Is a Placebo a More Effective Antidepressant Than an Antidepressant? - Magaziner

Is a Placebo a More Effective Antidepressant Than an Antidepressant?


Conventional treatments for depression usually consist of prescribing prescription antidepressants, the side effects of which may include nausea, loss of sexual desire or sexual dysfunction, insomnia, blurred vision, constipation and dry mouth. In some cases, these medications can mimic or even accentuate such symptoms of depressions as fatigue, weight gain, insomnia and suicidal thoughts. Often we will see patients in our office who have had many years of antidepressant medication who are looking for ways to improve their treatment response or ween themselves off of their medications.For these people, there is an innersense that the medications they are taking, are not helpful. They are in a constant state of medicine evaluations and tweekings to get them to the “right levels.”

Controversy in the medical community

There is a great deal of controversy in the medical community as to whether some patients get any benefit from their antidepressant medications. Extending the controversy is the belief that some patients do just as well if they were given a placebo instead of the medication. A placebo is a starch or sugar pill that contains no medication.

Dr. Irving Kirsch is a noted researcher from Harvard Medical School. He has written numerous papers on the “Placebo effect,” in patients.

In June 2019 he wrote this in the journal Frontiers in psychiatry.(1)

“Antidepressants are supposed to work by fixing a chemical imbalance, specifically, a lack of serotonin or norepinephrine in the brain. However, analyses of the published and the unpublished clinical trial data are consistent in showing that most (if not all) of the benefits of antidepressants in the treatment of depression and anxiety are due to the placebo response, and the difference in improvement between drug and placebo is not clinically meaningful and may be due to breaking blind by both patients and clinicians. (The doctors and patients became aware of what was the placebo and what was the real medication during the study and this skewed the results to favor the medication).

Although this conclusion has been the subject of intense controversy, (this study) indicates that the data from all of the published meta-analyses (outcomes) report the same results. This is also true of recent meta-analysis of all of the antidepressant data submitted to the Food and Drug Administration (FDA) in the process of seeking drug approval.

Other treatments (e.g., psychotherapy and physical exercise) produce the same benefits as antidepressants and do so without the side effects and health risks of the active drugs. Psychotherapy and placebo treatments also show a lower relapse rate than that reported for antidepressant medication.”

Suggesting placeo, exercise and psychotherapy offered the same benefits without side-effects would of course be considered controversial.

In 2014, Dr. Hirsh also wrote in the Handbook of experimental pharmacology, (2) “Instead of curing depression, popular antidepressants may induce a biological vulnerability making people more likely to become depressed in the future.”

Placebo can work for some patients, researchers are not sure how

A 2015 article published at the National Institutes of Health’s Research Matters by Carol Torgan, Ph.D. (3) suggests how placebo may work for some patients:

“A placebo is a substance, such as a pill or shot, that doesn’t contain any active medicine. Scientists typically use placebos as controls in research studies. This helps them understand how much of a medicine’s effects are due to the drug itself, versus how much are due to participants’ expectations or other factors. People who are given a placebo may report improvements in symptoms, sometimes even when they know they’re taking something that doesn’t contain real medicine.”

This article examined a 2015 paper in the Journal of the American Medical Association (JAMA).(4) In this study patients were divided into two groups. One group was told that they would be receiving “a potentially fast-acting antidepressant” which was a placebo with no medicine, or they would be receiving a placebo. The patients who received the fake medicine “a potentially fast-acting antidepressant,” showed a notable response in bettering their depression symptoms. This lead the researchers to suggest that it was not the placebo that helped the patients in as much as the anticipation that they were getting fast-acting antidepressant. The anticipation of treatment made the patients feel better.

“antidepressants are neither safe nor effective; they appear to do more harm than good.”

If you suffer from depression or care for a family member who does you know there are no easy answers. This article is presented to show some concerns in the medical community that some antidepressants are not helpful, may make symptoms worse, and do more harm than good.

In 2012, researchers already questioning the effectiveness of antidepressants wrote in the journal Frontiers in psychology.(5)

“We have reviewed a great deal of evidence of the effects of antidepressants on serotonergic processes throughout the body. Some of the effects are widely known, but they have been largely ignored in debates about the utility of antidepressants. Indeed, it is widely believed that antidepressant medications are both safe and effective; however, this belief was formed in the absence of adequate scientific verification. The weight of current evidence suggests that, in general, antidepressants are neither safe nor effective; they appear to do more harm than good.”

In treating depression there are no easy answers

In treating depression there are no easy answers, treatment is a journey to wellness. Placebo maybe the answer to question of the effectiveness of antidepressants. But, as pointed out, placebo’s effect maybe more in the patient’s anticipation that they may be taking something that will help them.

At the Magaziner Center, we treat depression by thoroughly assessing each patient’s physical state and looking for all possible triggers. Because depression has been linked to imbalances of specific neurotransmitters, we use an extremely thorough series of screenings to determine their levels as well as those of key amino acids. We also test for any nutritional deficiencies, chemical toxicities, adrenal and hormonal imbalances, allergies or food intolerance and excesses of heavy metal.

Once having determined what physical causes may be involved, we use proven natural methods to treat them such as sublingual desensitization, nutritional therapies, chelation therapy, mind-body healing, neurotransmitter therapy and hormone balancing.

This is not an easy challenge for some people but it begins with the idea of what is wellness and how it can be realistically achieved. If you would like to explore more information, please contact our office so we can start a conversation with you.

1 Kirsch I. Placebo Effect in the Treatment of Depression and Anxiety. Front Psychiatry. 2019 Jun 13;10:407. doi: 10.3389/fpsyt.2019.00407. PMID: 31249537; PMCID: PMC6584108.
2 Kirsch I. The emperor’s new drugs: medication and placebo in the treatment of depression. InPlacebo 2014 (pp. 291-303). Springer, Berlin, Heidelberg.
3.Placebo Effect in Depression Treatment. https://www.nih.gov/news-events/nih-research-matters/placebo-effect-depression-treatment
4 Peciña M, Bohnert AS, Sikora M, Avery ET, Langenecker SA, Mickey BJ, Zubieta JK. Association Between Placebo-Activated Neural Systems and Antidepressant Responses: Neurochemistry of Placebo Effects in Major Depression. JAMA Psychiatry. 2015 Nov;72(11):1087-94. doi: 10.1001/jamapsychiatry.2015.1335. PMID: 26421634; PMCID: PMC4758856.
5 Andrews PW, Thomson JA Jr, Amstadter A, Neale MC. Primum non nocere: an evolutionary analysis of whether antidepressants do more harm than good. Front Psychol. 2012 Apr 24;3:117. doi: 10.3389/fpsyg.2012.00117. PMID: 22536191; PMCID: PMC3334530.

 

 

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