Against Depression, a Sugar Pill Is Hard to Beat

The Washington Post ^ | May 7, 2002 | Shankar Vedantam

[grundle]

Against Depression, a Sugar Pill Is Hard to Beat

Placebos Improve Mood, Change Brain Chemistry in Majority of Trials of Antidepressants

By Shankar Vedantam

Washington Post Staff Writer

Tuesday, May 7, 2002; Page A01

A new analysis has found that in the majority of trials conducted by drug companies in recent decades, sugar pills have done as well as -- or better than -- antidepressants.

Companies have had to conduct numerous trials to get two that show a positive result, which is the Food and Drug Administration's minimum for approval. What's more, the sugar pills, or placebos, cause profound changes in the same areas of the brain affected by the medicines, according to research published last week...

... the makers of Prozac had to run five trials to obtain two that were positive, and the makers of Paxil and Zoloft had to run even more...

When Leuchter compared the brain changes in patients on placebos, he was amazed to find that many of them had changes in the same parts of the brain that are thought to control important facets of mood...

Once the trial was over and the patients who had been given placebos were told as much, they quickly deteriorated. People's belief in the power of antidepressants may explain why they do well on placebos...

[chaos_5]

I know there are people out there with extream mental disorders, but everyone I have ever known who was given any of these “depression” drugs should have been told to get over themselves and suck it up.

[who_would_fardels_bear]

My favorite sugar pills. Guaranteed to cheer anyone up:

[dfwgator]

They certainly worked for President Reagan.

[OCC]

I want to invest in the company that manufactures placebo pills.

[BRL]

and these:

[netmilsmom]

When I was the Office Manager for Psychs we call Prozac, Paxil and Zoloft “Candy Pills” because GPs handed them out like candy.

Seriously, if one is in need of a Serotonin reuptake inhibitor, that person needs it. If not, it can do more harm than good. Slowing the production of that neurotransmitter causes tons of problems in a healthy patient.

[Conservativegreatgrandma]

I would plead with anyone contemplating going on any of these dangerous drugs to have strong second thoughts. These drugs have created a hopeless drug addict out of my mother and given her no happiness.

I hate these drugs. I've seen what they've done to people. One young man's growth is stunted unbelievably and he's in jail awaiting sentencing. Little good the drugs did him.

Perhaps there are some extreme cases where drugs can be justified but I'd be extremely careful and have some kind of plan to get off the drugs, which may, or may not be able to be accomplished.

[chaos_5]

Unless you are institutionalized, I don't think these drugs should ever be taken. People need to be told that life sucks, you don't need to feel happy, now make the best of what you have.

I'm not trying to be dramatic. I'm speaking as someone who would be put on those evil things if a typical head shrinker had their way. They make you go crazy! Nightmares, suicidal thoughts, and then the flat line nothingness of the drugs few weeks later.

So what if someone has mood swings. So what if the world makes you angry! So what if you never “feel happy”! It's over rated.

Besides, when things are real bad, there are always kittens! How could any one be sad when they have kittens. =o)

LOL
Yeah, I don't like depression meds either.

[Enchante]

I agree with you speaking about a lot of milder cases, but you don’t understand anything about truly serious depression (I do, both from personal experience and some fellow patients).

No doubt, these medicines are over-prescribed and there are plenty of people who could suck it up and get along without them.

But really severe depression can be a deadly downward spiral of its own and it doesn’t always clear itself, or at least not soon enough for safety.

I believe that many cases of alcoholism and other forms of drug abuse are people desperately trying to “self-medicate” really serious depression.

I know of lives saved by SSRIs, literally.

[Conservativegreatgrandma]

I can't get over how docs just write prescriptions for these things without having any kind of a plan as to how to get the patient off them.

This is tragic. The drugs do more harm than good.

[Enchante]

I also believe that many “accidents” are suicides when only one person is involved. Depression can be deadly, more times than you know about.

[VOA]

A new analysis has found that in the majority of trials conducted
by drug companies in recent decades, sugar pills have done as
well as -- or better than -- antidepressants.

Having had one relative basically shrivle-up-and-die from profound
depression...I suspect sometimes antidepressants really are needed.

But I do recall an article in C&EN (Chemical and Engineering
News; the main publication of The American Chemical Society)
that one study done on "counseling" of the depressed showed it was
just as effective when delivered by non-professionals as when done
by degreed psychologists/shrinks.
What really seemed to make a difference for the depressed subject
was how much the "counselor" cared and how much time they'd spend
with the depressed subject.

That old placebo effect can be pretty significant in some cases.
AND thank heavens we have an expanding range of pharmaceuticals
to back us up when the placebo just won't do the job.

[chaos_5]

but you don’t understand anything about truly serious depression

I do, and I'm not refering to those cases.

[Enchante]

OK, as long as we agree that the most serious cases are quite different from the “I don’t feel well this week” kind of thing..... :^)

[Lizavetta]

Here's my two cents...

You've got the truly depressed...those who can't function. Whether it's out of balance chemicals or what have you, I don't know. If the drugs help them, then great.

Then you've got those who take anti-depressants because they are bored with their lives, their jobs, their spouses, they're frustrated that they're overweight or in crappy careers, they somehow expect that normalcy is joy and cheer most of the time (which is NOT true) and they're looking for, frankly, relief from normal life.

THOSE people should quit being so self-absorbed and self-focused and get outside themselves. I have seen the more people focus on their 'depression' the more unjoyful they get. The more they DO stuff and quit staring at themselves in their mental mirror, the better they get.

[chaos_5]

OK, as long as we agree that the most serious cases are quite different from the “I don’t feel well this week” kind of thing..... :^)

Oh yeah, no argument about that.

I just get frustrated with the over perceptions of anti depression meds, especially in teens. Half the people I knew were on them for something.

The girls have their self image destroyed by the miles of photoshoped models in magazines, and then put on meds. The boys are called “Borderline” because they are just being rambunctious teens.

It's out of control.

Then there is the fact that the range of human emotion includes the pain and suffering of everyday life, and you just shouldn't medicate that away. (IMO)

[chasio649]

The more they DO stuff and quit staring at themselves in their mental mirror, the better they get.

---

I have found that to be true....we all have our days and get in a rut...it will pass if you don’t focus on it.

[Sax]

There are those with a brain chemical imbalance, and for those, it is a most terrible struggle.

For a vast majority, they just need a jumpstart, a mindset change, something to reset the outlook - the red pill or blue pill - an unbeknowst placebo offers that start. But there's a danger there too. For many a quick fix pill is the beginning to compounding the problem rather than a solution. Pills are a last resort - not a 'let's give it a go' attempt at finding an easy answer.

I personally have never taken, or trusted pills, but I've seen folks that do. Risky business, an initial 'success' often fades quickly.

[hunter112]

In a related story, diabetics on sugar pills did significantly worse...