# Irving Kirsch’s research



## Ashtad bin Sayyif (Apr 28, 2011)

A quick bit of background info on Kirsch himself can be found here and the details of his book, in which his findings are explained in more detail, can be seen here. I'm dreadfully curious: is there anyone who has given serious attention to his findings?

Some of his major points seem to be as follows: (1), no study has ever successfully established that there is any low amount of any neurotransmitter in the brain of a depressed person. (2), Kirsch had to file a Freedom of Information Act against the FDA in order to discover that many studies finding no difference whatsoever between antidepressants and placebo &#8230; have not been published! Both publication bias and the obvious monetary incentives have been implicated. (3), when we include these studies which found no positive result in a broader meta-analysis (as Kirsch did-you can read the analysis here), we find that there is a negligible difference if any between any antidepressant and placebo. (4), even this difference could well be explained by the fact that people in trials like these suspect that they may be taking the placebo. But once the common side-effects of an antidepressant kick in, suddenly, they know they're on the real thing. And it could be that at this point, positive expectations kick in and then so does the placebo response. (5), SSREs - which do the OPPOSITE thing to neurochemistry as SSRIs - seem to show the same response rate as SSRIs. This is explicable on the assumption of an overwhelming placebo reaction, but totally inexplicable on the serotonin hypothesis of depression. If that hypothesis were true, we would expect SSREs in fact to INDUCE depression, but they don't seem to do this.

In short, there seems to be substantial evidence that antidepressants are indistinguishable, or at least overwhelmingly indistinguishable, from placebo. Discovering this, I decided to taper off the Lexapro I've been on for two years for severe suicidal-depressive episodes, and I've been off them for roughly six weeks now. I find that, even though I truly believed at the time that Lexapro was improving my mood, I am in fact "cycling" through these moods at the same rate I was before. However, whether through the cannabis I've been using about once weekly for several months now, or being off all medication, or something else, my depersonalization has suddenly, spontaneously become intense (which is why I'm here). And please note that I don't make these points to alarm anyone: if anything, you should feel empowered-because if these findings are true, and you {think} an antidepressant has been helping you-then, well, in reality, you can reach that same level of improvement without spending time and money on pharmaceutical companies. If the improvements that antidepressants have made on your life are actually all in your head, then I would hope that this would show you the empowering fact that the improvement you have made was not due to a drug, but to the power of your own positive expectations.

In any case. I'm dreadfully curious if anyone else has given Kirsch's work any serious thought or attention. I typed "Kirsch" in the search bar as soon as I got here, and found no results.


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## Ashtad bin Sayyif (Apr 28, 2011)

That is, indeed, an interesting question. I suspect that it could be anything from finding an antidepressant that doesn't have tremendous {negative} side effects to simply the passing of time and changing of circumstances that tend to happen as treatment goes on. Possibly, those circumstances aren't so much easing their depression directly as they are contributing to the build-up of positive expectations towards this next thing to try - maybe the sentiment many people have is that they know one of them will work, but they don't know which one; so the more that they try, the closer they know they must be to the one that will work for them and the more positive expectation / hope they start to have.


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## gill (Jul 1, 2010)

I think the problem is that, how do you measure something that is very subjective such as depression? I mean, a doctor doesn't draw blood to see if a med is helping, they just ask you, and there is their evidence, you know?


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