[lbo-talk] Antidepressants and Placebos

Michael Pollak mpollak at panix.com
Thu Feb 28 21:11:28 PST 2008


On Thu, 28 Feb 2008, Andy F wrote:


>> Dr. Turner discovered that most studies with negative results were
>> never published in journals, and so doctors had no way of knowing how
>> poorly antidepressants have actually fared. While 94 percent of
>> antidepressant studies published in journals show antidepressants to be
>> more effective than placebos, only 51 percent of all registered studies
>> were determined by the FDA to show antidepressants superior to
>> placebos.
>
> NPR interviewed one of the authors of this study

Just for the record, if you're talking about this NPR interview on the Diane Rehms show (with Steve Roberts subbing as host):

http://wamu.org/programs/dr/08/02/28.php#18860

The co-author they are talking to (Blair Johnson) is actually the co-author of a different study, namely the one B posted on Tuesday, with Irving Kirsch as the lead author:

http://mailman.lbo-talk.org/pipermail/lbo-talk/Week-of-Mon-20080225/003949.html


> and he said the point was not that SSRIs don't work at all, just that
> their advantage over placebos was primarily in the severely depressed.

Interesting, FWIW, that seems the opposite of the conclusion of the article I posted (an summary analysis built largely on yet a third article, in the New England Journal of Medicine, lead author Erick Turner), which suggested the studies were biased towards the symptoms of mild depression because SSRIs had better results there.

So I guess, as they say, more research is needed :o)

What would be interesting if these two peer-reviewed studies -- one a survey of studies, and one a single study -- were taken seriously and people tried to seriously test this hypothesis. I think the one thing both articles get across is that wrong or right, the hypothesis seems, rather amazingly, to have not been seriously tested. But we certainly have the tools for testing it scientifically. It's not a matter to settle by argument.


> Interestingly, he also suggested that taking advantage of the placebo
> effect has therapeutic value.

Absolutely. All of modern medicine is founded on the reality of the placebo effect. Until we admitted its reality -- that it always showed up, and usually in incredibly large amounts, no matter what scientific criteria we used to measure success -- we couldn't filter it out. The placebo effect is not a fake effect. It's just one we can't explain and try not to think about because it feels funny.

And it's not trivial to say that because of the belief system that formed our identities, most of us can only believe with real force in medical help that is scientific and costs money. So without this apparatus, a placebo effect probably couldn't be produced on a mass scale in our society.

Hmmm. On that reasoning, maybe we should leave well enough alone :o) Who would be helping if we disproved them?

Michael



More information about the lbo-talk mailing list