A recent study has shown that taking anti-depressants is no better than taking a placebo for people who have mild to severe depression (they do have an effect on those with very severe depression).

This article is an excellent rundown of the study and the surrounding issues:


One of the interesting questions it brings up is whether studies like this should be publicized-the idea being that if people are getting a real benefit from a placebo, then maybe you shouldn't mess with that. Agree or disagree?

If you take antidepressants, what do you think of these findings? Do you still believe they work? Will you continue to take them?

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Right. It wasn't really a recent study, but that people finally sat down and reviewed all the literature and studies on the question and came to this conclusion.
Yeah-it's not recommended that people just drop the drugs if they decide to stop taking them as this can cause withdrawal symptoms (perhaps heightened by the reverse placebo effect?). People should talk to their docs.

The placebo effect is indeed interesting. I've read studies like the one you cited and it's just amazing how much power your mind has on how you feel.
I took a mild dose for a year - 20 and 10 milligrammes of citalopram, after my business crashed, my father died and I had severe stress symptoms - and I knew the dark winter was approaching...

I never thought it would be for me. I don't really believe in those drugs, but I thought - what the hell, let's try it.
It did help - surprise.

But I still don't like the thought of drugs. So I dropped them half a year ago. I think maybe they just gave me some time to get on my feet again. I feel better this winter than I have done many other winters. I tend to be sensitive to the loss of light.

Do I believe the work? I know they had some effect - side effects - but not much. It wasn't like everything was suddenly easy. So it's hard to tell.

Placebo. Hmmm. Maybe it's just due to lack of calcium? Or maybe the glass of water you take them with, works wonders?
A mild depression is when you havn't tried suicide yet.
A severe depression is when you succeed.

- sorry - just being morbid.

I've always had a hard time getting doctors to take me seriously. Partly because "you're such a big strong man - nothing wrong with you for sure"-syndrome and partly because when I'm with others I will get my act together, and perhaps even crack a joke. That attiude is dangerous. Because I can be very depressed or ill - and still able to act normal. I had pneumonia with a high temperature for 10 days - before a doctor asked me if he should save my life - as he put it. I found that to be a very good idea.
I don't subscribe to the idea that men whine.
The placebo effect works for many things. Back when I was a pharmacist I remember having patients demand the brand name drug over the cheaper generic because they tried both and said the brand worked better. I remember one time in particular because the drug the patient was claiming to be inferior to the brand was in fact the same drug! The drug in question was what is known as an ultra-generic. Sometimes to complete with the generics and get a bit of their action, brand name companies will make a deal with a generic company and will produce a drug with the generic's label on it. Then the generic company can sell it at the lower generic price (thus completing with the other generics) and the brand get's its share of the generic's profits.

But all the aside, at the end of the day, it's still the same darn pill!
How do the different drugs differ from each other? I know the older ones were based on raising your serotonin, which the article argues is ineffective. Do the other drugs do something besides raise serotonin or do they raise the serotonin in a different way?
Brett they don't actually work by raising serotonin. Well, not in the long run. They reduce the reuptake of the serotonin from the synapse, letting the serotonin have more activity on the 5-HT receptors (serotonin receptors), which in turn causes the neuron to downregulate the number of receptors expressed on its surface. Sort of like how if I move the tv closer to your ear you will respond by turning down the volume. This is possibly why when you take antidepressants you get an energy high after one week (raised serotonin) but the "feel good" effects take 4-6 weeks to kick in (takes a while for the changes in the receptors to occur). This is also why, according to some, antidepressants cause an increase in suicide. You got a guy who wants to end his life but lacks the energy to it. Then he takes an antidepressant and suddenly, although he still wants to die (got to wait a few more weeks to improve that) he now has the energy to do it. But then again it may all be just magic because the serotonin model is still just a theory among many. The other antidepressants act on all sorts of neurotransmitters. Serotonin, norepinephrine (noradrenaline to you Brits), dopamine, acetacholine. Some are more selective to a few of these and others act more broadly.
Really interesting Nick. Thanks for that explanation.
I bet there is a lot more going on. The brain is a complex organ. Fat chance we are gonna solve a problem with it by just pushing a button that increases serotonin. Want to read about something really cool with the brain, look up Neuroplasticity.
Just skimmed the article. No time to read it right now. Not sure if they mentioned him but Dr. David Healy (no relation) has written some interesting material on the antidepressant debate. His "Let them eat Prozac" is a good read.
The Placebo effect is fascinating. It's why I rarely take any medication whatsoever, except for when I am truly ill. I've worked to convince myself that the right mondset will alleviate most conditions. This is generally true.


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