In this podcast, David and Fabrice discuss recent startling and disturbing research studies by Dr. Irving Kirsch and others that suggest that the chemicals called “antidepressants” may, in reality, have few or no true antidepressant effects above and beyond their placebo effects. Dr. Burns illustrates the placebo effect with a thought experiment, and explains why it is so confusing to researchers and the general public alike.
In addition, David and Fabrice discuss additional troubling research by Dr. David Healey and others that indicates that the chemicals called “antidepressants” appear to cause a doubling or tripling of the likelihood that a depressed individual will commit suicide or become actively suicidal, as compared with depressed individuals treated with placebos. David concludes with a discussion emphasizing that the needs of marketing are in conflict with the needs of sciences, and proposes some solutions to this serious problem.
Dr. Burns emphasizes that he is only providing his interpretation of some extremely controversial studies, based on his research training and clinical experience. He urges listeners to do their own research and critical thinking on this disturbing topic, and emphasizes that many may come to different conclusions.
Suggested Reading
Antonuccio, D.O., Burns, D., & Danton, W.G. (2002). Antidepressants: A triumph of marketing over science? Prevention and Treatment, 5, Article 25. Web link: http://journals.apa.org/prevention/volume5/toc-jul15-02.htm
Antonuccio, D.O., Danton, W.G., DeNelsky, G.Y., Greenberg, R., & Gordon, J.S. (1999). Raising questions about antidepressants. Psychotherapy and Psychosomatics, 68, 3-14.
Garland, E. J. (2004). Facing the evidence: antidepressant treatment in children and adolescents. Canadian Medical Association Journal, 170, 489-491.
Healy, D. (2003). Lines of evidence on the risk of suicide with selective serotonin reuptake inhibitors. Psychotherapy and Psychosomatics. 72, 71-79.
Jureidini, N., Doecke, C.J., Mansfield, P.R., Haby, M.M., Menkes, D.B., & Tonkin, A.L. (2004) Efficacy and safety of antidepressants in children and adolescents, British Medical Journal, 328, 879-883.
Khan A, Khan SR, Leventhal RM, Brown WA (2001). Symptom reduction and suicide risk in patients treated with placebo in antidepressant clinical trials: a replication analysis of the Food and Drug Administration Database. International Journal of Neuropsychopharmacology, 4, 113-118.
Kirsch, Irving. (2010). The Emperor’s New Drugs: Exploding the Antidepressant Myth. New York: Basic Books.
This is a fascinating analysis. I’ve never tried antidepressants, just REBT and CBT type therapy. Sometimes, I find it much more difficult to fight off the cognitive distortion gremlins when I’m tired or during certain times of the month coinciding with the last portion of my menstrual cycle. I’ve sometimes considered taking something to support my mental processes during those times. After listening to this podcast, I think regular practice and building habits in disputing skewed thoughts is probably the best inoculation against lean mental occasions in my experience rather than something chemical. Of course, this could just be confirmation bias.
Yes, you are right! Thanks so much, david
I have been searching for your article and unfortunately the link(s) no longer work.
Try a search in google scholar and let me know if you can find it! d
Many may come to a different conclusion…Dr dam that’s a cop out.. Stand by your convictions
Hi Gary, well there’s a lot of wisdom in your thinking. Albert Ellis was more “in your face,” and simply blurted out what he thought, regardless of who might be upset by his thinking. I totally admired him for that. I’ve found that our field is highly political, and people believe what they WANT to believe, regardless of what I might think is the truth. Also, I’ve tried to be a little careful about the topic of antidepressants, because so many think they are benefitting, and while it is likely just a placebo effect, I hate to alienate people or pull the rug out from underneath someone who may already be feeling shaky and vulnerable. And, of course, thousands of people, including the MDs who prescribe these drugs, are TOTALLY sold on the idea that the antidepressants can have “some effectives” for “some people.” I have a pretty up front chapter on the placebo effect in my book, Tools, Not Schools, of Therapy,” which is for therapists and available on my website, in the shop. Warmly, david
Antidotally, this was my experience with antidepressants. This would also explain the mysterious lag time and why they all seem to all work the same. IT takes a while to start focusing on the better feelings and then believing the drug is working. This idea works especially well if you think you are broken.
Thanks for your thoughtful comment! d
Hi Dr. Burns.
Thank you for another very enlightening podcast.
I’m curious if you think anything has changed on this topic in the last five years? If not, why are SSRI prescriptions still rising, even for teens, in our country? This seems alarming.
Many people now have been taking these drugs for decades. Are there any studies in their long term effects?
Also, given how difficult withdrawal is for many people tapering off SSRIs, can we conclude the drugs have strong physical and psychiatric effects (even if they have not actually been helping depression?). Or is it possible these withdrawal symptoms can be entirely attributed to a nocebo effect? I guess we can m’t know for sure without double-blind withdrawal studies.
I hope I haven’t asked too many questions here. Thank you, as always, for all you are doing!
Thanks! I am not aware of any research showing that the recently marketed drugs are any more effective. But they are sold due to advertising. Although they have few or no beneficial psychiatric effects that I am aware of, they do bind much more tightly to certain brain receptors, like serotonin receptors, so withdrawal causes strong perturbations in the brain. The withdrawal effects are primarily physical, although I’m sure there could also, in theory, be an amplifying “placebo” effect. I am just speculating! Best, david
I like your questions, but they are in the realm of, “Daddy, why is the sky blue?” This is an excellent question. And we could also ask, “Daddy, why is there so much corruption and nutty thinking in the world these days!” Best, david