Do antidepressants actually work to treat depression? They do have some effect, although in most studies the effect is barely distinguishable from the placebo control.
Irving Kirsch, a psychiatry professor in the UK, first discovered this through his interest in the placebo effect. His recent article, Antidepressants and the Placebo Effect(1), explains. The following are the most important points:
The reason why both patients and doctors become “unblinded”, that is, they guess that they’re getting medicine, is because antidepressants have side effects, like insomnia and sexual dysfunction.
Kirsch remarks, “In the data sent to us by the FDA, only 43% of the trials showed a statistically significant benefit of drug over placebo. The remaining 57% were failed or negative trials.”
The FDA requires two clinical trials showing benefit before drug approval. But pharmaceutical companies are allowed to keep trying until they get two good trials, hence the negative trial’s don’t count.
Furthermore, Kirsch carefully distinguishes between statistical benefit and clinical benefit, and he says that in almost all cases, the minute statistical benefit would not be enough for doctors to notice or for actual benefit to the patient.
As in so many other cases, this is now all about money. Big Pharma isn’t about to let go of its cash cows, and it has enablers in the FDA and among bought-and-paid doctors and scientists.
If serotonin “imbalance” doesn’t cause depression, what does? Depression is an inflammatory disease. Anything that fights inflammation will fight depression: exercise, weight loss, low-carbohydrate diet, curcumin, etc.
PS: This post is shorter than usual. I have such a backlog of things that I want to write about, but I’m too busy to write thousand-word articles about them, so I may try a few of these shorter pieces.
PPS: Slightly related: check out the list of side effects of another psychoactive drug, Aricept, used to treat dementia.