This is another one of those articles that sat in my drafts for a long while and needs out. The original story is out of Newsweek, but I found it via a column in the San Fransisco Chronicle.
The Newsweek article is quite long but worth a read. I’ll just focus on the beginning where it goes into the history of a study done in 1998 comparing the effectiveness of various anti-depressants versus their placebo counterparts. They tracked 38 different drugs for usefulness (based on research done by the very companies that supplied them), with 3000 patients taking part. The authors of the study were psychology researchers Irving Kirsch and Guy Sapirstein of the University of Connecticut. It was a good study, but:
when Kirsch compared the improvement in patients taking the drugs with the improvement in those taking dummy pills—clinical trials typically compare an experimental drug with a placebo—he saw that the difference was minuscule. Patients on a placebo improved about 75 percent as much as those on drugs. Put another way, three quarters of the benefit from antidepressants seems to be a placebo effect. “We wondered, what’s going on?” recalls Kirsch, who is now at the University of Hull in England. “These are supposed to be wonder drugs and have huge effects.”
The study’s impact? The number of Americans taking antidepressants doubled in a decade, from 13.3 million in 1996 to 27 million in 2005.
Bold is mine here.
Kirsch is well aware that his book [The Emperor’s New Drugs: Exploding the Anti-depressant Myth] may have the same effect on patients as dropping the magic feather did for Dumbo: without it, the little elephant began crashing to earth. Friends and colleagues who believe Kirsch is right ask why he doesn’t just shut up, since publicizing the finding that the effectiveness of antidepressants is almost entirely due to people’s hopes and expectations will undermine that effectiveness.
I say it’s better to understand that than forever live without knowing you’ve been fleeced. People who think they need pills to combat their moods should be aware that the meds will work better if they expect them to work. Any doubt about it will limit their effectiveness. Positive thinking does have good uses from a health perspective. Fostering optimism, yeah?
As to that Chronicle article, Mark Morford takes things a step further by introducing religion and faith into it, as people are often told that all they need is to accept Jesus Christ as their personal saviour and then things will turn out okay. He also brings in a money angle.
The organized religion racket rakes in hundreds of billions a year, and requires a massive toll in guilt, shame, dogma, homophobia, war, pedophilia and sexual hysteria. The antidepressant market runs $10 billion a year and makes millions into casual addicts, convincing many they are powerless to get better without chemical assistance.
Morford also mentions a study done with psychedelics that I could have sworn I wrote about but I guess it got missed. LSD (or MDMA or psilocybin) really can alter mood for the better, and long-term, if done carefully. His link to the study is dead but a New York Times article from April offers up some information.
The results so far are encouraging but also preliminary, and researchers caution against reading too much into these small-scale studies. They do not want to repeat the mistakes of the 1960s, when some scientists-turned-evangelists exaggerated their understanding of the drugs’ risks and benefits.
Because reactions to hallucinogens can vary so much depending on the setting, experimenters and review boards have developed guidelines to set up a comfortable environment with expert monitors in the room to deal with adverse reactions. They have established standard protocols so that the drugs’ effects can be gauged more accurately, and they have also directly observed the drugs’ effects by scanning the brains of people under the influence of hallucinogens.
Whichever article I’d read about this (probably that yahoo one he’d linked) stated that one hit was all it took, too – a second would never be necessary. Morford also points out the monetary aspect of that – no pill manufacturers have patents on that stuff and therefore can’t make any money off this treatment. And besides, what company would ever want an easy single-use solution when they can get people into the rut of years and years of expensive refills?
Kirsch was clear about not wanting people to drop their drugs cold-turkey, though. Withdrawal symptoms are a bitch and even if people are feeling better with the drugs, they may as well keep using them instead of going through that. But if anyone’s on anti-depressant drugs and pondering the decision to get off them, look to your doctor to help you wean yourself away in stages. The idea is to get better, not do yourself more harm in the process.