It is estimated that 13.1 to 14.2 million American adults suffer from clinical #depression and that 32 million will face the disease at some point in their life. Only roughly 57% ever receive treatment, but those that do seem to find relief in antidepressant medications, such as SSRIs, #tricyclics, and MAO inhibitors. However, whether or not it is actually the medication which is supplying that relief is up for debate. And this is exactly the debate that is bravely addressed by psychology researcher Irving Kirsch, in his book The Emperor’s New Drugs: Exploding the Antidepressant Myth, and which is addressed in Newsweek’s article “Why Antidepressants Are No Better Than Placebos”, by Sharon Begley.
Backed by Kirsch’s research, Begley writes that “Yes, the drugs are effective, in that they lift depression in most patients. But that benefit is hardly more than what patients get when they, unknowingly and as part of a study, take a dummy pill—a #placebo. As more and more scientists who study depression and the drugs that treat it are concluding, that suggests that antidepressants are basically expensive Tic Tacs.”
The placebo effect, “a medical benefit you get from an inert pill or other sham treatment” continues Begley, “rests on the holy trinity of belief, expectation, and hope.”
Begley goes on to point out that some researchers even wonder if “antidepressants are ‘a triumph of marketing over science’” and points out that “even defenders of antidepressants agreed that the drugs have ‘relatively small’ effects.” Kirsch’s study indicated that “patients on a placebo improved about 75 percent as much as those on drugs. Put another way, three quarters of the benefit from antidepressants seems to be a placebo effect.”
Further, it appears to that those small effects are really only evident in patients which exhibit severe levels of depression, not for the mild to moderate cases. Although any amount of depression is incredibly difficult, vastly overwhelming, and often simply unbearable, it seems that those suffering from the more mild to moderate levels could very well benefit greatly from treatment for depression without medication. Which begs the question… why then, since this study, has “the number of Americans taking antidepressants doubled in a decade, from 13.3 million in 1996 to 27 million in 2005”?
Psychology researcher Steven Hollon of Vanderbilt University reaffirms the pervasiveness of this placebo effect when he states that “many have long been unimpressed by the magnitude of the differences observed between treatments and controls… […] what some of our colleagues refer to as ‘the dirty little secret.’”
This is undoubtedly difficult for patients and doctors to hear. A doctor who has witnessed improvement in a patient wants to believe that the treatment they are prescribing is the basis for that improvement… otherwise, how does one really quantify or measure the efficacy of one treatment over another? But should this desire for standardization get in the way of a patient knowing the truth about his or her treatment options or prescriptions?
Psychotherapists could be excited at the prospect of an upsurge in talk therapy as opposed to medication. It has been shown that #psychotherapy is actually more effective than both pills and placebos, and carries a lower rate of relapse for sufferers of depression. Unfortunately, most people that currently seek treatment for depression are receiving such from their primary-care doctors, not from psychiatrists (as many do not accept insurance). Psychotherapy is just not a viable option for many patients.
Depression is devastating for the individual ensnared in its net, as well as often debilitating to the healthy functioning of entire families. If a pill provides some semblance of relief, even if only by way of a placebo effect, is that really such a bad thing? Perhaps not. But one must take into consideration the side-effects which often accompany antidepressant medications, the high cost for prescriptions, the high potentiality for relapse, as well as the difficult and painful symptoms which may arise with withdrawal from that particular medication. Could there be a better way? Are there other viable treatment for depression without medication?
Second Opinion Physician believes so.
See full article from Newsweek