--- In [email protected], "shanti2218411" <[EMAIL PROTECTED]> wrote:
> However,there are many treatments which
> are only modestly more powerful than the placebo and I think this is
> the case with SSRI's.

However, this I assume is only your conjecture, perhaps well founded
by your experience as a practicioner, but still conjecture.

It would seem to me that whether a treatment has useful effects is a
disccussion relevant primarily to the subject and their doctor. With
possible input from family and health carrier if the treatment is
being funded under insurance. And NOT relevant to any bystanders aor
back seat drivers. 

And hypothetically, if there is  placebo effect, if thats what
actually is occuring and the SSRI has no physiologic effect (a premise
I find quite shakey), still as you point out, there is a structure of
support -- with a myriad of factors, that is generating the real
effect, via placebo. Thus the questions is certainly not, as some
posters have implied now and in the past (BB), that the SSRI support
structure is a waste, that the results are imaginary, aka placebo,
that doing nothing would produce the same results.  

For example, its silly to tell someone "here are your sugar pills,
take one daily", and expect them to have a REAL placebo effect. They
have to BELIEVE that there is "Big MOJO" enlivened in the
thereapy/pill for a placebo to have a REAL effect. 

The major research question would appear to be is there a more
cost-effective support structure that can yield the same effect. That
is, if its a real placebo effect, can a "Big MOJO" expectation be
created by other, lower costs, less side effect means. Or if the
effect is part direct physiologic and part placebo, is there a way of
ramping up the "BIG MOJO" expectation and reduce the more costly and
side-effect ridden drug.






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