[lbo-talk] Debate Resumes on the Safety of Depression's Wonder Drugs

[Wojtek Sokolowski]

> I know this is a common claim, but at the individual level,
> it's impossible to verify.  The problem here is placebo
> effects: in any one case, it's impossible to untangle the
> effects of positive expectations about the therapy from
> the actual effects of the therapy itself.  --And placebo
> effects are not trivial for SSRIs: 50-70% of the positive
> therapeutic effects of SSRIs at the group level can be
> attributed to placebo effects, as assessed in double-blind
> placebo-drug trials.  This doesn't mean Prozac is useless;
> it just means the success of Prozac therapy
> is substantially improved by positive
> expectations about the drug.
> 
> Miles

1. People with affective disorders often do not have any positive
expectation about their medication because of its side effects.  In
fact, a frequently expressed opinion by people with such disorders is
that their medication does not cure, but makes their disorder more
bearable.

2. That affective disorders are caused by brain chemistry rather than
life circumstances or a "wrong attitude" is pretty well established. So
is the fact that SSRIs do affect that chemistry.  Still uncertain is
what actually causes the "chemical imbalance" that produces affective
disorders. 

3. A suggestion that affective disorders can be cured by changing the
person's attitude rather than his/her brain chemistry smells of new age
quackery - akin to faith healing or efforts to "cure" gay people by
proper therapy.

Wojtek