Irving Kirsch, The Emperor’s New Drugs: Exploding the Antidepressant Myth

Whitaker,

doi:10.5406/amerjpsyc.124.3.0370

Cited by 6 publications

(7 citation statements)

References 2 publications

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“…That morning, I awoke to find that our paper was the front page story in all of the leading national newspapers in the United Kingdom. A few months later, Random House invited me to expand the article into a book, entitled The Emperor's New Drugs: Exploding the Antidepressant Myth, which has since been translated into French, Italian, Japanese, Polish, and Turkish (Kirsch, 2009). Two years later, the book, and the research reported in it, was the topic of a five-page cover story in the influential American news magazine, Newsweek.…”

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confidence: 99%

Antidepressants and the Placebo Effect

Kirsch

2014

Zeitschrift für Psychologie

126

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Antidepressants are supposed to work by fixing a chemical imbalance, specifically, a lack of serotonin in the brain. Indeed, their supposed effectiveness is the primary evidence for the chemical imbalance theory. But analyses of the published data and the unpublished data that were hidden by drug companies reveals that most (if not all) of the benefits are due to the placebo effect. Some antidepressants increase serotonin levels, some decrease it, and some have no effect at all on serotonin. Nevertheless, they all show the same therapeutic benefit. Even the small statistical difference between antidepressants and placebos may be an enhanced placebo effect, due to the fact that most patients and doctors in clinical trials successfully break blind. The serotonin theory is as close as any theory in the history of science to having been proved wrong. Instead of curing depression, popular antidepressants may induce a biological vulnerability making people more likely to become depressed in the future.

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confidence: 99%

Antidepressants and the Placebo Effect

Kirsch

2014

Zeitschrift für Psychologie

126

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“…Like the WHO and CDC, the studies claim depression causes substantial economic burdens on national healthcare systems and employers and results in significantly reduced productive labor, requiring unnecessarily higher healthcare resources. Furthermore, many exercise science reviews point to a meta-analysis questioning the efficacy of antidepressant medications, suggesting they are no more effective than placebo (Kirsch, 2010;Kirsch et al, 2008). To the exercise science community, the findings from Kirsch and colleagues seemed to open a new opportunity to argue exercise is more effective than placebo (Blumenthal et al, 2007(Blumenthal et al, , 2012.Thus, many in exercise science promote the prescription of exercise interventions as a potential therapy tool in place of or alongside traditional treatments for depression as well as for populations with chronic illness and comorbid depression.…”

Section: Relationship To Depressionmentioning

confidence: 99%

A syndemics approach to exercise is medicine

Clarke

Adamson

2021

Health (London)

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This paper offers new insights into the promotion of the Exercise is Medicine (EIM) framework for mental illness and chronic disease. Utilising the Syndemics Framework, which posits mental health conditions as corollaries of social conditions, we argue that medicalized exercise promotion paradigms both ignore the social conditions that can contribute to mental illness and can contribute to mental illness via discrimination and worsening self-concept based on disability. We first address the ways in which the current EIM framework may be too narrow in scope in considering the impact of social factors as determinants of health. We then consider how this narrow scope in combination with the emphasis on independence and individual prescriptions may serve to reinforce stigma and shame associated with both chronic disease and mental illness. We draw on examples from two distinct research projects, one on exercise interventions for depression and one on exercise interventions for multiple sclerosis (MS), in order to consider ways to improve the approach to exercise promotion for these and other, related populations.

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“…Though Kramer raised concerns about the use of medication for such purposes, it was his claim about the medications' effects that entered the public consciousness. In subsequent years, the popular literature has become more critical about psychotropic medication in particular (e.g., Kirsch, 2010;Whitaker, 2011) and the pharmaceutical industry in general (Carlat, 2010).…”

Section: Psychopharmacology and Psychiatrymentioning

confidence: 99%

A brief history of psychopharmacology in the context of psychology and psychiatry.

McGrath

2019

APA Handbook of Psychopharmacology.

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The moral treatment movement spurs the founding of York Retreat by William Tuke. Offering compassionate treatment for individuals with SMIs, it was widely emulated. The aggregation of individuals with SMIs in asylums that adopted a humane treatment philosophy spurred research into the disorders. Bayer introduces Aspirin, the first widely successful medication. Veterans of World War II create a large population of patients needing help with emotional difficulties. The National Mental Health Act establishes the National Institute of Mental Health. The Humphrey-Durham amendment to the 1938 Food, Drug, and Cosmetic Act defines whole categories of drugs available only by prescription. Previously, prescriptions were largely limited to psychoactive drugs (e.g., cocaine; Temin, 1980). Lehmann and Hanrahan (1954) report dramatic effects administering chlorpromazine (Thorazine ® ) to individuals with schizophrenia, resulting in swift adoption in North America. The term antipsychotic comes into use. The second antipsychotic, reserpine, is also described for the first time. Schou, Juel-Nielsen, Strömgren, and Voldby (1954) publish the first controlled trial of lithium for mania. Meprobamate (Miltown ® ) is identified as a less sedating anxiolytic than the major tranquilizers, founding outpatient psychopharmacological treatment. It is quickly followed by the more popular chlordiazepoxide (Librium ® ). The Mental Health Study Act creates funding for psychopharmacology research. The first monoamine oxidase inhibitor, iproniazid, is described by Nathan Kline as a treatment for depression. Approved for use in 1958, it was withdrawn in 1961 because of hepatic effects. Kuhn's (1958) article on imipramine introduces the tricyclics to a wide audience. Among other firsts, Kuhn coins the term antidepressant. Amitriptyline follows. In a marketing innovation, it was introduced with the first book about depression written for nonphysicians (Ayd, 1961). Amendments to the Food, Drug, and Cosmetic Act establish randomized, placebo-controlled, double-blind studies as the gold standard for evaluating medications. Schildkraut (1965) introduces the catecholamine hypothesis of depression. Based on drug evidence, depression was associated with insufficient levels of catecholamines, and treatment effects with the inhibition of catecholamine uptake. Coppen (1967) made the parallel argument for serotonin, and later dopamine was implicated in schizophrenia on similar grounds (Creese, Burt, & Snyder, 1976). Fluvoxamine, the first so-called selective serotonin reuptake inhibitor, is marketed. It is followed four years later by fluoxetine (Prozac ® ). Listening to Prozac is published (Kramer, 1993), in which the author suggests psychotropic medications can help you feel "better than well."Note. SMI = severe mental illness.

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Irving Kirsch, The Emperor’s New Drugs: Exploding the Antidepressant Myth

Cited by 6 publications

References 2 publications

Antidepressants and the Placebo Effect

Antidepressants and the Placebo Effect

A syndemics approach to exercise is medicine

A brief history of psychopharmacology in the context of psychology and psychiatry.

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