Are modern anti-depressants merely placebos?

At Discover Magazine, psychologist Irving Kirsch argues that the current generation of anti-depressants don't really address specific chemical imbalances. He argues that they function at all because they are placebos:

[Current anti-depressants such as Prozac] all have different and in some cases opposite effects on brain chemistry, and yet they all show exactly the same response rate. It’s uncanny! That suggests it’s really the placebo effect that is helping the patients. In practice, all the different antidepressants have the same response rate. In a population of depressed people, they all work equally well. If they were actually correcting chemical imbalances, it would mean that the exact same number of people who are depressed have each kind of chemical imbalance: The proportion of people who have too much serotonin is exactly the same as the fraction who don’t have enough norepinephrine. The odds against that are astronomical.

I hope this makes it clear that I'm an equal opportunity skeptic. I don't merely pick on alternative, fringe and fraudulent treatments (e.g., homeopathy).

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Placebos and magic

At TED, magician/comedian Eric Mead discusses "The Magic of the Placebo." Based on the studies considering reports of patients, it turns out that needles injecting inert substances are more powerful than blue-colored pills containing inert substances, which are more powerful than white pills, which are more powerful than tablets. No active ingredient in any of these, yet we see predictable differences in the power of these "medicines." Belief is what makes placebos work. But YOU are not so naive as to be taken in by something with no active ingredient, right? If you're squeamish about needles, you'll find this talk extra-interesting. After viewing this video, I saw the story-telling power of Hollywood in a new light.

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Backhanded celebration of homeopathy

It's homeopathic awareness week! Neurologica wants to take full advantage:

According to the British Homeopathic Association . . . June 14-21 is Homeopathy Awareness Week. I would like to do my part to increase awareness of homeopathy. . . I am all in favor of homeopathic awareness. The scientific community should use this week to make the public acutely aware of the fact that homeopathy is, put simply, utter rubbish. Neurologica has put together a detailed account of the world's most over-embellished version of the placebo effect. Consider the homeopathic advocates' arguments for why homeopathic drugs can't be tested:

Many homeopaths have argued that homeopathy cannot be subjected to the same type of studies as are conventional drugs. This is because each patient, from a homeopathic perspective, is unique, and cannot be lumped into a single category. Whereas conventional medicine can compare treatments of 1000 diabetics with two different medications, homeopaths cannot produce large numbers of patients with the same totality of illness requiring the exact same treatment. In making this argument, that of untestability, such homeopaths are securing their position in the halls of pseudoscience, for if their is one single quality which separates scientific theories from nonscientific ones, it is falsifiability. If homeopathic remedies cannot be tested, then they can never be grounded in science.

Neurologica's article is well written and well documented. I agree entirely.

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If you are taking the anti-depressants Prozac, Effexor, Paxil or Serzone, don’t read this post.

Are they gone?  Are all the millions of people who take Prozac, Effexor, Paxil and Serzone-who-are-not-severely-depressed gone?  Good.  Now we can talk. The rest of you have probably already read the news that:

Antidepressant medications appear to help only very severely depressed people and the drugs work no better than placebos in many patients, British researchers said Tuesday.

Why would the news media ever report the truth regarding these wildly-hyped antidepressants?   After all, scientists have long known that most of the power of these drugs is in the placebo effect.  Or, at least, scientists should have suspected this, because the FDA was refusing to release the full data sets regarding these drugs trial, at least until the good scientists who work on this new report (Prof Irving Kirsch and colleagues) requested “the full data under freedom of information rules from the Food and Drug Administration, which licenses medicines in the US and requires all data when it makes a decision.”  Gosh, it appears that some of the relevant data wasn’t available to the forty million people taking these drugs, until long after the release of these drugs through massive corporate guerilla marketing.

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In its advertisements, the manufacturer of Prozac, Lilly, doesn’t say anything about the drug not working well for large numbers of the patients for whom it was being prescribed.  In fact, Lilly makes this claim:

The safety and effectiveness of PROZAC have been thoroughly studied in clinical trials with more than 11,000 patients. There have been more than

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Continue ReadingIf you are taking the anti-depressants Prozac, Effexor, Paxil or Serzone, don’t read this post.