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Can Antidepressants and Other Depression Cures Really Be Placebos?

Posted: 24/02/2012 00:00

Irving Kirsch of Harvard Medical School has certainly reignited debate in regards to antidepressants and placebos following his stint on CBS's 60 Minutes.

The prestigious medical school's Director of Placebo Studies has apparently run out of other drugs to look at under a microscope and taken a swipe at antidepressants.

There has been plenty of - often shouty - debate as to whether these drugs work, mixed in with the odd 'governmental mind control' conspiracy theory but why is this area of the industry targeted? Why not other prescription drugs? Or even recreational drugs?

Always our beloved antidepressants.

Kirsh has been studying placebos for 36 years and says mere sugar pills can treat irritable bowel syndrome, ulcers and Parkinson's disease - and now he says they've been curing all manner of mental health illnesses for years.

When pushed for a direct answer from a CBS reporter, Lesley Stahl, he said: "The difference between the effect of a placebo and the effect of an antidepressant is minimal for most people."

"They'd have almost as large an effect and whatever difference there would be would be clinically insignificant."

Stahl bites back at the professor: "But people are getting better taking antidepressants. I know them."

"People get better when they take the drug. But it's not the chemical ingredients of the drug that are making them better. It's largely the placebo effect," Kirsh says.

Michael Thase of the University of Pennsylvania says that his research found that antidepressants help up to 14% of people who are 'moderately depressed'. Those statistics increase drastically for those who are considered 'severely depressed'.

Thase added: "I wish our antidepressants were stronger. I hope we have better ones in the future."

"But that 14% advantage over and above the placebo is for a condition that afflicts millions of people, that represents hundreds of thousands of people who are better parents, who are better workers, who are happier and who are less likely to take their life."

Although Thase and Kirsh disagree, the fact that some placebo effect exists, especially in the less severe cases, remains untouched - but to what degree?

In the UK, we had a complete overhaul of the way these drugs were prescribed as the NHS commissioned its own review of clinical trials.

The NHS discovered that for 'mild to moderate depression', these drugs have little or no effect on the patient - did you know this? I didn't.

Whilst I knew that how effective the drug was depended on the severity of the depression, I didn't know that the NHS did not now prescribe to those deemed to have 'mild symptoms'.

Does nobody else see a major flaw in Kirsh's idea? Kirsh - and many, many before him - are attempting to enlighten the antidepressant taking population.

They want us to 'understand' that our SSRIs, our SNRIs, our MAOIs and our Tricyclic antidepressants are in fact useless and that they only work because we feel so strongly that they're medical miracles.

Well don't you see? Call me a conspirator, but this looks reasonably obvious - if Kirsh were to be correct, and we suddenly saw the light, wouldn't our medication stop working instantly?

If we did view them as placebos, then the placebo effect would cease to exist and we would all fall back into depression.

Surely, even if all antidepressants are only 2% effective and 98% placebo, the worst thing we can do is prove it.

 

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07:27 AM on 02/29/2012
I think that for those who really suffer with a mental illness placebos obviously do not work. The real issue this points to are the number of people who are misdiagnosed or use mental illness as an excuse for bad behavior (http://wp.me/pydAP-1KQ). So I do not believe in placebos.

Of course this did not prevent Glaxo SmithKline from amongst other indiscretions try to pawn off placebo antidepressants on an unsuspecting public . . . something for which they were heavily fined (http://wp.me/pydAP-1Dh).
05:12 AM on 02/29/2012
If the placebo effect is true then why don't all of the anti-depressants work? I've tried many and only certain one's work. I believed all of them would work but only a few helped me. You also have to find the right combination with mood stabilizers. I believed in all of these combo's and yet only a few work. Sorry, but I don't believe in the placebo.