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Placebo pp 291–303Cite as

The Emperor’s New Drugs: Medication and Placebo in the Treatment of Depression

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Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 225))

Abstract

Antidepressants are supposed to work by fixing a chemical imbalance, specifically, a lack of serotonin in the brain. Indeed their supposed effectiveness is the primary evidence for the chemical imbalance theory. But analyses of the published data and the unpublished data that were hidden by the drug companies reveal that most (if not all) of the benefits are due to the placebo effect. Some antidepressants increase serotonin levels, some decrease it, and some have no effect at all on serotonin. Nevertheless, they all show the same therapeutic benefit. Even the small statistical difference between antidepressants and placebos may be an enhanced placebo effect, due to the fact that most patients and doctors in clinical trials successfully break blind. The serotonin theory is as close to any theory in the history of science having been proved wrong. Instead of curing depression, popular antidepressants may induce a biological vulnerability making people more likely to become depressed in the future.

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Author information

Authors and Affiliations

  1. Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Irving Kirsch

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  1. Irving Kirsch
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Correspondence to Irving Kirsch .

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Editors and Affiliations

  1. Neuroscience Department and National Institute of Neuroscience Labs, University of Turin Medical School, Turin, Italy

    Fabrizio Benedetti

  2. Department of Psychosomatic Medicine, University Hospitals Tuebingen, Tuebingen, Germany

    Paul Enck

  3. Neuroscience Department and National Institute of Neuroscience Labs, University of Turin Medical School, Turin, Italy

    Elisa Frisaldi

  4. Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, Essen, Germany

    Manfred Schedlowski

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Kirsch, I. (2014). The Emperor’s New Drugs: Medication and Placebo in the Treatment of Depression. In: Benedetti, F., Enck, P., Frisaldi, E., Schedlowski, M. (eds) Placebo. Handbook of Experimental Pharmacology, vol 225. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-44519-8_16

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