Should We Take A Placebo??

[4Maddie44]

I have just read in my newspaper (The Daily Mail in the UK) that anti-depressants are a complete waste of money, and we may as well take a placebo.

It states new research shows they don't even work on the brain in the way we thought they did.  For years we were told depression was caused by low levels of serotonin  in the brain and that anti-depressants boosted it.  Now it is found that rather than low levels, depressed people might have DOUBLE the amount of serotonin in parts of their brain.  

The doctor who wrote the article, said the only reason anti-depressants worked was because of the placebo effect.

Now I would say that anti-depressants have saved me from a life of deep depression.  But this doctor claims that the  placebo effect is particularly strong in treating depression.  He states that in drug trials there was little difference between anti-depressants and placebos.  He thinks drug companies know this, but hide the fact, because of huge profits.

The doctor's name is Irving Kirsch and he is professor of psychology at ther Un iversity of Hull, UK.  His b ook about this is called, "The Emporer's New Drugs: Exploding The Antidepressant Myth."

Well I would rather take a sugar pill, if it worked, than chemicals.  What do other people think??

[4Maddie44]

The article mentioned above can be found on www.dailymail.co.uk/health/article-129971/whyanti-depressants are simply a confidence trick

[4Maddie44]

Surely a placebo would only work if we were not told it was a placebo,

I truly believe that antidepressant medication has saved me from a life of deep depression.  Articles like this make me question why I am taking medication.  Quite upsetting.

[Paxiled]

First of all, anti-depressants don't increase the amount of serotonin or any other neurotransmitter, so the author has got that wrong.  They inhibit the breakdown of used serotonin so it can be used longer.  There is no evidence anyone has more or less serotonin than anyone else, and that isn't the point.  What the author also doesn't mention about placebo is that, although it's true anti-depressants don't beat placebo by much in trials, placebo effects wear off fairly quickly while the medication keeps working.  On the other hand, psychotherapy is premised on changing a person's thinking, and if a placebo helps to do that, than it would be much better than an actual med because there wouldn't be side effects.  But that isn't really a placebo effect, that's a real effect, isn't it?

[M4Y0U]

There are two things you must know on the Daily Mail. 1. The Daily Mail is very biased. 2. The Daily Mail is wrong.

What we have here is a very biased psychology professor with poor understanding of neurobiology.

Our understanding of neurobiology underlying depression is actually pretty good. We tested it and most biological depression are caused by a lack in one or many of the monoamine transporters (serotonin, dopamine, norepinephrine).

Our understanding of the the placebo effect on the other hand is very limited. The impact of beliefs on our biology are not quite well understood. I support the idea that we should use the placebo effect to our advantage but in some case it can be dangerous. Take homeopathy for example, they claim to be able to heal everything. This can be very dangerous for someone suffering from a threatening illness. Hemeopathy is a perfect example of using the placebo effect since homeopathy have no scientific evidence and no active ingredients other than warer, it is against the principles of chemistry. The principle of chemistry are clear and with the extreme dilutions homeopathy is using, the result is a product with no active ingredient and only water. Test it if you want, you can drink as many bottle of homeopathic remedies and you won't overdose nor be harmed more than drinking water.

It is true that some SSRIs and SNRIs can be useless with insignificant results compared to placebo because sometimes it's not just about keeping serotonin in the synaptic cleft but sometimes you need to antagonize serotonin receptors which would suggest an increased serotonin. Sometimes a person just need more dopamine or norepinephrine, not just serotonin.

Depression linked to high levels of serotonin is just not true and have no scientific evidence.

Please note that I studied both neurobiology (and biology) and psychology. I am a defender of evidence-based-medicine (EBM).

I would like to see any reference of the Daily Mail article. There is probably none.

http://www.leyton.org/2008/05/09/why-the-daily-mail-is-a-bad-thing/

M4

[ufcfan]

I've read some reports that a lot of doctors have written regarding antidepressants being just a wast of money and I can't understand what they're talking about. To me that's like saying that a schizophrenic doesn't need to be on any medication and they should be given a placebo. If someone tried to give me a sugar pill and told me that it was an antidepressant I feel like I would know if it weren't because I feel a difference in the medications that I've tried since I first started taking antidepressants. I felt a decrease in depression when I started taking Celexa but, I had to stop taking it because of the sexual side effects and what the medication did to my stomach. I take Welbutrin now and feel better and seem to also have more energy and my sex drive back. To me it seems like if I didn't notice a difference in the physical and mental effects then I would see an argument for the placebo effect but, I feel better. Not perfect but better. So if it was just as simple as giving someone a pill and telling them they'll feel better then I wouldn't have noticed a difference in the medications. I understand where some of these doctors are coming from but, it just seems off to me. I take a laundry list of medications and I have a counselor so to me it's important to utilize the medicine as well as therapy to work through the issues that a lot of us face. I can see using a placebo to see if someone is faking a mental illness. Like I said, take a schizophrenic or even someone with a severe bipolar disorder off of their perphenazine  or lithium and see how quick things go sour for them. Like I said, this is just my opinion. Tom Cruise said he read a lot of books but, that don't make him a doctor!

[slim_runderpants1009]

I feel that we should take the placebO only if we do not know we are taking the placebo  as we can trick ourselves into thinking that we are taking the actual antidepressant and therefore think we are getting better and so start to feel better because we are convinced the "antidepressant" is working. However, I feel we should not take the placebo if we know about it as we know it is not the real drug and therefore do not trick ourselves into thinking that we are getting any better. Thus staying in the state we are in.