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Antidepressants versus placebo smackdown!

Posted by Anyuser on September 24, 2002, at 9:49:24

The Psychiatric Times published “point/counterpoint” articles on the topic of antidepressants versus placebo. Here are the links:

http://www.psychiatrictimes.com/p020906.html
http://www.psychiatrictimes.com/p020909.html.

These articles are mainly (boring) statistical arguments. The Phd knocking drugs says there is no meaningful difference between the benefits of antidepressants and the benefits of placebo. The MD defending drugs concedes that the benefits of antidepressants versus placebo are minuscule (!), but that miniscule benefits add up in a public health setting.

I believe that the benefits of antidepressants are much more than placebo effect for me, and not at all miniscule. That has been my subjective feeling, my experience. I think the placebo versus antidepressant debate is a product of two difficulties: (1) the difficulty of distinguishing between depressed patients whose malady is fundamentally biochemical and those whose malady is fundamentally psychological, and (2) the difficulty of measuring a mental state on the various “scales.” Whenever my pdoc asks me to fill out a questionnaire before a consultation, I feel like I'm indulging an eccentricity of his. It's something I have to do before I can tell him how I really feel.

For whatever reason, I am always deeply discouraged when the advocates of talk therapy knock antidepressant medication. I supposed that is a weakness in me, one of a long list. I hate to think the benefits of antidepressants are nothing more than wishful thinking. I know talk therapy is wishful thinking for me. Literally “wishful thinking.”

What do you think about this debate?


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poster:Anyuser thread:120924
URL: http://www.dr-bob.org/babble/20020922/msgs/120924.html