Do Antidepressants Work?

The short answer is yes, but not for the reasons one might imagine. Antidepressants work not because of their active ingredients but because of the placebo effect. In other words, a sugar pill works just as well as the antidepressant, and has none of the side effects of drugs that aim to fix "chemical imbalances" in the brain. This is the conclusion of a fresh new research study by Harvard scientist Irving Kirsch, which adds to an accumulating body of evidence on the medical inefficacy, and the dangers of antidepressants and other overprescribed psychotropic drugs for tens of millions of people who use them everyday (see video below; more resources here).

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[Namit]

In this excellent survey article, Siddhartha Mukherjee looks at the latest developments in depression research. SSRI drugs that seek to restore "chemical imbalances", he suggests, seem to work only for severely depressed patients, particularly those with a family history of depression. In any case, the interaction of SSRI drugs with the brain appears to be far more complex than previously thought. Mukherjee concludes:

John Gribbin, a historian of science, once wrote that seminal scientific discoveries are inevitably preceded by technological inventions. The telescope, which situated the earth and the planets firmly in orbit around the sun, instigated a new direction in thinking for astronomy and physics. The microscope, taking optics in a different direction, ultimately resulted in the discovery of the cell.

We possess far fewer devices to look into the unknown cosmos of mood and emotion. We can only mix chemicals and spark electrical circuits and hope, indirectly, to understand the brain’s structure and function through their effects. In time, the insights generated by these new theories of depression will most likely lead to new antidepressants: chemicals that directly initiate nerve growth in the hippocampus or stimulate the subcallosal cingulate. These drugs may make Prozac and Paxil obsolete — but any new treatment will owe a deep intellectual debt to our thinking about serotonin in the brain. Our current antidepressants are thus best conceived not as medical breakthroughs but as technological breakthroughs. They are chemical tools that have allowed us early glimpses into our brains and into the biology of one of the most mysterious diseases known to humans.