isn't treating symptoms but causes?
Different people are depressed for different reasons. People who get serious head insuries are more likely to develop depression. If you have a way to address the causes of depression within one person, you don't necessarily have a way to address it for the next person.
According to Wikipedia there are small studies that seem to show a short-term antidepressant effect, but their size and methodological quality appears to be insufficient to consider them conclusive evidence. There seems to be nothing on long-term effects.