As we discussed last time, it is fundamental to the testing of new drugs to have a placebo or "sugar pill" as a control when designing these tests. Sometimes, the interesting thing to notice when reading the results of these trials is not how effective the actual drug being tested works, but rather how well the placebo works! Sometimes the effectiveness of the sugar pill is stunning. Case in point, SSRI trials as reported in this IJN article. The authors reported that the majority of antidepressant trials conducted by drug companies have found that 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 over half the time. That is why, as I told you last time, Prozac needed 5 trials to get the FDA mandated 2 positive ones. Who'da thunk that sugar pills would treat depression better than these expensive drugs?
In one recent trial, which compared the effectiveness of the popular antidepressant herb St. John's wort to that of antidepressant drug Zoloft, St. John's wort alleviated depression in 24 percent of study's subjects compared with 25 percent for Zoloft. But wait; read further...the placebo cured depression in 32 percent of participants, much to the embarrassment of the medical industry!
It's not as if these drugs don't work, but so does St. John's wort. Perhaps we simple patients are vastly over-estimating how effective these antidepressants actually are. It has been discovered quite conclusively that placebos create the same positive changes in areas of the brain affecting moods that the drugs are designed to effect.
To me these findings are quite scandalous and they call into question the whole concept of depression and it's treatment. The article reports that in 2002 there were 25 million trips to the doctor in the US due to depression and that 9 out of 10 times the patients got a prescription for antidepressant drugs. The cost of all this is staggering, especially when sugar pills would have gotten similar or better results overall.
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