The only way that a medication can get approved for an indication by the FDA is if during controlled clinical trials, it was more effective than placebo. Keep that in mind. Double blind studies with a placebo control group area always used and the group with medication attached must outperform and of a significant level in patient populations in order to then be approved for that indication. And the placebo group that is blinded also has side effects from their placebo . . . go figure.
I know many personally that have true clinical effect from the medication they have been prescribed. It's anecdotal as they weren't part of a clinical study or trial but enough for me to feel confident that medications do work for many people. But it is individual. And self reporting how you feel is subjective. Some think that if they take an antidepressant they should never have any sadness, blues or anxiety. It mellows those things out for people but it should not eliminate all feeling to numbness in my opinion. But that is some people's expectation.
I feel these drugs can save lives and have. :>) And I did take Prozac and it helped significantly with two areas-- low level depression and social anxiety.
What studies? There are no studies that prove antidepressants are a placebo. As Mom says, all approved medications have to do clinical trials to prove the drug beats placebo in double blinded studies. Now, they don't beat placebo by very much, that's true. That's one reason why so many have been approved -- none work all that well, but there are a lot of them to try so you have a good chance of one of them working for you. Another thing to consider is that placebo effects tend not to last -- they stop. Drugs keep working. Drugs do have significant downsides and taking them should be done with great care. But they do work when they work. Now, can you have a placebo effect with an approved drug? Yes. You can. That happens when a drug hasn't actually kicked in yet and you feel better. Or when the drug doesn't work at all and you feel better. It happens. It's not a bad thing, because placebos, not being active, don't harm you. Drugs can harm you even when they work. But don't let a life go completely down the toilet because you avoid taking a drug that might be the best thing for you based on false information. Peace.
Artmesia, do you have someone in your life that is treatment resistant or are you having difficulty?
Yes when you find the right one that works for you.
I tried a dozen different ones with no real benefit, but kept trying them one by one until we tried one that was actually a very old antidepressant, and THAT one actually started working for me, and I slowly started getting better and better, and I thought, "I could live with this", and I continued to get better still, and I thought, "Wow, this is pretty good!", and I got even better than that! And I thought, "Oh my God I had no idea this is better than I ever imagined!" And it got even better than that!
I kept getting better for an entire year, and it absolutely changed everything.
A few years later my doctor took me off it, I went into decline. We went back on it, I got better.
A few years later we went off it again (don't ask, we were stupid back then), we tried every other medication there was, nothing worked, I went downhill and got really bad, we eventually restarted the one antidepressant that DID work for me, I slowly got better again.
All those other antidepressants I tried, they didn't work for me. They would have worked as well as any placebo. But this one that works for me, definitely works for me.
The problem is, in other fields of medicine, we have one pill that works for everyone. You have a problem, you take this pill, it works for everyone. Doesn't matter who you are. In psychiatry however, it matters who you are. You have a problem, there are two dozen pills out there that have been found to work for others, one of them might work for you, but most of them probably won't. We have no way of knowing which one will work for you. We just have to try them all, one by one, until we find the one that works for you.
From a study point of view, this means, take any pill and try it on a group of random people, that pill isn't going to be the magic pill for most of those people. It's not going to work any better than a placebo. (By the way placebos are pretty effective! I've decided I'd by them if they were for sale!) The setup of the study is wrong. The setup is assuming all people are the same, and the pill should work for all people, like pills do in other fields of medicine.
In psychiatry, we're looking for a pill that works for SOME people. We find a pill that actually works like magic for SOME people, it's the magic cure for those lucky people, and it definitely works for those people. But there are other people that pill didn't work for, so we find another pill that works for SOME people, and then another pill that works for SOME people, and we get this whole collection of pills, each pill is the magic cure for a subgroup of people, and it definitely cures them. We shouldn't study the effectiveness of these pills using random groups of people. Doctors and patients know if a pill is working or not. When a pill works for an individual it DEFINITELY works. There's no question then pill that works for me DEFINITELY works for me. We did the "Try taking me off it" test 3 times, and the result was pretty definitive. That's the kind of test that convinces one the pill really does work. Don't need a random sample of people.
Instead of testing a pill on a group of people, we flip it and test a group of pills on a person.