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The Emperor’s New Drugs: given ever larger doses of antidepressants, any
Exploding the Antidepressant Myth improvements in levels of depression are likely
By Irving Kirsch, PhD due to the “enhanced placebo effect.” How do we
Random House, 2009 know this? Because patients who took increased
amounts of placebos showed just the same sorts
Dr. Irving Kirsch originally set out inno- of improvements as those who took increased
cently enough to investigate the placebo effect amounts of antidepressants! This means that a
of antidepressant drugs. During the course of sugar pill would have worked just as well as the
his investigations, however, a series of surpris- prescription drug. The problem with high doses
ing discoveries led him to the conclusion that of antidepressants as opposed to placebos is not
the actual “antidepressant effects” of the drugs merely that they don’t work, but that at higher
ranged from ineffective to downright dangerous, doses, they do much, much more harm, as their
including both minor and truly harmful and of- side effects become seriously magnified, and
ten fatal side effects such as diabetes, increased often fatal.
risk of heart attacks, severe weight gain, nausea Dr. Kirsch further suggests that patients
and insomnia to name a few. Dr. Kirsch doesn't given antidepressants as opposed to placebos in
claim that antidepressants work any better than supposedly blind trials “improve” because they
placebos. In the reverse, he claims that placebos frequently “break blind,” which means that they
work about as well as antidepressants but with develop terrible side effects from the drug and
none of the harmful side effects. Thus, placebos deduce—accurately—that they got the “real
Dr. Kirsch has are actually powerful medicine. deal” as opposed to the placebo. This psycho-
How do you measure depression? This is logical trick actually produces an “enhanced
systematically important to know for those individuals who placebo effect” because patients feel better as a
stripped the might visit a doctor at some point in their lives result of knowing that they got the drug and not

antidepressant complaining of depression. A doctor determines the placebo.
efficacy claims a patient’s level of depression based upon a Dr. Kirsch analyzed thirty-eight clinical tri-
numerical scoring method called the Hamilton als of major antidepressants, involving thousands
by dint of Scale. This Hamilton Rating Scale for Depres- of depressed patients, and as a result presents a
large-scale sion, or HRSD, is a summation of scores com- shattering and methodically analyzed indictment

meta-analyses piled by doctors based on interviews and obser- of antidepressant efficacy, Big Pharma data-doc-
vations of patients. As Dr. Kirsch explains, “The toring, and FDA collusion and complicity—all
that indicate doctor rates the patient’s mood, thoughts about of which come at a large cost to human health.
75 percent suicide, sleep disturbances and other symptoms Depression is a heterogeneous condition
of an of depression. For example one point is given if and is much more complex than lowered levels
the patient feels that life is not worth living, and of say, serotonin, Kirsch asserts. In fact rigorous
antidepressant’s four points are given if the person has made a research shows that reducing serotonin levels,
efficacy comes serious suicide attempt. The result is a numerical even dramatically, in healthy individuals has ab-
from its score that can range from zero to fifty-one. solutely no effect whatsoever on their depression
Dr. Kirsch has systematically stripped the levels. That is to say, they do not get depressed

placebo effect, antidepressant efficacy claims by dint of large- at all! If reducing serotonin levels does not cause
a mere 25 scale meta-analyses that indicate 75 percent of an depression in a healthy person, how could we
percent from antidepressant’s efficacy comes from its placebo make the illogical leap that raising serotonin
effect, a mere 25 percent from the drug itself. levels will make a depressed person feel better?
the drug itself. Worse, for severely depressed patients who are We have been bombarded with “low serotonin”

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