Newsweek has an excellent article that charts the rise and fall of antidepressants from their status as a wonder drug that made people ‘better than well’ to the recent evidence that suggests for many people, they’re not much better than placebo.
The piece particularly follows the work of psychologist Irving Kirsch who was the first to conduct a meta-analysis of the effects of anti-depressants back in 1998.
Titled “Listening to Prozac but hearing placebo” it suggested that the drugs were hardly more effective than placebo and, for many, marked Kirsch out as a biased and dangerous ‘anti-psychiatrist’.
However, later studies in a similar vein by both Kirsch and others have supported his original findings and many countries have now changed their treatment recommendations as a result.
The Newsweek article tracks this story but also picks up on many important subtitles in the story, notably that the research doesn’t suggest that antidepressants are useless – quite the opposite – just that their effect is only in part due to their direct chemical effect; and that many patients in trials work out that they’re not taking placebo because of the side-effects and this realisation can trigger a stronger placebo effect.
It also integrates evidence from the recent STAR*D study, one of the most complete on the best methods to treat depression.
If you want a good overview of the debate on the effectiveness of these iconic drugs, this is a good place to start.
Additionally, if you’re interested in a good analysis of the most recent study in this area, just published in the Journal of the American Medical Association, the Neuroskeptic blog has a great write-up and analysis of what this means for the concept of depression itself.
Link to Newsweek piece on antidepressants (via @DrDavidBallard).
Link to write-up of JAMA study at Neuroskeptic.