Psycho-Babble Medication | about biological treatments | Framed
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We need placebo

Posted by med_empowered on July 29, 2005, at 16:23:58

In reply to Re: Antidepressants, posted by SLS on July 29, 2005, at 8:09:21

Here's the thing: if the argument is that depression is a medical condition that is best treated medically, we *need* a placebo control--this is, afterall, how we evaluate all other medical treatments (including other psychotropics, such as neuroleptics or anxiolytics). The FDA recognizes the importance of the placebo effect--thus, all ADs have to prove more effective than placebo in at least 2 large scale, randomized trials. It may well be that the nature of depression makes it more responsive to placebo. Then again...many depressive episodes are self-limiting, so if one left a patient alone for 6-12 months the odds of that individual recovering from depression w/o any sort of intervention are pretty good, too. Instead of questioning placebo--which is a necessary control for medical research-- I think we need to question our current treatments and what seems to be the prevailing assumption that depression is best treated with antidepressants. Given the billions upon billions of dollars spent by individuals, insurance companies, and various government health agencies on antidepressants and other mental health treatments, I think that if anything we should hold these treatments--which, though sometimes helpful often are expensive and full of side-effects-- to a higher standard than the one to which they are now held, not a lower one. Some researchers argue (and I agree) that a better control than simple "placebo" would be so-called "active placebo". Basically,, an "active placebo" would produce minor side effects--drowsiness, for instance-- that are commonly associated with psychotropic treatment. By adding a few well-known side effects, one could tell even better the precise difference in efficacy between the control arm and the treatment other words, does Prozac help people because of some action on the brain, or do Prozac's side effects make the user think they're getting "strong medicine" and thus heal them primarily through an (active) placebo effect?




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