Wednesday, February 27, 2008

The Placebo Effect

Probably like many people opening my bottle of antidepressants this morning, I had to pause. Should I bother splitting that pill, or should I move directly on to the caffeine course? The reason for the pause is a study widely reported yesterday that basically says that, for most people, antidepressants aren't much more effective than placebos. In other words, it may have been all in our heads. 

In a way, this is positive news. Learning that a pill isn't effective is a good way to get off it, and getting off of a pill is a good way to get rid of the side effects that go with it. (Many partners of people on libido-killing "happy pills" may soon have cause to celebrate. But what if the side effects were all in our heads, too?) On the other hand, if the placebo effect was working for a lot of people, what happens now? The placebo effect tends to be a lot more effective before you know it exists. Regaining one's innocence after having it crudely stripped away is no easy task, particularly if you're bummed out. 

How can I put faith in my bottle of Celexa now that I know I might as well have been sprinkling Tang on my breakfast cereal? They need to quickly invent a followup study that convinces us that there's a new magic pill. The best pill would be a capsule made of nothing. Then they need to design an excellent marketing campaign to convince us that we need this drug to look as happy as the people on TV. Then they need to over-prescribe it so it will become de-stigmatized, like Prozac back in the day. (A best seller will help.) Finally, they need to take whatever measures necessary to keep the placebo effect hidden in a safe, dark cave.

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