Power Of Placebo And The Antidepressant…

Prozac was a popular antidepressant in the 90’s after being recommended for considerable personality transformations by best selling author Peter Kramer. Then became a backfire of stories in the 2000’s of Prozac and other SSRI’s causing suicidal thoughts among teens.

In 2008 studies suggested that the drugs were in fact no more effective than placebo’s, except for cases of the most severe depression.

Recent study published has sought findings to help explain the paradox on SSRI’s.

The technique known as growth mixture modelling, allowed authors to track individuals and as to whether they improved or worsened over time in response to medication or placebo response. The researchers found that approximately three quarters of patients improved on medication than on placebo and that just under a quarter of patients did not respond well to drug treatment and actually became worse on the SSRI’s than patients that were given a placebo.

The benefits of ‘growth- mixture modelling’ is that it reveals treatment pathways of patients rather than an average outcome.

”This haas huge implications for understanding the effectiveness of our current system of medication”.

The data questions on how much demonising of antidepressants linked to just a placebo response. It definitely raises awareness that some patients are better off on a placebo

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Irving Kirsch, professor of psychology at the University of Hull, said ”while many people may benefit from antidepressant treatment (although most of them to a degree that is not clinically significant), about 1 in 4 are made worse.”

“What makes this particularly problematic is the fact that we don’t know who these people are,” Kirsch says. “Although placebo may not be a viable treatment option, there are other treatments that on average work as well as antidepressants, [such as] physical exercise and cognitive behavioral psychotherapy. As far as we know, these alternatives don’t make people worse.

“This suggests to me that antidepressants should be kept as a last resort, and if a person does not respond to the treatment within a few weeks, it should be discontinued,” says Kirsch.

A separate trial published in the American Journal of Psychiatry (AJP) in December highlights other potential complications. The authors of that paper report that since 1980, the percentage of depressed patients responding to a placebo in clinical trials has risen by 7% per decade, reaching 50% in some studies. In history often patients of severe cases of depression from psychiatric hospitals were recruited for studies. However today often people who have less severe symptoms get put through trials from advertisements and are often paid, this causes a slight problem amongst findings, if you consider that maybe the very depressed wouldn’t even be able to answer an advertisement, whilst the less depressed might be persuaded to exaggerate symptoms of depression in order to be able to do the trial in the first place.

Given the complex nature of the study of antidepressants, it seems that data analysis will steadily grow, until scientists can figure out a root that bearing in mind that antidepressant could backfire for them in the future.

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