The Emperor’s New Drugs: Exploding the Antidepressant Myth
by Irving Kirsch. Basic Books, 2010
Prozac, Zoloft, Paxil, Effexor, Celexa. These popular antidepressants are effective—but their function arises mainly from the placebo effect. Psychologist Irving Kirsch arrived at this conclusion a few years ago after he and his colleagues took a thorough look at all the data from experiments with antidepressants.
In The Emperor’s New Drugs, Kirsch reports that sugar pills are about as effective as antidepressants and that for many years drug companies withheld this information. Moreover, these placebos don’t have to be sugar pills; even a synthetic thyroid hormone, disguised as an antidepressant, helped to alleviate depression in subjects with no thyroid problems.
Kirsch reveals some unsavory pharmaceutical company practices. He reports that drug companies frequently manipulate scientific data—by cherry-picking positive results, withholding negative findings from publication, and “salami slicing” (publishing positive data multiple times). For instance, in the 1990s GlaxoSmithKline conducted several trials on the effectiveness of the antidepressant Paxil, which showed the drug was no more effective than a placebo. The trials also revealed some dangerous side effects, including a possible increased risk of suicide. GSK, however, decided not to release most of the negative data to the public. When this negligent behavior was later uncovered, the company was sued by the New York attorney general for engaging in “repeated and persistent fraud.” The company was forced to make all the data public.
In light of the fact that tens of millions of Americans—including many children—are taking antidepressants, it’s hard not to find Kirsch’s account disturbing. Moreover, it makes one wonder about the testing and approval processes for other medications. “For society as a whole, knowledge of what the data on antidepressants really say should be a clarion call,” Kirsch says. We can only hope that the call will be heard.