There's one additional issue I don't think anyone has yet touched on. When we talk about efficacy of a medication, we should ask from whose point of view.
What a patient wants to know is: will this anti-depressant medication help me? If the alternative is no treatment, then anti-depressants clearly help. This is an evidence-free post, but I recall that there are usually substantial rates of improvement compared with no treatment, perhaps of the order of 60%. A researcher wants more. He/she wants to know the source of the improvement. Is it specific to the type of drug prescribed, the neurochemical change it is presumed to produce, etc, or is the improvement due to non-specific factors, such as the expectancies of the patient and the prescribing doctor? To determine whether the drug has unique as opposed to non-specific benefit, you need to show that it's superior, not to no treatment, but to a placebo condition. But the patient couldn't give a tinker's fart about such stuff. All he/she wants to know is whether the drug will help. The doctor, aware or not of the conflicted state of the literature on this question, can nevertheless answer truthfully, "yes". This leaves unresolved whether a doctor should prescribe an expensive medication whose effects may be largely placebo. But as the question of their efficacy relative to placebo is still controversial, it seems to me it's better to prescribe anti-depressants than not to. Relative to no treatment, they do work for many. Stephen -------------------------------------------- Stephen L. Black, Ph.D. Professor of Psychology, Emeritus Bishop's University Sherbrooke, Quebec, Canada e-mail: sblack at ubishops.ca --------------------------------------------- --- You are currently subscribed to tips as: [email protected]. To unsubscribe click here: http://fsulist.frostburg.edu/u?id=13090.68da6e6e5325aa33287ff385b70df5d5&n=T&l=tips&o=12823 or send a blank email to leave-12823-13090.68da6e6e5325aa33287ff385b70df...@fsulist.frostburg.edu
