Is the Efficacy of “Antidepressant” Medications Overrated?

Deacon, Brett J.; Spielmans, Glen I.

doi:10.1002/9781119095910.ch13

Cited by 6 publications

(4 citation statements)

References 45 publications

(52 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the present study, survey responses revealed that psychiatrists frequently raise patient expectations about medications' effectiveness, consistent with research on the powerful role of the placebo effect in antidepressant efficacy ( 23 , 24 ). Nearly all prior research has indicated that higher expectations promote better outcomes ( 25 ) [though see ( 26 )].…”

Section: Discussionsupporting

confidence: 84%

The Importance of Patient Expectations: A Mixed-Methods Study of U.S. Psychiatrists

Rosenfield

Bernstein

2021

Front. Psychiatry

View full text Add to dashboard Cite

Objective: To examine how psychiatrists think about and modulate non-specific factors (e.g., hope, expectations) in clinical practice.Methods: U.S. psychiatrists were recruited for two studies assessing attitudes and behaviors related to non-specific factors. Study 1 entailed remote qualitative focus groups (k = 7) with n = 26 participants (36.0% female). Study 2 was a quantitative survey with n = 346 respondents (34.0% female) designed to assess the generalizability of focus group findings.Results: Four themes were identified in Study 1 that were used to inform the survey (Study 2): (1) Expectations (2) Hope, (3) Placebo Effect, and (4) Aesthetic Features. Nearly all surveyed psychiatrists (92.2%) considered patient expectations at least “most of the time” when interacting with a patient. Focus groups revealed that psychiatrists often attempt to balance optimism and realism to improve outcomes. A majority of survey respondents believed office design and physician attire could at least somewhat influence expectations (72.5 and 77.3%, respectively) and even outcomes (51.5 and 58.7%, respectively). Focus group psychiatrists described how physical features may be used as therapeutic tools.Conclusions: Psychiatrists are highly mindful of patient expectations. Although there is variability in the perceived importance of expectations, hope, the placebo effect, and aesthetic features, many utilize these factors in clinical practice.

show abstract

Section: Discussionsupporting

confidence: 84%

The Importance of Patient Expectations: A Mixed-Methods Study of U.S. Psychiatrists

Rosenfield

Bernstein

2021

Front. Psychiatry

View full text Add to dashboard Cite

show abstract

“…A popularized narrative about the use of antidepressants to treat depression is that they are safe, effective, and work according to the chemical imbalance hypothesis, that is, by altering the neurochemistry of the brain ( Deacon & Spielmans, 2017 ). However, in the late 1990s and the first two decades of the 2000s, concerns (such as those listed below) surfaced in the research literature concerning antidepressants and their use to treat depression (e.g., Healy, 1997 ; Kirsch, 2010 ).…”

Section: Components Of the Critiquementioning

confidence: 99%

Critiquing the Critique: Resisting Commonplace Criticisms of Antidepressants in Online Platforms

Sthamann

McMullen

2021

Qual Health Res

View full text Add to dashboard Cite

Critiques of antidepressants in public spaces such as print media, blogs, social media, websites, and radio and television programs are now commonplace. Such critiques typically center on issues such as the side effects and risks of antidepressants, overblown claims of effectiveness, the fallacy of the chemical imbalance hypothesis, overprescribing, and the availability of equally or more effective nonmedication interventions for depression. In this article, we employ a discursive analysis to show how online commenters fashion a particular counter-argument to these critiques. Prominent in this counter-argument is that only “real” depression benefits from antidepressants, and that a “one-size-does-not-fit-all” understanding of these medications is needed. We argue that, while this nuanced counter-critique contains features that make it difficult to undermine, it simultaneously embeds many unanswered questions.

show abstract

“…A growing body of research shows that placebo effects are therapeutically significant in the treatment of: acute ( Benedetti, 2014 ) and chronic ( Vase et al, 2014 ) pain, migraine ( Kam-Hansen et al, 2014 ), major depressive disorder ( Kirsch, 2014 , 2019 ; Deacon and Spielsman, 2017 ), anxiety disorders ( Sugarman et al, 2014 ), irritable bowel syndrome ( Kaptchuk et al, 2008 ), alcohol dependence ( Weiss et al, 2008 ), Parkinson’s Disease ( Lidstone, 2014 ), intellectual disabilities ( Jensen et al, 2017 ), and binge eating disorder ( Blom et al, 2018 ).…”

Section: Placebos and Placebo Effectsmentioning

confidence: 99%

Putting the ‘Art’ Into the ‘Art of Medicine’: The Under-Explored Role of Artifacts in Placebo Studies

et al. 2020

View full text Add to dashboard Cite

Research in social psychology demonstrates that physical environmental factors-or "artifacts" such as provider clothing and office décor-can influence health outcomes. However, the role of artifacts in augmenting or diminishing health outcomes is underexplored in the burgeoning discipline of placebo studies. In this paper, we argue that a careful consideration of artifacts may carry significant potential in informing how placebo effects can be maximized, and nocebo effects minimized in clinical settings. We discuss the potential mechanisms, including classical conditioning, response expectancy, and mindsets, by which artifacts might enhance or diminish these effects. Next, we propose testable hypotheses to investigate how placebo and nocebo effects might be elicited by artifacts in care settings, and conclude by providing innovative research designs to advance this novel research agendum.

show abstract

Is the Efficacy of “Antidepressant” Medications Overrated?

Cited by 6 publications

References 45 publications

The Importance of Patient Expectations: A Mixed-Methods Study of U.S. Psychiatrists

The Importance of Patient Expectations: A Mixed-Methods Study of U.S. Psychiatrists

Critiquing the Critique: Resisting Commonplace Criticisms of Antidepressants in Online Platforms

Putting the ‘Art’ Into the ‘Art of Medicine’: The Under-Explored Role of Artifacts in Placebo Studies

Contact Info

Product

Resources

About