Placebo Effect?

[Darwin's i-Pod]

http://thechart.blogs.cnn.com/2011/06/1 ... -placebos/

I don't know what to think about this... I just know I'm scared that it might be true.

I hope it's not

[Michigoose]

I've always wondered about this.

I usually come to the conclusion that I don't care whether it's placebo effect or not. If it is, I wish someone would make placebo pills with fewer side effects. And that they'd be cheaper, but maybe that's also part of the placebo effect. "I paid a lot for it, so it must be working."

[Eternally Learning]

I'll begin by stating I'm not an expert in the field of mental health or neurology and do not even have a firm opinion on these matters myself so please do not take anything I say as anything more than my opinions, assertions, and questions.

On its face the wikipedia article on anti-depressants seems to back up some of what this article is putting forth in that it says that the effects beyond placebo are not very large and not always consistent. There are some tidbits of knowledge that make me question whether these drugs are all placebo though.

First, there's the fact that each drug's effects can change drastically from person to person as is reinforced by all the testimonials on just the MIHH show alone. It seems to me that such a fact would wreak havoc on the statistical results given by any study (though I admit, there could be ways to account for this in the study-design). Second, while the argument can be made (and certainly is being made) that the effects beyond placebo of this category of drug are minimal, the article seems to skip straight to the concept that they are non-existent. Given that this is not just one drug we're talking about, but a whole category I have to wonder if such a statement is not ideologically driven. Furthering that thought of mine is the part of the article implying the age-old canard that Big Pharma has tainted all the results and has everyone in their pocket. All medication that claims to be effective in treating illness goes through tons of testing beyond what the pharma company does.

Third, there's the side-effects of what these drugs do. In the matter of suicide-risk being higher, this is explained by the psychomotor-retardation (i.e. lack of will power/motivation) being eased before the depression is, meaning that the patient is more able to follow through with plans of suicide. If it was just a placebo effect then why would it behave in such a manner, I would think it would be all or nothing. Lastly, there's also the need to build up and wean off the medication to consider. In many cases, a placebo effect becomes apparent due to the unlikely fast reversal of symptoms. You can see this in cases of patients who have psychogenic disorders which manifest physically and can be confused easily with actual physical problems, but when they receive known ineffective treatments, their symptoms reverse sometimes overnight when any real treatments of physical problems would tend to be lengthy. If anti-depressants were truly only relying on placebo to be effective then why wouldn't the effects be similarly speedy?

To wrap all of this up, I'll also drop this little nugget in the same vein as what Michigoose said. Even if what these people are saying is true, and anti-depressants are only complex placebos, might that not be enough for a thought disorder? I know the movie A Beautiful Mind was not overly based on reality in the details, but they did get one thing right. John Nash was able to push through his mental illness and live a reasonably normal life (flaws and all) through a sheer act of will. I'll be blunt, I don't have that kind of will-power, and I'm not quite sure that most people do. Perhaps even just a placebo would give me or others the illusion of power and enable us to push through our problems.