Anti-depressants are the most prescribed medications in the history of mankind. Doctors have issued hundreds of millions of prescriptions over the last two decades. But how effective are they? It appears that much of the benefit that some people perceive is a kind of generalized treatment effect that has nothing to do with molecules in the brain. Instead, it seems that people often feel better from just being in treatment. In clinical trials, antidepressants don’t work much better than a placebo pill.
The File Drawer Phenomenon
If that’s the case, why does the ‘science’ seem to suggest that antidepressants are highly effective? One major reason is that pharmaceutical companies conduct the research—and this really matters. If a drug is equally as effective as a placebo, then about half of trials will show that the drug outperformed the placebo, while the other half will show that the placebo outperformed the drug. If a drug company puts their ‘failed trials’ into a file drawer and sends their ‘successful,’ trials out for publication, the published literature will seem to suggest that the drugs work. Research over the past ten years has shown that pharmaceutical companies are indeed building up huge file drawer repositories of failed trials—research they hope will never see the light of day.
