I am writing this because I have read and overheard so many people say antidepressants are just placebo. I understand why people think they can be so certain of this, there is quite poor evidence for their use in a way. However I also think their is poor evidence to say they are just placebo. And this is coming from an individual who has tried three different antidepressants, at different doses in the past year with a very minor, if any beneficial effects.
Normally deciding if a drug works is prety simple, you compare it to placebo or reccomend treatment in the group you are wanting to treat. The problem with doing this with depression is that diagnosis is based on symptoms, it’s not even a huge list. Just think of all the times you put all your symptoms into webMD. Did you just get one option? Multiple pathologies can lead to the same symptoms. For most illnesses there are other diagnostic tests that can be used. For depression occasionally people get mania and/or hypomania and they get a different classification of bipolar disorder. Shockingly bipolar disorder has a different treatment. There are multiple theories about the underlying pathology of depression, and maybe there is only one cause, but maybe their isn’t.
So.. My point is that is you group people into one and test a drug on them that may only work for one pathology it’s going to be hard to see the true result. I feel like no one is going to follow me on this. Let’s take breast cancer for an example, approximately 20% of breast cancers are HER-2 positive. If specific HER-2 treatments were only given to breast cancer in general compared to only those who were HER-2 positive, the same benefit couldn’t be seen. Not the best example but I need to go to sleep.
Good night .