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Do Anti-Depressants Work? It Very Well Might Be the Placebo That Does the Trick

Psychologist Irving Kirsch unveils the ineffectiveness of antidepressants and suggests there's more to the placebo effect than once imagined.

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And yet I remain convinced that antidepressant drugs are not effective treatments and that the idea of depression as a chemical imbalance in the brain is a myth. When I began to write this book, my claim was more modest. I believed that the clinical effectiveness of antidepressants had not been proven for most of the millions of patients to whom they are prescribed, but I also acknowledged that they might be beneficial to at least a subset of depressed patients. During the process of putting all of the data together, those that I had analyzed over the years and newer data that have just recently seen the light of day, I realized that the situation was even worse than I thought. The belief that antidepressants can cure depression chemically is simply wrong.

Evidence that was known to the pharmaceutical companies and to regulatory agencies was intentionally withheld from prescribing physicians, their patients and even from the National Institute for Health and Clinical Excellence (NICE) when it was drawing up treatment guidelines for the National Health Service (NHS) in the UK.

My colleagues and I obtained some of these hidden data by using the Freedom of Information Act in the US. We analyzed the data and submitted the results for peer review to medical and psychological journals, where they were then published.

Our analyses have become the focus of a national and international debate, in which many doctors have changed their prescribing habits and others have reacted with anger and incredulity. My intention in this book is to present the data in a plain and straightforward way, so that you will be able to decide for yourself whether my conclusions about antidepressants are justified.

The conventional view of depression is that it is caused by a chemical imbalance in the brain. The basis for this idea was the belief that antidepressant drugs were effective treatments. Our analyses showing that most – if not all – of the effects of these medications are really placebo effects challenges this widespread view of depression.

As controversial as my conclusions seem, there has been a growing acceptance of them. NICE has acknowledged the failure of antidepressant treatment to provide clinically meaningful benefits to most depressed patients; the UK government has instituted plans for providing alternative treatments; and neuroscientists have noted the inability of the chemical-imbalance theory to explain depression. We seem to be on the cusp of a revolution in the way we understand and treat depression.

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Dr. Irving Kirsch is professor of psychology at the University of Hull, UK, and professor emeritus at the University of Connecticut. His research has been published in the British Medical Journal as well as the New York Times , Newsweek, and more.

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