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’60 Minutes’ antidepressants report may be ‘explosive,’ but it’s not ‘new’

Researchers have long questioned the efficacy of antidepressants like Prozac.

On Sunday, CBS’ “60 Minutes” broadcast what it called an “explosive” report on “new scientific research” that has found that antidepressants are no more effective than placebos at treating mild and moderate depression.

Explosive? Well, yes, when you consider, as “60 Minutes” correspondent Lesley Stahl reported, that the 17 million Americans with depression are spending an estimated $11.3 billion annually on drugs that research says don’t work for most of the people using them. (Antidepressants have been found to help people with severe depression.)

But new? Hardly. Studies linking the placebo effect to antidepressants have been around for more than a decade.

In fact, the main medical expert featured in the “60 Minutes” story, psychologist Irving Kirsch, who is assistant director of the Placebo Studies Program at the Harvard Medical School, published his first major paper on this topic in 1998.  That one caused a medical uproar at the time, as did a second paper Kirsch co-authored in 2002. That’s the paper he talks about in the “60 Minutes” story — the one in which he looked at unpublished as well as published studies from the pharmaceutical industry. (As Kirsch points out to Stahl, drug companies frequently decline to publish their unfavorable findings. He had to request those studies from the Food and Drug Administration.)

Since then other researchers have come to similar conclusions. Indeed, many scientists researching depression have now discarded the entire rationale behind antidepressants — the theory that depression is caused by some kind of brain chemical imbalance, especially low levels of the hormone serotonin. In the “60 Minutes” broadcast, one of these researchers, psychiatrist Dr. Walter Brown of Brown University, referred to the serotonin theory as “a gross oversimplication.”

It’s not as though the antidepressant/placebo story hasn’t received press coverage in the past. Newsweek ran a cover story in 2010 called “The Depressing News About Antidepressants,” shortly after a major meta-analysis (a study that looks at the best evidence from many smaller studies) found that any benefit of antidepressants over placebo pills was “minimal or nonexistent.” Time magazine ran its own major piece on the topic a few months later.

And there have been many other articles in the media as well, including a thorough venting of the subject in a 2008 Men’s Health article by Minnesota-based freelance writer Paul Scott.

Then there is the widely reviewed book that Kirsch himself wrote on the topic (“The Emperor’s New Drugs: Exploding the Antidepressant Myth”) in 2010.

All this history made me wonder why Stahl seemed so astonished during her interview with Kirsch. She seemed to be unaware of the decade-long controversy surrounding antidepressants. At one point she says to Kirsch, “But people are getting better taking antidepressants. I know them. We all know them.”

“Yes,” replies Kirsch. “People get better when they take the drug. But it’s not the chemical ingredients of the drug that is making them better. It’s largely the placebo effect.”

Still, better late than never, I guess. Having the topic featured on “60 Minutes” will certainly bring it to the attention of many, many more people. The show also does a service by talking about the two treatments for mild and moderate depression that some research has shown to be effective: exercise and talk therapy.

You can watch the entire “60 Minutes” segment below.

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Comments (4)

  1. Anonymous Submitted by Anonymous on 02/21/2012 - 02:59 pm.

    I agree that not much was new in this report. But this brings up some important questions: Why does prescribing continue to go up? Why do psychiatrists still hold to the chemical imbalance theory?

    One thing that the 60 Minutes report didn’t emphasize was what happens to people when powerful chemicals are introduced into their brains? What happens when they are removed? In order to not have to call their drugs addictive psychiatrists made up terms like “SSRI discontinuation syndrome” that was just a fancy way of saying withdrawal.

    There was a good article from the journal Frontiers of Evolutionary Psychology a few months ago that postulated that the brain would try to regain its former balance when these chemicals were added, either slowing down production of serotonin, or killing off receptors. The authors wondered whether the brain would ever be able to get back to balance, or whether permanent brain damage would be sustained. You can read the whole article for free here:

    Early evidence suggest there may be permanent brain damage.

    • Anonymous Submitted by Anonymous on 02/21/2012 - 03:33 pm.

      I don’t know why the Minnpost website doesn’t allow links in comments anymore, but…here’s the title of the journal article, if you google it it will show the article: Blue again: perturbational effects of antidepressants suggest monoaminergic homeostasis in major depression. Don’t be scared off by the scientific title – the paper is very readable.

  2. Submitted by Pat Berg on 02/22/2012 - 08:10 am.

    URLs are supposed to turn into links automatically

    It says so in the text immediately below the box where I’m typing this.

  3. Submitted by Sharlene Spalding on 02/22/2012 - 10:19 am.

    Did not address the dangerous side effects

    Trouble with this story is no one really address the dangerous side effects of the drugs. Anti depressants are powerful drugs. What about increase risk of suicide particularly with adolescents. Kirsch was almost flippant about whether one takes the placebo or one takes the drugs- the results are the same. For many individuals the side effects of anti depressants are seriously harmful.

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