More and more people around you are being diagnosed with depression or ADHD, but is that an illusion?
We all know about the placebo effect. But a Harvard Medical School professor has applied the same theory to antidepressants and his findings are likely to rile drugmakers. Why? He filed Freedom of Information Act requests to obtain unpublished clinical trial data and found that, when combining results with published data, the various antidepressants were no better than dummy pills.
“These are the studies that show no benefit of the antidepressant over the placebo. What they did was they took more successful studies – they published most of them – and they took their unsuccessful studies, and they didn’t publish that…. If they were mildly or moderately depressed, you don’t see a difference at all. The only place where you get a clinically meaningful difference is at these very extreme levels of depression,” Irving Kirsch tells 60 Minutes.
I first took a close look at treatments for mental illness 15 years ago while researching an article for Scientific American. At the time, sales of a new class of antidepressants, selective serotonin reuptake inhibitors, or SSRI’s, were booming. The first SSRI, Prozac, had quickly become the most widely prescribed drug in the world. Many psychiatrists, notably Peter D. Kramer, author of the best seller Listening to Prozac, touted SSRI’s as a revolutionary advance in the treatment of mental illness. Prozac, Kramer said in a phrase that I hope now haunts him, could make patients “better than well.”
Clinical trials told a different story. SSRI’s are no more effective than two older classes of antidepressants, tricyclics and monoamine oxidase inhibitors. What was even more surprising to me—given the rave reviews Prozac had received from Kramer and others—was that antidepressants as a whole were not more effective than so-called talking cures, whether cognitive behavioral therapy or even old-fashioned Freudian psychoanalysis. According to some investigators, treatments for depression and other common ailments work—if they do work—by harnessing the placebo effect, the tendency of a patient’s expectation of improvement to become self-fulfilling. I titled my article “Why Freud Isn’t Dead.” Far from defending psychoanalysis, my point was that psychiatry has made disturbingly little progress since the heyday of Freudian theory.
We spend more than £250 m a year on antidepressants in the UK – and it’s a complete waste of money. They are not much better than sugar pills, they have nasty side – effects, such as sexual dysfunction, and they increase young people’s risk of suicide. New research shows they don’t even work on the brain in the way we thought they did.