A group of researchers actively engaged in antidepressant clinical trials wrote that the findings were not new. How is it that no one did this before? Antidepressants have side effects, and when a patient experiences these side effects, they know that they are in the drug group rather than the placebo group. Inactive placebos do not cause side effects. What we did is called a meta-analysis, and it is a common technique for making sense of the data when a large number of studies have been done to answer a particular question. For an antidepressant medicine to actualize its usefulness in the eyes of consumers, individuals need to be diagnosed by trusted authorities as being clinically depressed. He lives in Hull, England.
But I also believed that antidepressant drugs added something substantial over and beyond the placebo effect. Four types of treatment were analyzed: antidepressant medication, psychotherapy, placebo, and no treatment. This was repeated through much of Europe, the United States, Canada, Australia, and China. When I began to write this book, my claim was more modest. Maybe the chemical theory of depression is not completely invalid after all.
Web links were active as of the time the paper was posted but are not updated. When a person guesses they are taking the active drug their expectations change. There is Navigation menu in the top-right of every page. As much as 40% of data on antidepressants is never published, nor made available to researchers and doctors. He gathered the results from thirty-eight clinical trials involving over 3,000 depressed patients that had been published in leading medical journals. In fact, 80% of patients in clinical trials guess correctly which group they are in, mainly due to the presence of side effects. I believed that the clinical effectiveness of antidepressants had not been proven for most of the millions of patients to whom they are prescribed, but I also acknowledged that they might be beneficial to at least a subset of depressed patients.
Instead of curing depression, popular antidepressants may induce a biological vulnerability making people more likely to become depressed in the future. After publication, the surprise was of a different nature. As we have seen, when a patient knows they are receiving a prescribed drug for a specific condition, the efficacy of that drug significantly increases. Do they work, or are they no better than placebos? The trial was then repeated with the same antidepressant. But I also support many of the programs that we refer to that do their best to reduce multiple medications for adolescents and attempt to minimize the use of pharmaceuticals. In chronically hospitalized depressed patients, 60 percent of 58 imipramine-treated patients improved, compared with 16 percent of 64 placebo-treated patients.
When it did work, I assumed it was the active ingredient in the antidepressant that was helping my clients cope with their psychological condition. I suspect this actually translates to lost profits rather than the well-being of depressed patients. Similarly, books are not available to purchase directly from OnlineBookClub. This relationship, coupled with the disclosure of manipulated data, eventually led to officials from the regulatory agencies of the European Union to ask how some antidepressants were ever approved. As a clinical psychologist, I referred depressed psychotherapy clients to psychiatric colleagues for the prescription of medication, believing that it might help.
Pharmaceutical companies were quick to see the significance of this research, leading to the development of different classes of antidepressants. Depression, we were told, is an illness — a disease of the brain that can be cured by medication. To this end, placebo treatment has moved far beyond giving a sugar pill to patients suffering from an undetermined illness. The therapeutic benefit of antidepressants over placebos is not backed up by evidence-based medicine. Irving Kirsch conducted a meta-analysis of clinical studies that examined the effectiveness of various treatments for depression.
This does not mean that depression does not exist. But finding a representation of depression in the brain does not mean it is caused by a chemical imbalance or a physical illness. Important Note about Bookshelves and OnlineBookClub. Irving Kirsch raises a number of concerns with pharmaceutical drug trials that have distorted the data and improves the chances of them successfully getting their drugs to market. In contrast, almost all thirty-six trials demonstrating negative results were suppressed.
This is not a book about alternative medicine and its outlandish claims. One of his suggestions is exercise, which he says is most effective for moderate to severe depression. He was seemingly on solid ground in this assumption. Please tell us how to improve this website! In cognitive behavioral therapy, the patient is actively working on observing behaviors and thoughts and then changing them based on discussions with the therapist. Using this complete data, he discovered that there was even less of a drug effect for antidepressants than that suggested by the published literature.
So that means you can jump down to the section below to see the full list of what other members have put this book on their have-read or to-read lists. Yet the author retained some doubts as not all his patients were helped by antidepressants. Expensive placebos also work better than cheaper ones. How could it be that these drugs worked as effectively as antidepressants? An active drug that causes statistically significant improvements in patients may not cause significant clinical improvements, which is achieved by a minimum reduction of three points on the Hamilton rating scale for depression Irving Kirsch, 2010, pg. The book constantly reiterated that antidepressants are hardly more effective than placebos.