New pitch for placebo power.Much fanfare has greeted drugs touted as balms for depression, such as fluoxetine fluoxetine /flu·ox·e·tine/ (floo-ok´se-ten) a selective serotonin reuptake inhibitor used as the hydrochloride salt in the treatment of depression, obsessive-compulsive disorder, bulimia nervosa, and premenstrual dysphoric disorder. (Prozac). These medications indeed elicit chemical changes in the brain linked to mood improvements, but the lion's share of their effectiveness stems from the placebo effect placebo effect
A beneficial effect in a patient following a particular treatment that arises from the patient's expectations concerning the treatment rather than from the treatment itself. , according to a statistical analysis of 39 studies of treatments for depression.
"How people think about an antidepressant antidepressant, any of a wide range of drugs used to treat psychic depression. They are given to elevate mood, counter suicidal thoughts, and increase the effectiveness of psychotherapy. drug and its effect on how they feel may influence improvement more powerfully than the chemical substance itself," contends Guy Sapirstein of Westwood Lodge Hospital in Westwood, Mass.
Sapirstein and Irving Kirsch kirsch
A colorless brandy made from the fermented juice of cherries.
[French, short for German Kirschwasser; see kirschwasser. of the University of Connecticut The University of Connecticut is the State of Connecticut's land-grant university. It was founded in 1881 and serves more than 27,000 students on its six campuses, including more than 9,000 graduate students in multiple programs.
UConn's main campus is in Storrs, Connecticut. in Storrs compiled data from published studies consisting of 3,252 moderately to severely depressed individuals who had randomly received antidepressants Antidepressants
Medications prescribed to relieve major depression. Classes of antidepressants include selective serotonin reuptake inhibitors (fluoxetine/Prozac, sertraline/Zoloft), tricyclics (amitriptyline/ Elavil), MAOIs (phenelzine/Nardil), and heterocyclics (including Prozac or any of several related drugs), placebo pills, psychotherapy, or no treatment. Trial periods lasted from 2 to 15 weeks.
The researchers then calculated the extent to which each treatment, on average, yielded brighter moods.
From a comparison of these estimates, Sapirstein and Kirsch assert that the placebo effect-a measure of the psychological impact of being given a medication, even if it contains no active substances-plays a dominant role in sparking favorable responses to antidepressants. The placebo effect is twice as strong as either the pharmacological effects of antidepressants or "nonspecific nonspecific /non·spe·cif·ic/ (non?spi-sif´ik)
1. not due to any single known cause.
2. not directed against a particular agent, but rather having a general effect.
1. " factors, such as the passage of time, they maintain.
This conclusion gains force from some prior evidence (SN: 10/10/92, p. 231), but it remains tentative until issues such as differences between placebo and no treatment effects are better understood, the researchers hold. Still, they say that available data probably underestimate the placebo effect.
For instance, antidepressant researchers typically do a pretest to weed out volunteers who respond strongly to a single placebo pill. Moreover, an unknown number of studies in which antidepressants fail to outperform placebos are either not submitted or not accepted for publication, Sapirstein adds.