Depression: placebo vs prescription drugs
Posted by Mike Furci (01/19/2011 @ 9:41 am)
Those who study depression and the drugs that treat it are concluding that antidepressants are no different than a placebo or “sugar pill”.
Placebos are widely used when studying pharmaceuticals. E.g., in a controlled clinical trial, one group will be given the real medication while another group is given a placebo in order to observe if the effects of the drug are due to the medication or to the power of suggestion.
Research has found that patients do improve on SSRIs, tricyclics, and even MAO inhibitors. This conclusion is the basis for blindly prescribing antidepressants to anyone who complains of being depressed.
When researchers compare the improvement in patients taking medication, however, with the improvement in those taking a placebo, they find that the difference is minuscule.
The magnitude of benefit of antidepressant medication compared with placebo increases with severity of depression symptoms and may be minimal or nonexistent, on average, in patients with mild or moderate symptoms. For patients with very severe depression, the benefit of medications over placebo is substantial.
These trials comprised 10030 depressed patients who participated in 52 antidepressant clinical trials evaluating 93 treatment arms of a new or established antidepressant. Fewer than half (48%, 45/93) of the antidepressant treatment arms showed superiority to placebo.
Int Jour of Neuropsychopharmacology
Despite the failure of prescription drugs when compared to a placebo for mild to moderate depression, the number of Americans taking antidepressants doubled in a decade, from 13.3 million in 1996 to 27 million in 2005. Is this increase due to an increase in the prevalence of severe depression? Of course not. Walk into a doctor’s office and complain about being depressed; most will prescribe an anti-depressant on the spot. Th...