Posted by MattDDS on September 24, 2002, at 15:41:58
In reply to Re: Antidepressants versus placebo smackdown!, posted by Anyuser on September 24, 2002, at 14:49:39
>>It is impossible for me to reconcile the thought that antidepressants give only placebo benefit with other things we "know" about about antidepressants. Such as, the side effects of ADs kick in right away, while the benefits kick in after weeks. If the benefits were placebo, wouldn't they kick in right away, witht the side effects?
This is a good question. I have actually thought about this myself. Unfortunately, I don't have an answer. Neither, I imagine, does anyone else.
However, it appears you may be getting caught up in a thinking error. It does not logically follow that antidepressants are therefore effective simply because they have an unexplained delayed onset of action. Personally I don't see how this relates to the issue of their efficacy. Namely, that they fail to perform much better than placebos. Typical studies report that placebo effect accounts for over 75% of antidepressant efficacy. This is miniscule! Especially if one considers that this "statistically significant" difference could be due to the unblinding effects of clinical trials that we were discussing. I would love to see Pfizer or Lilly do an AD trial against diphenhydramine. Of course, they would not pay for it! We have to remember that drug companies, though not demonic and evil as some have portrayed, are human and have strongly vested financial interests which may bias clinical trials. Did you read about the "filing effect" in the article you posted?
Keep in mind I am not talking about **personal** efficacy, as I cannot argue whether they have been effective for one person in particular. Antidepressants can be effective for certain people, as can placebos. Unfortunately, we can only study effects of antidepressants on groups.
poster:MattDDS
thread:120924
URL: http://www.dr-bob.org/babble/20020922/msgs/120970.html