Paxil gave me a buzz almost immediately and I had been told it would take 30 days to have an effect. It had to be the placebo effect and yet I remember lying in my bed with the windows open with my cat feeling the spring breeze in nirvana, definately a buzz. Of course if we could harness the placebo effect life would change. And as has been mentioned here, if the mind can cure itself if told a pill will make it sane, what effect does being told by a doctor that you are a mental defective have on the mind's performance?

The antidepressents I have taken did affected me the first day. They do change blood/brain chemistry right away. It is a drug. BUT Sure it doesn't reach peak saturation for a week or something. NOTE according to the chemistry of drugs, MANY use the placibo effect of a higher dose of psychiatric medicine (in times of mental trouble) when it is chemically proven it maxs out at a certain dose.
Last Psychiatrist most_important_article

yes i know "last psychiatrist" is talking antipsychotics , not antidepressents, but I am sure they work the similar brain chemistry.
Better link to charts on saturation levels.
no_not_effexor_too

What we believe is very powerful...in both directions. When I believed I was sick, I acted sick. Now that I don't believe I'm sick, I don't act sick. Of course it isn't that simple, but I have been astounded at the power of this change in mindset. I don't mean to be blithe though, it took at least 4-5 years to make this shift. I traded a short term positive placebo effect (drugs did work for a time), for a very long term negative one.

It may be possible to positively harness the placebo effect, provided you are availing yourself of a "treatment" that doesn't cause damage. I get regular acupuncture treatment (for physical problem). I have seen marked positive physical changes that I believe are a result of the acupuncture. There is some scientific evidence out there and I don't think it is all placebo effect, but I've decided to also embrace any portion that is. There are no side effects and it is not damaging my body (unlike drugs), so I'll take any positive effects, whatever the source.

This power of 'suggestion' that the drugs are working is central to my theory on the way identities and experiences progress or rather degrade once the authority figure shrink tells you have one of the psychotic disorders.

The power of suggestion that the drugs are keeping you well, and the power of suggestion that the consequences are certain death if you go off meds or something similarly dramatic.

The power of suggestion is at work in an abstract way I could even go as far as to say that all psych consumers are in the classic sense of the word 'hypnotized' in the sense that the man has said you will take this pill and you will feel less moody, but in the countersense you are also suggestable in the sense that you are actually going to live the experience of a disease that you are told will be with you for life

I'm saying what psychiatry does in saddling people with these false diseases, these constructs, voted into existence, that do not exist on the autopsy table, with speculative science at every turn, the abuse of the authority and the abuse of the power of suggestion, serves to create a situation where people going through a rough pathc in life, enter the office, are told they have a brain disease, and are told the statistics of the others with the same disease, and the terror and fear and spectre of death is just manufactured, and it is sick, evil, and psychiatry has instilled more terror into citizens of the west than islamists could ever hope to.

The irony is, if you go fight the islamists in a western army, you'll get a 'brain disease' and the shrinks will have their smutty hands on your neurology as you languish.

Answer to your question on trusting the ADs....

Of course not. Depression isn't a brain disease, a bad day, a bad year is not a brain disease, hating that you are fat, isn't a brain disease, being upset that you didn' get the amount of prestige in life you wanted isn't a brain disease, being upset over going bankrupt, isn't a brain disease, all the fraud science in the world will never prove it is.

The so called normal healthy neuromechanics in the content person's brain are not even known, to assume we have a biological treatment for sorrow is height of hubris, and reductionist, and biologically deterministic in the utmost.

The shrinks practice a pseudoscience, it's evil, it's corrupt, it kills, it warehouses innocent people in neuroprisons for misarable, brutish and short lives, and it must be fucking stopped that the end of the story.

People need to believe in themselves; and how to find this isn't in a bottle or a book. From the beginning of treatment, if medication is used, the patient/person must be told, that the med [anti depressant] is not a cure or end all be all.

It is in fact human determination, that pulls one self from darkness. If that is understood from the beginning, the patient is not left with false hope, and a better pavement of ground work for a glimpse into the future that often takes a person into a looking-back period, of their life, and changing things that are obvious and possible triggers to a breakdown for instance.

I've had this discussion with a person in my life who has bottomed out in a very bad way.

When rx'd an anti depressant, that's the talk I had. I encouraged the person to seek self.While inpatient in a psychiatric unit. Examine the life, and reminded the person that the med was in fact not the answer, it could help, but I felt I should be honest, based on experience, and based on this person's previous experience with Prozac and Effexor, which were not good ones, and also never did the most important part: the pills didn't "fix" the life problems, which have now nearly destroyed the person's life in a very, very bad way.

I feel it's imperative for the false hope not to be left with a pill for patients in severe crisis.

If I've learned anything, this is it.

From my own experiences on Prozac, I lost 6 months of my life in a numb state of mind, and once off of the drug, I could barely remember that I had moved to a new home, and I had no idea how long I had not gone to work. Turns out I hadn't worked for 3 months. I was going through the motions, of daily life at bare minimum.

My anecdotal stories above are just that. Not saying take a med or not, nor writing to create a defensive discussion from successful med users. I just believe there has to be a healthy balance or a quality life just isn't going to happen.

I've witnessed someone have a severe life breakdown and it's not a pretty site at all. I've brought to the table w the doctor and the person, to look beyond the anti depressant, and look at decades instead. So far, it appears the person needed to hear that and is glad I said it, but the work, the hard part, will be for the person to want to fight for their life, no one can do it for them.It's where a person might find themselves at a crossroad, and the other side is a dark one.

It is a disservice to people when doctors, especially inpatient psych docs, discharge patients w pills only. False hope in a bottle does not work for life. It just doesn't. To witness a person suffering from a suicide attempt is a serious situation, and a week on a anti depressant hasn't made a difference, which says much about the placebo affect.

The person is massively fractured in self-esteem, worth and there isn't a sign of any determination at all.

Which I hope the doctors pay attention to w/ regard to the drug not being a cure, or maybe not a help at all.

Placebo effects from psychological methods, such as religion, can be extremely powerful. As someone who has had a so called "religious experience" snap me very quickly out of a deep depression, I have first hand experience of the human mind's ability to trick/heal itself, especially when this is amplified by a crowd of True Believers. The problem is that people can become dependent on that kind of high just like they can with a drug--and so yes, you're not putting dangerous chemicals in your body, but there can still be some serious consequences. I think it is important to understand multiple methods for inducing self-healing by way of placebo effect, but it's important to remember that anything that has a powerful effect on the human mind can be dangerous under some circumstances, and should not be taken lightly.

It must be remembered that these ARE psychoactive substances...they DO make you feel different. The interpretation of how they make you feel may be placebo---in fact the very fact that they do make you feel different aids the placebo effect. They're doing something so I'm gonna believe they are making me feel good and sometimes even damn good!!

Too bad I can't have an orgasm, damn.

These aren't sugar pills. And they do make you feel different.

By the way...they never made me feel good, but I did lose the ability to orgasm and I had various negative psychiatric symptoms that I did not realize at the time were drug induced. Even with this profile I was on virtually every SSRI and SNRI over a period of about 10 years. I've been clean for a couple of years now. Never missed them after the unpleasant withdrawal. (I've had much worse withdrawals with other drugs though---though I know I was lucky with the SSRI withdrawals)

Your friend's comment on 9/11 reminded me of the brouhaha over Elizabeth Wurtzel's remark, "I had not the slightest emotional reaction. I thought, 'This is a really strange art project.' It was the most amazing sight in terms of sheer elegance. It fell like water. It just slid, like a turtleneck going over someone's head." This remark of hers reputedly is what pushed her film Prozac Nation straight to video. Prozac does this to people I'm sure. Your friend describes what I am sure is a typical reaction to Prozac very well. Joseph Glenmullen in his books quotes patients describing Prozac as an "attenuated form of cocaine". I also believe that it can have a stimulant effect after just one pill -- it's the blunting effect that takes longer.

I’m glad you wrote on this topic and your post is excellent. I have been thinking about this very issue since the study came out (and have thought about it before too). People misunderstand, in my opinion, what the conclusion is saying. If a/ds are equivalently effective to placebo, this is not the same thing as saying they are both working by exactly the same mechanism. In both there is the psychological dimension of course of acting proactively to do something to get better. That turns out to be enough apparently in the case of the placebo for some recovery but there is more than that going on with the a/d as so many who have taken them describe. Peter Kramer didn’t just randomly pick out the expression “better than well” – he was describing the high that many people get the moment they start taking an antidepressant. These pills didn’t become blockbusters just because they employ a placebo effect to work their magic. I have to agree with Glenmullen that it’s more like taking cocaine or even meth – only watered down versions. In my view the study also demonstrates that depression is self-limiting and often gets better no matter what you do. (Of course it can come back too.) I have heard of that crying jag happening a lot - a few weeks or months after coming off an antidepressant – it’s often the trigger for re-medicating.

Joanna Moncrieff has recently written a book that I would love to get my hands on called The Myth of the Chemical Cure. In it she says that if we just called a spade, a spade in the field of psychopharmacology, in other words, classified drugs according to their drug effects, as stimulants and sedatives, rather than pretending they are “disease” specific – e.g. antidepressant, antipsychotic, the whole practice of psychiatry would be a lot better off. SSRIs aren't curing or healing depression but they are giving people a drug effect that takes their mind off their miseries for a certain period of time but there is a thin line between the activation that gets you to a high and the activation that pushes you over the edge to violent and bizarre behavior.

Oh would you look at that! Undiagnosed wrote a comment just before mine, but it wasn't up yet when I wrote and submitted mine, and it is along the same lines, this power of suggestion working in both positive and negative ways is obviously something others have realized. And that is a good thing that it is getting out there, Joanna Moncrieff is a mental health hero, and that's something to be, I didn't know that book was out, and I bought up big on antipsych books on amazon a month or two ago, I will have to get The Myth of the Chemical Cure. Sounds great, man she does a good job with her essays that I have seen.

The negative placebo effect element has to be seen for what it is, that the sheer act of a psychiatric diagnosis by the shrink is something so powerful and unbridled that is a dangerous thing, it can change the way you look at yourself in every way, and some will be glad to have a scapegoat for the pain they feel, others will experience a short feeling of relief, followed by a disintegration of their self worth as they come to think of themselves as a walking birth defect.

Has anyone seen the RUBBISH about brain disease over at schizophrenia.com ? That evil, evil, criminal E Fuller Torrey has written some rubbish over there I can tell you.

Enlarged ventricles in schizophrenics supposedly controlled for neuroleptic use! Was it controlled for benzo use? Was it controlled for tobacco use? You absolute evil, evil, old man. At least he is old and won't be on the scene forever.

what I am seeing interpreted as placebo effect is what I think of as the validating power of a Dx and an Rx. there was something about being told that there really was something wrong with me that could be fixed that made me instantly feel better. I felt like I had the power over my destiny in the palm of my shaky little hand. the problem is it takes a lot less effort to take a pill every morning than to eliminate white carbs and get on a damn bike, though, which is why the long term effects differ so much.

Remember when Tink got the Lost Boys to shoot Wendy and they had to get the thermometer to make her better? it's little-kid logic that gets us so enslaved. our Drs are so learned and noble and wise and yet they can't find the time to do their research, but because they have the title and we don't, we blindly obey.

I'm sticking with acupuncture and valerian and 5htp from now on.

I think for once I don't even know where to start with an issue like this. Is it even possible for a single individual to ever separate placebo effect from drug efficacy with respect to their personal experience? Statistically we can when looking at a large group of people, but for an individual?

SSRIs never inherently made me feel better, only different in some qualitative way. (This is aside from Paxil, which nearly killed me). As if I experienced my life differently, though they never made me any happier or less depressed.

Hell I'd say let's go back to prescribing sugar pills with a nominal copay. No side effects with the same efficacy! And I'm serious.

A family member who used Benadryl for sleep with psych med use, ran out of Benadryl. I found a tin of 'tic tacs'cinnamon type 'mints'. They looked pretty close to Benadryl. It was at night, for bedtime use.In a quandary, I handed the tic tac with a glass of water for the person who was distraught they were out of Benadryl. I said this should kick in within 5 minutes. The person slept like a rock and the next day told me that Benadryl sure works great!!

The power of suggestion indeed.Harmless candy too.

NAP, you are probably right that it is not possible for an individual to separate efficacy from placebo effect. It is good that we are discussing what these drugs actually do to people. It troubles me to think of all of the people have been labeled treatment resistant because ineffective drugs didn't cure them, or worse labeled bipolar and/or psychotic because (we) experienced normal side effects of this drugs.

As a result of these studies doctors should be burning up the phone lines and sending out letters to patients and amending insurance accessible medical histories.

In case any docs are reading here's a sample draft of a letter to patients that could be sent out: "Dear Ms. Smith, Your diagnosis of treatment resistant depression was erroneous as it turns out the drug I originally prescribed for you is not actually a treatment for depression. Following your ingestion of this drug, it is likely all of the psychiatric symptoms you have experienced were caused not by an organic brain defect but by a combination of the ingestion of the drug and suggestion by me a doctor that you had some sort of brain defect.

I will now refer you to a doctor qualified to monitor you as you cease taking the other drugs I prescribed you which it also turns out don't treat depression or the side effects of the drug originally prescribed but instead make it more likely that you will harm yourself or someone else as you stop taking these extremely dangerous and addictive drugs which have been proven to have virtually no clinical efficacy. All treatment related to your ceasing use of this drug will be financed by me. However, since discontinuing these drugs has proven impossible for many people due to their severe addictive properties, whether you choose to try to cease taking these drugs, or
if you, like many others are unable to quit taking them, I will finance your monitoring free of charge and indemnify you for any harm you may experience and/or cause as I am totally responsible for your addiction having falsely assured you these drugs were not addictive. Furthermore, it turns out I may have mislead you by implying that your psychic distress was anything other than a wise, well reasoned and compassionate response to this complex life, hence, any distress you feel is likely felt as a response to my suggestion that your brain is defective combined with the poisons I prescribed based on the cuteness of a pharmaceutical sales person and the uniqueness of the free post it notes she gave me. It is not your brain, it is my ability to practice medicine, that is defective. I am voluntarily surrendering my license to practice medicine. But hey, don't be mad at me, anybody, presented with a hot young drug company rep would have done the same thing."

This is one instance where blaming the victim, i.e. the patient, is not appropriate.

Basically then, are we to beleive that an antidepressant (or placebo) is merely doing the work of a shrink/counsellor?

In essence, this seems to be the gist of things doesn't it? Or have I got it all wrong?

Take an antidepressant for mild to moderate depression and the patient 'may' feel they are getting better.

Go talk to a shrink/counsellor and the patient (over time) will feel they are getting better.

Take a placebo for mild to moderate depression and the patient 'may' feel they are getting better.

I'm surprised there has been no entrapaneur who has latched onto this very lucrative market.

Think about it. A drug that claims to cure your depression but really it's a sweet - the patient, obviously does not know this.

You could get past the FDA/MHRA with the ingredients of the drug as both regulators seem pretty useless when it comes to regulating the drugs we take anyway.

If there were only such a market eh?

It seems Pharma have the stranglehold on this too because basically their drugs to cure depression on placebos with chemicals.

The only benefit seems to be long term adverse reactions. Maybe we should thank Pharma for showing us what addiction feels like, giving us sleepless nights, electrip zaps jolting through our bodies, hightened aggression, feelings of suicide and homicide plus a host of other reactions that accompany these drugs?

End of the day, Pharma and the regulators have lied to us all. For years they have touted 'The benefits far outweigh the risks'.

Thier studies are akin to giving a small child a gun, leaving the child in a room and intermittently allowing a group of people into that room. Some of the people want to show the child love, others want to kill the child. The child does not know the good from the bad so shoots and kills 3 random people. Luckily for the child, he kills one child murderer - Phew! these guns can come in pretty handy, it saved the child from being murdered. Let's publish the results, it don't matter about the two innocent people that the child killed... at the end of the day, the gun saved this child's life!

An extreme analogy, I agree, but one that is the basis of clinical trials.

Or am I wrong?

Fid