The following information is for educational purposes only.
Here’s the skinny on the debate. The issue on antidepressants comes down to a few areas. First, do they work? To answer that question, one can go to the research on it for an answer. The vast majority of research suggests that antidepressants are effective for depression. So where’s the loop whole you may be asking yourself. Some valuable research that is note worthy is by Kirsch and Sapirstein (1998). They conducted a meta-analysis that included 19 studies out of 1,500 that met certain criteria. Kirsch and Sapirstein concluded that 75% of the responses were placebo response; leaving 25% or less to be a true drug effect. A placebo is a dummy pill.
In an effort to establish rates of therapeutic response between placebo and antidepressants, Khan, Warner, and Brown (2000) conducted a study that analyzed 45 FDA clinical trial data for all antidepressants approved in the United States over a period of 11 years. Khan et al. reported that nearly half of the 45 studies showed only a modest effect for antidepressants with an effect size of < .5.
In another study on the efficacy of antidepressants, Kirsch, Moore, Scoboria, and Nicholls (2002) reported on the six most widely-prescribed antidepressants approved by the FDA between 1987 and 1999. Their report identified a mean drug-placebo difference of two points on the Hamilton Rating Scale for Depression. This research suggests that differences between antidepressants and placebo are small. Furthermore, many of the randomized, placebo-controlled trials of antidepressants go unpublished. Once those unpublished trials were analyzed, medication was shown to offer only a modest benefit compared to placebo treatment, even for severely depressed patients (Kirsch et al.).
The next issue over antidepressants is side effects. Pharmaceutical companies have improved upon antidepressants, but various side effects can exist for some people and be bothersome. There are people on both sides of the issue as to whether antidepressants are effective and can cause little adverse reactions. It seems that the majority of professionals and the media believe that antidepressants are effective and safe. Voices on the other side of the issue are less heard.
So what do professionals on the other side of the issue have to say? To give you an idea, Moncrieff (2007) believed that a sedative effect may be why antidepressants appear to be better than a placebo. Moncrieff explained that a sedative creates a state in which it may be difficult for an individual to feel an emotion. What Moncrieff calls the drug-centered model suggests that drugs may be harmful when taken frequently and continuously because a drug may inhibit normal functions of the body.
Breggin (2007), who explained that people’s lives can often be severely disrupted by psychoactive medication, proposed that patients could experience a spellbinding effect or intoxication anosognosia effect. Breggin defined spellbinding as a person’s response to the effects of medication. For instance, a person who fails to recognize the harmful effects of the medication may instead overestimate its positive effects. When that happens, the individual may believe that the medication is actually helping, when it actually is the cause of some psychological symptoms.
Breggin (2007) has summarized his earlier work, in which he named the spellbinding effect as the brain-disabling principle. The first four of the eleven brain-disabling principles in his summary include:
1. All biopsychiatric treatments have a common mode of action - the disruption of normal brain function. None of them improve brain function; 2. All effective biopsychiatric interventions work by causing generalized brain dysfunction….; 3. Biopsychiatric treatments have their therapeutic effect by impairing higher human functions, including emotional responsiveness, social sensitivity, self-awareness or self-insight, autonomy, and self-determination….When the disruption in normal function is interpreted as advantageous, the treatment is considered successful….; and 4. Each biopsychiatric treatment produces its essential or primary brain-disabling effect on all people, including normal volunteers and patients with varying psychiatric diagnoses. (Breggin, 2007, p. 7)
A third issue over antidepressants is whether they can be addictive or not. In general, antidepressants are not believed to be addictive, but some newer research has shown the opposite to be the case. Either way, what I’ve witnessed is people who have depression not getting the help they anticipated. After a while on antidepressants, some people may need their medication dosage increased. Yet, symptoms still persist and dosages increase. You decide for yourself what to make of this…
The last issue addresses the question many people have, are antidepressants necessary? This kind of decision is something you’ll have to make. Something that may help you decide what is best is believe is whether depression is genetic/biological or environmental. Genetic and biological causes are generally thought to be cured through psychopharmacology (antidepressants), because medication is believed to help the brain function as it is supposed to (normal functioning neurotransmitters). Environmental causes such as stress or uncontrollable negative thinking causes are generally believed to be cured through therapy such as cognitive therapy.
Newer studies suggest that antidepressants they may protect the brain (hippocampus) from damage and restructuring of depression. Other research suggests that depression is best helped through a variety of interventions. Learning a variety of skills that improve one’s thinking is essential for learning to cope with the past, how one’s life is in the present, and having peace about the future: When Your Mind Is Clear, the Sun Shines All the Time shows you how this is possible.
As recommended by psychologists, this book can work in adjunct with antidepressants or with therapy. You can learn intervention skills at my workshop. Visit www.needhelp2succeed.com for more information.
