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1:21:55 · 13K views · Aug 15, 2014
Psychologist Irving Kirsch gives a distinguished lecture on antidepressant trials and the placebo effect. He argues drug-placebo differences are small outside severe depression.
HN points to it in discussions of antidepressant efficacy, the serotonin model and the power of placebos.
4 comments from Hacker News
If you're ever board and you want to watch something on placebos I highly recommend watching this lecture by Dr. Irving Kirsch. Placebos are pretty nuts and probably really undervalued. this video
Since here we are talking about placebo, I wonder if it has a meaning to say "placebo" when speaking about psychotherapy, since there is no "substance". Of course there is going to be a placebo effect as long as people think it's going to work. I think the point is that since in mild and moderate depression we have to choose between the placebo of a drug and the placebo of psychoterapy, let's choose the one with less side effects. On the topic of placebo, I found Irving Kirsch's talk about anti-depressants vs placebo in depression [1] very interesting. [1] this video
Having just watched the linked video, it sounds like there is only a clinically (as opposed to statistically) significant difference between SSRI's and placebos for the extreme end of severe depression. One of the interesting points the speak made was: The difference in response recovery rate between studies where the patients know they will receive an anti-depressant (drug vs. drug) and studies where they know they may recieve a placebo (drug vs. placebo) is bigger than the difference in recovery rate between drug and placebo. He then points out that due to side effects, patients are fairly reliably able to determine whether they are on a placebo or on an anti-depressant. When discussing the equivalent efficacy of SSRIs and SSREs he says: "Were there any truth in the serotonin model of depression, and I don't know any responsible researcher in the area who still contends there is. (It's only in marketing where you still see that talked about) Where there any truth to that, SSRE's should not help people recover from depression, it ought to make them depressed" Link to time: this video If that is correct, I think it might be valid to claim that " that the serotonin model of depression has been disproven" although I think "beyond a shadow of a doubt" seems hyperbolic. It might be also be argue that "the serotonin model of treating depression" might be clearer.
> Stimulates the Brain to Produce Serotonin except that the serotonin model of depression has been disproven without a shadow of a doubt: this video the device may have some effect as placebo but if that's what you're going for, there are many other cheaper alternatives