Teens guessing they were taking an antidepressant led to substantial improvement, while actual treatment with the drug did not, researchers found.
Prescribing an antidepressant to depressed teens is challenged by a new study finding that the drug’s apparent effectiveness is accounted for by the placebo effect. Because antidepressants carry the risk of serious adverse effects, including suicide and violence, the Citizens Commission on Human Rights (CCHR) is urging doctors who are prescribing antidepressants to heed recent studies indicating the drugs may be doing more harm than good.
Researchers in Australia and the U.K. who conducted the study cited concerns about the rising number of children and adolescents being prescribed antidepressants, given the questionable effectiveness and known harms of the drugs.
“There has been a significant rise in the use of antidepressants throughout the world in recent decades, with dramatic increases among children and teenagers, despite concerns about a heightened risk of suicidality, the influence of financial interests and general concern about the use of drugs in children,” wrote lead author Jon Jureidini, a child psychiatrist at the Critical and Ethical Mental Health Research Group at the University of Adelaide in Australia.
In the study, researchers addressed the fact that outcomes of clinical trials testing whether drugs are effective can be influenced by the placebo effect, whereby participants’ beliefs about whether they are receiving the actual drug or fake treatment (placebo) can affect results and inflate any apparent effectiveness of the drug.
Using data from an influential previous study of treatments for depressed teens, in which the drug given for treatment was the antidepressant fluoxetine (commonly sold as Prozac), the study focused on the accuracy of participants’ guesses about whether they were getting the drug or a placebo and to what extent that influenced their outcomes.
The researchers found that those depressed teens who guessed they were taking the antidepressant, regardless of whether they guessed correctly or not, improved more than those who were actually given the drug. What’s more, adolescents who thought they were on the antidepressant but were actually given a placebo experienced the greatest improvement.
“Treatment guess strongly predicted outcomes and may have led to the exaggeration of drug effectiveness in the absence of actual effects,” the researchers concluded. The study was published in the Australian & New Zealand Journal of Psychiatry.
One of the researchers involved in the study, British psychiatrist Joanna Moncrieff, M.D., was previously an investigator and lead author in the landmark 2022 study that found no scientific basis for the theory of a chemical imbalance in the brain, presumed to be the cause of depression and a rationale for prescribing antidepressants to correct that supposed imbalance.
For years, psychiatrists promoted the theory, which received considerable coverage
in psychiatric and psychopharmaceutical journals. However, despite decades of brain research, Moncrieff found there is no conclusive evidence of a chemical imbalance or other brain abnormality causing depression for antidepressants to fix, which calls into question the prescribing of antidepressants.
Known adverse effects of antidepressants include weight gain, nausea, insomnia, agitation, emotional blunting, sexual dysfunction, suicide and violence. An analysis of the FDA’s Adverse Event Reporting System in 2010 found that 31 out of 484 prescription drugs were disproportionately associated with violence, and 11 of those 31 were antidepressants. On discontinuing antidepressants, patients may experience withdrawal symptoms that can be severe.
Because of the risk of serious side effects and the lack of effectiveness of antidepressants, 31 prominent British medical professionals, researchers, patient representatives, and politicians, including Moncrieff, recently published an open letter
in the prestigious British medical journal, The BMJ, calling for the U.K. government “to commit to a reversal in the rate of prescribing of antidepressants.”
WARNING: Anyone wishing to discontinue or change the dose of an antidepressant or other psychiatric drug is cautioned to do so only under the supervision of a physician because of potentially dangerous withdrawal symptoms.