Do antidepressants work? Of course—everyone knows it. Like his colleagues, Irving Kirsch, a researcher and clinical psychologist, for years referred patients to psychiatrists to have their depression treated with drugs before deciding to investigate for himself just how effective the drugs actually were. Over the course of the past fifteen years, however, Kirsch€™s research—a thorough analysis of decades of Food and Drug Administration data—has demonstrated that what everyone knew about antidepressants was wrong. Instead of treating depression with drugs, we€™ve been treating it with suggestion.The Emperor€™s New Drugs makes an overwhelming case that what had seemed a cornerstone of psychiatric treatment is little more than a faulty consensus. But Kirsch does more than just criticize: he offers a path society can follow so that we stop popping pills and start proper treatment for depression.
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Starred Review. When he began a new research project on antidepressants and placebos (a "meta-analysis" of a large number of published studies), practicing psychotherapist and research psychologist Kirsch (How Expectancies Shape Experience) was surprised to uncover evidence that inadequate supervision by the FDA had allowed pharmaceutical companies to cherry-pick test results for publication and submission to the feds, suppressing unwanted outcomes; further, apparent evidence of active drugs' effectiveness when compared to placebos could often be attributed to patients correctly guessing which group they were in based on the side effects (or the lack thereof) they had come to expect in conjunction with anti-depressants. When his results were published in early 2008, Kirsch was surprised to find himself and his research the subject of front page newspaper stories, TV and radio coverage, and a vigorous debate in the medical community that continues to this day. Writing with a broad audience in mind, Kirsch expands on this important topic in a lively style with clear, cogent explanations of the science involved, and many examples of the differences between solid and flawed research. The result is a fascinating book with broad implications for science policy.
Recent surveys show almost 30 million Americans taking Prozac, Paxil, and their ilk at a cost of more than $10 billion annually. With decades of persuasive clinical trials and testimonials from patients and physicians attesting to it, such antidepressants’ overall effectiveness has long been deemed indisputable by psychiatrists. Yet according to psychologist Kirsch’s damning expose of pharmaceutical industry greed, that efficacy is entirely due to the placebo effect. Kirsch makes the bulk of his case by reviewing data from dozens of clinical trials dating back to the 1960s, including ones kept hidden by drug companies, which demonstrate that antidepressants work no better than pills that mimic antidepressants’ side effects. Kirsch also dismantles drug company assertions that newer antidepressants, such as serotonin reuptake inhibitors, work by balancing faulty brain chemistry. His contentions have already stirred controversy, including the predictable criticism from Big Pharma. Yet his work is an overdue wake-up call to the psychological professions to begin treating depression with more compassionate methods than expensive pill-popping. --Carl Hays
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