Sugar Pills Can Work as Well as Antidepressants
Sugar pills cure depression just as well as antidepressants. What’s more is that sometimes they work better.
According to a new analysis, the majority of antidepressant trials conducted by drug companies have found that sugar pills, or placebos, produce results similar to or better than antidepressant drugs. In one study of 96 antidepressant trials conducted between 1979 and 1996, no difference could be determined between the effects of antidepressants and sugar pills in some 52 percent of trials.
Drug companies are required to conduct two trials that yield positive results before the product will be approved by the Food and Drug Administration (FDA), and reportedly numerous trials had to be conducted before positive results could be shown. The makers of Prozac ran five trials before obtaining two that were positive, while the makers of Paxil and Zoloft had to conduct even more, according to researchers.
In one recent trial, which compared the effectiveness of the herb St. John’s wort to that of antidepressant drug Zoloft, St. John’s wort alleviated depression in 24 percent of study participants compared with 25 percent for Zoloft. However, the placebo cured depression in 32 percent of participants.
The findings do not mean that antidepressants such as Prozac, Paxil and Zoloft do not work, however researchers say that Americans may be overestimating the drugs’ effectiveness. Much of the improvement shown during clinical trials may be due to the close attention and evaluation the patients receive during the study -- a phenomenon that does not occur for most patients who use the drugs in everyday life.
Moreover, the sugar pills actually cause changes to occur in the same areas of the brain affected by the antidepressant drugs, according to recent research. It was also found that more patients’ depression is being alleviated due to placebos now than 20 years ago.
Placebos, or pills that have no effect, have long been used by scientists to distinguish the real effects of medicine from the illusive feelings of patients. Often in the field of medicine patients experience what is known as the placebo effect -- the feeling of getting better after being treated with placebos.
However, it seems that placebos may actually make a difference in the treatment of depression, as the disease is characterized by how people feel.
Many psychiatrists say that drugs alone will not cure depression. Instead, a combination of medication and psychotherapy appears to yield the best results. Despite this, antidepressants have become the automatic treatment for most cases of depression.
In 2002, there were close to 25 million doctor visits for depression, up from 14 million in 1987. Of these visits, medications were prescribed for nine out of 10 patients, according to recent research.
It is not known how many of these patients received therapy in addition to the medication, however, in 2001 less than one-third of doctor visits for depression were to psychiatrists and two-thirds of them were to primary care physicians. According to researchers, psychiatrists are more likely to administer medicines along with therapy, while physicians, who are less knowledgeable about therapy, are less likely to offer therapy to their patients.
Other studies have shown that in an average eight-week trial, each study participant, whether taking drugs or placebos, is questioned and examined by experts and caregivers for about 20 hours. Comparatively, the average depressed patient likely sees a doctor for only 20 minutes a month.
To add a piece to the puzzle, researchers say that often patients with similar symptoms have different problems with their brain chemistry. The neural mechanisms behind this, and the reasons why antidepressant medications work, are not fully understood.
In one study that followed changes in the brain associated with antidepressant drugs, results showed that many of same changes occurred in patients who took placebos. The parts of the brain that were primarily affected are thought to play a role in mood.
In this particular study, 38 percent of depressed patients got better from taking the placebo, compared with 52 percent from the medicines.
However, once the trial ended and the patients were told what they had been taking, the patients who had been on placebos fell back into their depression. It appears that one’s belief in the effect of antidepressant may account for the improved feeling in patients.
While some say that antidepressants drugs work primarily because of the placebo effect, others believe that the drugs produce an effect of their own. A related study found, through the use of a brain imaging technique, that these medications do in fact produce changes in the brain stem that did not occur in patients taking placebos. However, the effects of these changes are not yet understood.
The analysis led many to say that an integrated treatment that takes into account both biological and mental aspects may prove beneficial in the treatment of depression.
Dr. Mercola's Comments:
Depression or, more accurately, unrepaired emotional short-circuiting absolutely devastates health and, in my estimation, causes far more profound negative health consequences than all the rotten food, toxins and poisons we expose ourselves to.
Depression is responsible for about 66 percent of all suicides and can become a terminal illness. This illness should be taken seriously, as seriously as a diagnosis of a heart attack or cancer. If you are unsure whether you or someone you love is suffering with this common illness please review the article on how to diagnose depression.
Earlier this year I posted an article that clearly showed there is very little difference between most all antidepressants and placebos.
Does this mean that antidepressants don’t work? Absolutely not, but in the vast majority of cases a benefit is felt because the person taking the pill believes that the pill will heal their depression. The "science" is quite clear on this.
Similar to this placebo effect, last year I posted an article on a controlled trial of arthroscopic knee surgery for arthritis. Amazingly, the study showed that arthroscopic knee surgery is no better than a placebo, yet 650,000 Americans receive this infective surgery each year, at a cost of about $5,000 per procedure. This equates to a total cost of about $3.3 billion every year in the United States.
But that cost and waste is a mere drop in the bucket when compared to the devastation that results when people’s lives are damaged by the trauma of inadequately treated depression.
One major flaw of "expert" psychiatrists is their justification to keep people on antidepressants for the rest of their lives for so-called "maintenance therapy." Most experts believe that one-third of depressed patients need this therapy.
I have been to many lectures at major medical schools given by prominent psychiatric department chairmen, and I have asked the question from the audience, "Are there any non-drug options for this large group of people?"
The consistent response from these "experts" was no, and each of them would recommend lifelong drug therapy as the lesser of two evils. They justify this because of the fact that over 70 percent of patients relapse with depression once they stop their medications.
What a pity that so many are suffering because these "experts" are living in a delusion. Rather than recognizing that depression returns once a patient is off their medications because the drug doesn’t treat the cause, they elect to continue their Band-Aid approach.
To give some background of how I first became interested in depression, the treatment of this illness has fascinated me ever since I listened to an Audio Digest tape of Dr. Joseph Tally about 20 years ago. He was an animated physician who provided a compelling story of some of the issues I am presenting here. Of course, back then his main focus was helping people through the use of drugs.
At that time, the drugs were the first generation non-SSRI, primarily tricyclic, antidepressants and had plenty of side effects. The main challenge was to convince patients to stay on the drugs long enough to notice their effects. The drugs would cause terrible problems with dizziness, drowsiness, weight gain and dry mouth. For the most part, these drugs are rarely used today.
Prozac was the first SSRI antidepressant that seemed to work without the terrible side effects. When it came out I was like a kid in a candy store. I was a recent medical school grad and was totally brainwashed in the drug paradigm. I put well over 1,000 patients on Prozac -- probably closer to 2,000.
However, with time I gradually came to realize the futility of this approach and have since adopted a course of care that addresses the cause of the illness.
Like most families, I have been personally affected by depression. My own mother suffered from this problem several years ago and actually made several unsuccessful suicide attempts that really devastated me. This occurred just as I was making the transition into energy medicine, so initially she was treated with medications.
However, the medications and in-patient care were a terrible failure. Ultimately it was energetic techniques that helped her fully recover from the depression, and she is now healthier emotionally than she has ever been in her life.
Optimizing diet is clearly an important step in dealing with depression, and one of the most important tools is to make sure you are getting enough omega-3 fats. I have had large numbers of patients spontaneously take themselves off their antidepressants once they started taking fish oils, an excellent source of omega-3 fats.
Dr. Stoll, director of the psychopharmacology research lab at Boston's McLean Hospital and assistant professor of psychiatry at Harvard Medical School, discusses this topic extensively in his book The Omega-3 Connection. I highly recommend this book, which reviews new evidence supporting the use of omega-3 oils for depression.
I also recommend a high-quality source of fish oil. It is necessary to have a quality source to ensure that toxins and other impurities have been removed from the oil. I offer Carlson’s brand fish oil and cod liver oil on this site, as I have found it to be of superior quality.