Psychology: "Antidepressants: The Emperor's New Drugs? "
by Dr. Irving Kirsch
"Antidepressants are supposed to be the magic bullet for curing depression. But are they? I used to think so. As a clinical psychologist, I used to refer depressed clients to psychiatric colleagues to have them prescribed. But over the past decade, researchers have uncovered mounting evidence that they are not. It seems that we have been misled. Depression is not a brain disease, and chemicals don't cure it.
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As you might imagine, our study was very controversial. How could these drugs, which account for about 15 percent or all prescriptions in the US, be placebos? The antidepressants we studied had been approved by the FDA. If they were just placebos, why did the FDA approve them?
To answer these questions, my colleagues and I used the Freedom of Information Act to get the data that the drug companies had sent to the FDA in the process of getting their medications approved. What we found was even more shocking that what our 1998 study had shown. The difference between drug and placebo was even smaller in the data sent to the FDA than it was in the published literature. More than half of the clinical trials sponsored by the pharmaceutical companies showed no significant difference at all between drug and placebo. What they did find was differences in side effects, like nausea and sexual dysfunction, produced by antidepressants; and the FDA later determined that SSRIs, the most common type of antidepressants, actually increases the risk of suicide for children, adolescents and young adults.
In the 1990s, Director/ Producer Kevin P. Miller began producing documentaries about the great social issues of our time. Miller investigates collusion between pharmaceutical manufacturers and their regulatory watchdogs at the FDA, and also questions whether we have forced millions of children onto pharmaceutical drugs for commercial rather than scientific reasons. So why did the FDA approve these drugs? All they require is that there are two trials showing a statistical difference between drug and placebo. The drug company might have conducted 10 trials, and most have them might have failed to show positive results. Still, if there are two trials that have been successful, the antidepressant can be approved. And even in these two successful trials, it doesn't matter how large the drug effect is. It can be small enough to make no real difference in people's lives. It doesn't have to be clinically significant; it just has to be statistically significant.
Fortunately there are alternatives to treatment with dangerous but largely ineffective drugs. Psychotherapy works, and some types of therapy have been shown to be much more effective than antidepressants over the long run. Physical exercise also works, and at least for mildly depressed people, there are self-help books like David Burns's Feeling Good, that have been tested in clinical trials and found to be effective. So if you're feeling blue, you may not have to take pills to get better. Instead, talk to your doctor about safer and more effective alternative treatments."
Fortunately there are alternatives to treatment with dangerous but largely ineffective drugs. Psychotherapy works, and some types of therapy have been shown to be much more effective than antidepressants over the long run. Physical exercise also works, and at least for mildly depressed people, there are self-help books like David Burns's Feeling Good, that have been tested in clinical trials and found to be effective. So if you're feeling blue, you may not have to take pills to get better. Instead, talk to your doctor about safer and more effective alternative treatments."
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