Comments on: Anti-depressants and the placebo effect

By: Matthew Howard

Matthew Howard — Sun, 08 Nov 2009 22:36:22 +0000

Hey, thanks for writing such a great article. It is very interesting how people are so adament in their support for these drugs when even the manufacturer admits that they do not know physiologically/chemically what causes depression. The brain is a very complex organ, and science has yet to truly understand how it functions. The idea that you can try a variety of drugs for a chemical imbalance which is never measured is absurd. The Pharmaceutical industry has one motive, profit. There is no watch dog to protect consumers from dangerous products like these. This can be illustrated very well by the FDA’s approval of the artificial sweetener aspertame. This substance is correlated with brain tumors in mice, yet the FDA approved the substance as safe for public consumption. People are not mice, but they function physiologically the same. They react to carcinogens and other drugs in exactly the same way. Both develope cancers when exposed to benzene for example.

By: A Person

A Person — Thu, 05 Nov 2009 22:20:51 +0000

“I did not state you should treat ADHD with depressants, I said you do. That does not mean it is the only treatment.”

No, you do not treat ADHD with depressants. ADHD is treated almost entirely with stimulants. It is sometimes treated with other drugs, but never depressants. The idea of treating ADHD with a depressant is frankly ridiculous, as that would make the problem worse. It’d be similar to treating someone with hemophilia with an anti-clotting agent. It boggles my mind to see how anyone could make such a ridiculous statement and still claim to have any knowledge about the subject.

By: Chris

Chris — Tue, 08 Sep 2009 06:51:43 +0000

I just wanted to say thanks for this article, this was great. It’s also unfortunately a good example of how the medical “industry” (moreso in some countries than others) can be harmful and push unnecessary products, or even harmful ones (because of the side effects.) It also shows how many times profit takes precedence over good medical practice or good scientific methods.

Even more unfortunately, this is exactly the type of behaviour that has led so many people to question medicine in general and has led to support of a lot of pseudo-science BS, which causes ever *more* harm since people avoid proper treatment which can lead to suffering or death. Because of the real actual dishonesty and corruption that does sometimes exist, many people decide not to trust *any* of the products of big pharmaceutical companies, or to distrust doctors in general. Obviously, this isn’t good for anyone.

There’s no easy answer to this, but there are many possibilities that can help. These could include requiring more overview, more controls or regulation (i.e. requiring negative studies to be published, not just positive ones), more use of public vs private research, etc. These are all debatable (and some are political), but this is a clear problem that needs to be addressed in some way.

By: M Parrott

M Parrott — Fri, 08 May 2009 16:49:41 +0000

Well… It’s interesting. Placebo or not this sort of thing happens often. Obviously there has been a change. There’s varying theories as to why you may not see a change… But obviously without thorough investigation nothing can be determined.

By: CJ's relative

CJ's relative — Tue, 05 May 2009 19:51:04 +0000

Ugh, I don’t think I’m not so bad off I need to be ‘sorry’-ed for. As a musing, I’m a little confused about one anecdotal thing – If I am under the placebo effect, why am I the only one who doesn’t think that I’ve changed on medication? Shouldn’t I notice the difference before anyone else? I don’t think I’m any less erratic or dangerous than I was before. I would think that *they* are under a placebo effect, but many of them don’t know that I started taking medication – only that they think that I’ve changed. My belief in the placebo is so strong that it has convinced me that I’ve changed, subconsciously, when consciously I don’t feel different?
I’ve often wondered if I’m being played for a dupe, deeply insulting – but my doctors say that the paranoia is rather part of the disease. Haha.

By: M Parrott

M Parrott — Tue, 05 May 2009 17:50:14 +0000

Gary is correct, the problem is, as with any topic any author writes about on here people may have an emotional attachment to the idea. I am sure at some time you have all banded in all guns blazing with someone about how religion is false, or psychics are liars or any other topi, only to find they get emtionally distraught about the subject. When I wrote this article myself I did consider that both my Mother, Aunty, and other relatives are on anti-depressants themselves. So I’m not emotionally detached from what I wrote. It has as much a mark on my life as it does yours. It’s a kin to spending your life devoted to God, believeing in his exsistence, worshipping him and going to church every Sunday, only to find out he does not exist. You may find it hard to accept any of this, you may never accept this, but the facts are there for you to consider. An to dismay them with a glance is something I’d expect from a religious person. Not a crtitical thinker or skeptic.

CJ, thank you for taking the time to write such a very thoughtful comment and set of questions, you have certainly thought about this, and I am more than happy to answer any question you pose.

You are correct, the word “cure” is a deceiving word. The original idea of any medication is that it will help the problem and eventually you will be able to come off it. This is also the case with anti-depressants. People are supposed to come off them eventually. However new problems arise from taking a drug every day for years on end, you become addicted. This itself causes a lot of problems.

I am sorry CJ for the mis-communication. There is no problem with urine studies. It is a fantastic way to show that those with depression have abnormal levels of the monoamine neurotransmitters.

Animals and anti-depressants are a problematic area. As I have previously mentioned when humans have artificially low-levels of the three neurotransmitters produced there is no ill-effect. People do not become depressed. However, when non-human animals have artificially low-levels of the three created they do show signs of what appears to be depression. Obviously this arrises problems as to why do animals react differently, and then does this mean it is makes it very hard to generalise non-human animal studies to humans?

There is plenty of research into other theories for depression. Behaviourism, social learning theory and so on. But just like any psychological theory they all contain gaps, un-explainable facts. I would not suggest for the life of me that any theory for depression is correct, far from it. Psychologists are still to get it right, and maybe they never will. I could start a debte on the questionable existence of depression in one single entity due to it being a banding together of symptoms that should be considered as different disorders… However that’s another debate for another day.

CJ, I am sorry to hear about your relative, I truly am. When I write this maintain the idea in your head that I am not your relatives doctor and I have not gained a doctorate of yet. My words should not be taken as gospel, your relative should make their own choice of whether they should take medication, as with any psychological condition. If your relative is already taking medication then it would be a hinderence, as much as I consider these as nothing less than placebos, they are undeniably addictive drugs, and stopping taking addictive drugs is incredibly dangerous.

Again, thank you for reading.

By: Gary Peterson

Gary Peterson — Tue, 05 May 2009 15:53:56 +0000

Isn’t it interesting that most comments are emotional reactions to the post? It is understandable, but I think the author was attempting a more abstract or theoretical argument regarding the lack of scientific explanations regarding how the drugs work. Placebo effects can be found in animals, as one possible explanation for placebo effects involves basic conditioning principles. Again, people too readily embrace a physio/medical model, but a full theoretical understanding of these disorders is multi-disciplinary. I think it’s silly to respond with an either-or (body vs mind) plea as I indicated above. The author can respond to this, but I didn’t think he was saying anyone should throw out their pills. I was hoping more scientific researchers/theoreticians might respond.

By: ty

ty — Mon, 04 May 2009 22:40:35 +0000

Great article. Drugs aren’t needed at all ever by anyone, is my only qualifier.

By: Gary Peterson

Gary Peterson — Mon, 04 May 2009 20:29:01 +0000

I am NOT an expert in this area though I act like on from time to time. I thought some good points were raised by E. Doe and Mi as well as M. Parrott. These drugs can mess people up and it is guite a shuffle to watch as psychiatrists or others try to find the right mix. However, this is also just what I would expect if these drugs are really interacting with the patient X doctor relationship to induce demand character (social cues) for a placebo effect. My understanding is that drugs plus cognitive behavior therapy can be helpful but either alone is problematic. Is that correct? While E. Doe is correct to emphasize the biological foundations of these disorders lest we slip into an archaic mind-body dualism, the functioning body is active, behaves, lives, adapts, thinks, feels, relates to others and is thus part of a multiply-determined nexus of study. I just wish the psycho-biological experts could create a more effective approach to these problems.

By: CJ

CJ — Mon, 04 May 2009 20:12:47 +0000

I’m concerned about a few things in this particular article, particularly because I was pointed to it by a relative currently on medication for bipolar disorder. I have some serious questions, and I really would appreciate any response.

The use of the word “cure” at the beginning of the article. Are anti-depressants supposed to “cure” depression?

“No, honestly, urine.” I fail to see why you use this particular rhetorical device to question the usefulness of studying urine samples as part of a diagnosis. Or are you arguing that it’s not?

There are dozens of articles on PubMed alone dealing with the possible mechanisms for the efficacy of anti-depressants; a number of the experiments described deal with the behaviors and responses of animals in various trials. Are you suggesting that these effects can be explained by the placebo effect in animals?

Is there evidence-based research regarding a psychological mechanism for the changes in the amounts of neuro-chemicals? Efforts to disprove the current theory, even if they are compelling, aren’t evidence for this alternative theory. I would be very interested in evidence that points to alternatives, psychological or otherwise.

“…assuming one little tablet can cure such a complex thing as a psychological disorder.” This, of course, assumes that the problem is, in fact, a psychological rather than a physiological disorder. My relative’s doctors believe this to be a physiological condition, and it has taken years to find a treatment that seems to be effective. While that case is completely anecdotal and should not be accepted as evidence in and of itself, are you suggesting that my relative ignore the advice of the medical doctors? Again, I ask this in all seriousness, and I appreciate your responses.