Anti-depressants: have we been given placebos? Is this right?

Question

http://news.bbc.co.uk/1/hi/health/7263494.stm

The news this morning is saying that anti-depressants are no better than placebos, except in cases of severe depression.

I saw a medical professional on the news this morning who said that at least placebos give people hope, and now by exposing anti-depressants ineffectiveness, that hope has been taken away.

This makes it sound like doctors *knew* they were only placebos, and prescribed them anyway.

Is it appropriate to knowingly prescribe placebos?

Answer 1

The biggest problem (highlighted by some of these answers) is that so many people are all to ready to go and grab as many pills as possible for the tiniest thing, and doctors and drug companies are all to glad to supply them and make money. Doctors often prescribe drugs or placebos because they know that the patient will 'feel' better in their own mind, without the drug doing any harm (or good) physiologically.

I'm a nurse, so please don't think my opinion is uninformed or uneducated, and don't think that I don't value the use of drugs when necessary, they play a vital role in health care, of course they do.

My point is that people shouldn't be so quick to use them. Excercise has been PROVEN to be one of the best weapons against depression and a whole raft of other illnesses but the ammount of people who use it for this purpose are in the minority. The human body is wonderfully adept at treating itself, just live well, excercise a lot and don't be too quick to take medication if you don't need it.

Answer 2

I expect the practice has been going o a long time. Placebos often do work, the mind is an amazing tool, it can be tricked into accepting things that aren't really there or indeed into accepting that what someone says and prescribes will actually do us some good, if we don't know about it and it's effective because the mind accepts it as good then i don't have a problem with it. What i do have is will how many people who have become hooked on some of these drugs and relied on them for years, that should be more widely known about.

Answer 3

Like what Overcast Kid said



depression is all in peoples head so it makes sense that making them think there taking a drug that helps and in a lot of cases its worked

Answer 4

I've been taking anti depressants for over nine years.  I know how it feels when a drug isn't working, I've tried almost every one there is available.

I also know the difference when one does alleviate the symptoms.  

To say depression is all in someone's head and can therefore be 'cured' by a placebo shows a complete lack of wisdom on the subject.  Sometimes depression can affect a person due to exterior problems, the loss of a loved one, redundancy, divorce etc, other times, it can envelope a person without any specific reason, it takes no prisoners, there is no-one immune from a depressive bout.

Going for walks helps, but it doesn't remove the destructive symptoms of depression.

  I used to feel that I would rather 'sort myself out' than ever take anti depressants.   I know differently now.  I know how bad things become for me, doing even the minimal of ordinary things is a drain and more than I can cope with, so I take my anti depressants wisely and appreciate the difference they make to an otherwise intolerable situation

Answer 5

I won't read the article because I am sure I can answser all your questions without knowing what was written.

First of all, if you are buying Prozac, you are getting a drug called fluoxetine.  Every anti-depressant prescribed and sold in the UK (this goes for pretty much all of Europe and the US as well) contains a drug, and is not a placebo.

The research you are no doubt alluding to says that placebo and anti-depressant drugs affect people in the same manner.  The reason for this, depression is overwhelmingly brought on by psychological factors.  If the problem is psychological, the cure will be as well.  So, in these cases, it will not matter if the patient is getting placebo/ drug, it only matters if the patient believes the placebo/ drug will cure them.  If they believe it to be so, then the depression is alleviated.  If not, then the depression is not alleviated.  Why?  The drugs contain chemicals that interact with chemicals produced naturally by the body and it brings the chemicals in the body back into balance.  If the issue is not the chemical to begin with, then the drug -in and of itself- will not deal with the issue.

There is a small subsection of people who take antidepressants that are generally labelled 'severely depressed' 'manic depressed' and other names that aren't too flattering.  This subsection suffers from a chemical imbalance, and it is this chemical imbalance that drugs like fluoxetine fix.  Fluoxetine is in a class of drugs called SSRI, or commonly referred to as Inhibitors.  It is the active ingredient in Prozac.

Drug companies will likely deride independant studies on the efficacy of a drug, simply because drug companies make their money by selling drugs.  

Any doctor who prescribes a drug because he thinks he is giving his client hope, instead of curing something he knows to be wrong, should not be practicing medicine.  We entrust our well-being to doctors, and it is the professional resposibility of a doctor to be honest.  Doctors don't prescribe placebos per se, but they do prescribe drugs knowing the only benefit the drug will have is at best a psychological pick-me-up.  It is likely that the people that are being prescribed medications are seeing a psychiatrist when they should be seeing a psychologist.  The dynamic between the patient and the doctor is differs from pyschiatrist to psychologist.

BTW: The drugs that prescribed to the most severely depressed patients, there is NO doubt whether you have gotten the placebo or the real thing.

Finally, I am not a doctor.  Doctors should be consulted with matters of mental health.  Start with a psychologist, if he can't help you, he will refer you to a psychiatrist.  My gut tells me a lot of people want to take care of their 'depression' without putting the time and effort into seeking treatment from a psychologist.  They think the drug will fix in a couple minutes what could take a lifetime to sort out on a pyschologists couch.

I hope this helps and does not further confuse you.

Answer 6

I think you might find that the placebos were given to a group during trials, and that they consented to taking part in a trial. I don't think they would have been prescribed by GPs.

I suffer from depression, pills don't work for me and I've had to try many over the last four years. I still live in hope though. For the time being I'm off medication, and feel no different.

Answer 7

Not when you have to pay for a prescription at almost 7 quid a time!!  I stopped taking my pills now - they werent doing me any good whatsoever.. Go for a long walk, that`ll cheer you up more than anything!

Answer 8

To be honest, I would rather have a placebo and THINK it's helping me and making me feel better, than to actually be prescribed to a drug.

The power of the human mind is incredable. If placebos work just as well, why medicate people when we don't need to?

Answer 9

There is also proof that anti-depressants have made some people suicidal.

I agree with exercise, going for a walk is much better than taking any pills, placebo or not.

Also eat good food, fruit & vegetables, plus have enough sleep.

Alcohol also causes depression, if you drink too much.

Answer 10

My son opted to take anti-depressants when he went in to a severe depression after leaving Uni.He said it was like having a light switched on inside him again.I got him to try St. John's Wort first of all and it eased the depression but wasn't enough of a help.The contrast between the two he reckoned was amazing.They are hard to get back off though.He no longer needs anything.I 'd say it's down to finding the right tablet for the individual.

I also think this report is going to result in suicides if people assume that there is no help available from medication it may make a desperate situation appear insurmountable.I wish these reports were handled more responsibly

Answer 11

Yes, in answer to your question. The fact is, if you take something that has no detrimental or long term effects on your body, and you feel better for it, what's the harm? We were told at school that placebos are used regularly with regard to mental health. A lot of depression is more a 'state of mind' than an actual illness.

The question is, how important is it to you that a patient is taking an actual drug?

Answer 12

I agree with Ginny Jin.   People must have consented at one point to participate in trials.  I doubt a GP could prescibe placebos.  It would be morally and ethically wrong to mislead and trick patients.

Answer 13

i suffer from depression and im soon to be put on anti-depressants, i definalty wouldnt agree with being given a placebo i think id notice if it wasnt working, i think its wrong to give people with problems false treatment