The ground-breaking STAR*D study results published last year illustrated how the majority of people who take an antidepressant actually continue to have significant depressive symptoms. These results were surprising to some, but not me.
Why? Because back in 2002, folks like Irving Kirsch, Ph.D. and David Antonuccio, Ph.D. were already pointing out how much antidepressant research doesn’t show significant clinical effects over placebo, or a sugar pill (the counterpoint argument should also be read for balance). The first article discusses how much research shows that people taking the sugar pill experienced only a 2-point difference on the depression test they used. While statistically significant, 2 points has virtually no clinical significance. That is, a person who scores 26 versus 28 really doesn’t feel any less depressed.
Researchers with a critical eye have long held that many clinical trials have significant flaws that make their results less than compelling.
The one positive that came out of the STAR*D studies are that people who kept trying different antidepressants eventually did find relief from depression symptoms. This is important information — that individuals need to work with their psychiatrist or doctor to find not only the right dose level for them, but also the right medication. It is a completely trial-and-error process. So be certain to talk regularly to your prescribing professional and let them know if your medications aren’t working.
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4 Comments to
“Sugar Pill or Antidepressant to Treat Depression?”
Placebo results have always amazed me. It goes to show that our belief or faith in something has extrordinary power. Sometimes placebo effects are so good I wonder why the FDA would not approve a placebo pill :-). Seriously though the points made indicate the importance of good communication between the patient and the psychiatrist.
I told my shrink when I was depressed that the fact that nothing she prescribed seemed to work was a sort of proof that I was not amenable to the placebo effect.
I hate the trial-or-error nature of prescribing antidepressants. We are truly still in the dark ages when it comes to having a clue about what might work for a particular patient. It’s no fun being a guinea pig.
I’m concerned (and angry!) that the doctor’s I have seen aren’t checking or discussing medication changes even when the current medication doesn’t seem to be working. I guess I expect to much for $125 an hour.
Hey, speaking of which, anyone know where I can buy sugar pills in gross?
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Last reviewed: By John M. Grohol, Psy.D. on 5 Feb 2007
