17 million Americans with depression are spending an estimated $11.3 billion annually on drugs that research says don't work for most of the people using them.
Susan Perry, Minnpost, Feb 21, 2012
On Sunday, CBS' "60 Minutes" broadcast what it called an "explosive" report on "new scientific research" that has found that antidepressants are no more effective than placebos at treating mild and moderate depression.
Explosive? Well, yes, when you consider, as "60 Minutes" correspondent Lesley Stahl reported, that the 17 million Americans with depression are spending an estimated $11.3 billion annually on drugs that research says don't work for most of the people using them. (Antidepressants have been found to help people with severe depression.)
But new? Hardly. Studies linking the placebo effect to antidepressants have been around for more than a decade.
In fact, the main medical expert featured in the "60 Minutes" story, psychologist Irving Kirsch, who is assistant director of the Placebo Studies Program at the Harvard Medical School, published his first major paper on this topic in 1998. That one caused a medical uproar at the time, as did a second paper Kirsch co-authored in 2002. That's the paper he talks about in the "60 Minutes" story - the one in which he looked at unpublished as well as published studies from the pharmaceutical industry. (As Kirsch points out to Stahl, drug companies frequently decline to publish their unfavorable findings. He had to request those studies from the Food and Drug Administration.)
Since then other researchers have come to similar conclusions. Indeed, many scientists researching depression have now discarded the entire rationale behind antidepressants - the theory that depression is caused by some kind of brain chemical imbalance, especially low levels of the hormone serotonin. In the "60 Minutes" broadcast, one of these researchers, psychiatrist Dr. Walter Brown of Brown University, referred to the serotonin theory as "a gross oversimplication."
It's not as though the antidepressant/placebo story hasn't received press coverage in the past. Newsweek ran a cover story in 2010 called "The Depressing News About Antidepressants," shortly after a major meta-analysis (a study that looks at the best evidence from many smaller studies) found that any benefit of antidepressants over placebo pills was "minimal or nonexistent." Time magazine ran its own major piece on the topic a few months later.
Then there is the widely reviewed book that Kirsch himself wrote on the topic ("The Emperor's New Drugs: Exploding the Antidepressant Myth") in 2010.
All this history made me wonder why Stahl seemed so astonished during her interview with Kirsch. She seemed to be unaware of the decade-long controversy surrounding antidepressants. At one point she says to Kirsch, "But people are getting better taking antidepressants. I know them. We all know them."
"Yes," replies Kirsch. "People get better when they take the drug. But it's not the chemical ingredients of the drug that is making them better. It's largely the placebo effect."
Still, better late than never, I guess. Having the topic featured on "60 Minutes" will certainly bring it to the attention of many, many more people. The show also does a service by talking about the two treatments for mild and moderate depression that some research has shown to be effective: exercise and talk therapy.
You can watch the entire "60 Minutes" segment below.
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