We recently concluded a  heated debate on whether anti-
depressants are truly effective relative to placebo, with recent 
research claiming that they are not both supported and disputed 
by TIPSters.

Here's another possibility to explain why anti-depressants tend 
not to do well in placebo-controlled trials (unless you take the 
position that they in fact are effective relative to placebo and 
studies showing otherwise are shoddy and forgettable).

Placebos are getting stronger. In other words, the failure of anti-
depressants to show benefit relative to placebo is not due to 
poorer performance of the drugs, but to improved performance 
of placebos. This, I guess, is good news, although not 
necessarily for the drug industry. 

A new (and yet another) meta-analysis of anti-depressant 
response vs placebo reports this as one of its findings. Rief et al 
(2009) found that "the effect sizes in placebo groups in 2005 
were more than twice as great as those in 1980", indicating a 
substantial increase in placebo effectiveness. But note that this 
was only for observer ratings rather than for patient reports.

An interesting question is why. Possibly patients have greater 
confidence in the anti-depressant cure these days but, if this 
was the reason, one would expect that the effect would also 
occur for patient reports, probably to an even greater extent.

National Public Radio in the U.S. has an article on the finding 
here:
http://www.npr.org/templates/story/story.php?storyId=12436705
8 or http://tinyurl.com/yfmkauy
The growing power of the sugar pill (March 8, 2010)

Source:
Rief, W. et al (2009). Meta-analysis of the placebo response in 
antidepressant trials. Journal of Affective Disorders, 118, 1-8.

Stephen
--------------------------------------------
Stephen L. Black, Ph.D.          
Professor of Psychology, Emeritus   
Bishop's University               
e-mail:  sblack at ubishops.ca
2600 College St.
Sherbrooke QC  J1M 1Z7
Canada
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