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The Emperor's New Drugs: Exploding the Antidepressant Myth

4.05  ·  Rating Details ·  330 Ratings  ·  51 Reviews
Everyone knows that antidepressant drugs are miracles of modern medicine. Professor Irving Kirsch knew this as well as anyone. But, as he discovered during his research, there is a problem with what everyone knows about antidepressant drugs. It isn't true.

How did antidepressant drugs gain their reputation as a magic bullet for depression? And why has it taken so long for t
Paperback, 240 pages
Published September 3rd 2009 by Bodley Head (first published 2009)
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Books Ring Mah Bell
I was attracted to this book for a few reasons:
1. I like good debate over hot topics in the medical field, and the use and efficacy of antidepressants is a hot topic.
2. I have struggled with depression off and on for a few years and (once again) have taken myself off my antidepressant. There are many reasons for my choice, one of them is that I simply do NOT want to rely on a pill if I don't have to.
3. It has a very se
Emma Sea
Full disclosure: it's no secret I struggle with severe depression. Sometimes I stop my meds, because I feel fine, and then I end up trying to hurt myself. So for me, this is indeed personal.

The book is based on this published paper (open access). There's a summary here.

Kirsch's main argument is that "the overall effect of new-generation antidepressant medications is below recommended criteria for clinical significance" and psychotherapy is "at least as effective as antidepressant drugs and mor
Jul 13, 2013 K rated it really liked it
I wanted to read this book critically and remain skeptical of the author's controversial conclusions, that depression is not a chemical imbalance and that antidepressants work no better than placebos. And I would still be open to reading an intelligent, thoughtful rebuttal. But until that happens I have to say, Kirsch's arguments are quite convincing.

According to Kirsch, the evidence for antidepressants' superiority to placebos (by a margin which is statistically but not clinically significant,
Feb 19, 2012 Matt rated it really liked it
This book is fascinating from several different points of reference. I expect that the title draws people who are interested in depression and antidepressants specifically, and that question is certainly an important part of the story he's telling. Clinical depression is a particularly difficult disease in many respects. There is no consensus on its causes, although there are clear environmental and genetic factors that make people more prone to depression. Consequently, there is no one-size-fit ...more
Jenifer Mary Rune
Excellent book - anyone who wants to speak on the subject of anti-depressants will have to contend with Kirsch's findings. They are especially relevant given the current "crisis" in psychiatry regarding the NIMH's rejection of the DSM-5.

As a researcher, Kirsch has studied placebo effects for many years. His initial investigation into the placebo effect in depression spurred this book and his resulting rejection of the conventional view of antidepressants. Using the US Freedom of Information Act
Kelly H. (Maybedog)
Feb 12, 2011 Kelly H. (Maybedog) marked it as to-read
Shelves: 2-process-sort
THE VERY TITLE OF THIS BOOK IS DANGEROUS! Whether the antidepressants are working because they work or because of a placebo is irrelevant: they are still working for a lot of people and the vast majority have almost no side effects and no serious ones. But suggesting that their antidepressant may not work or is all in their head is enough to send a person with a serious depressive illness into a downturn that could prove fatal. It messed with my head and I was skeptical to begin with.

I'm willing
Apr 11, 2014 Jenny rated it really liked it
I started this book skeptical. Antidepressants are nothing but placebos? Really?

How do I justify that with all the people I know whose life and mental health have been changed for the better due to these drugs? All the people who felt for certain that their brain was different as soon as they went on the medication?

It took me a few weeks to get through the book because I had these moments of frustration on behalf of myself and other people, and I'd put the book down for a few days because of it
I cannot decide if the author of this work is a crackpot pushing a dubious agenda or someone who is in fact on to something about the way "Big Pharma" can, does and will do anything in their power to keep the current status quo regarding anti-depressants in place. And how in pursuit of this end basic science is tossed aside, the methodology for the approval of new -- and theoretically better -- medicines has been turned into something resembling a joke with a bad punchline, and even that a great ...more
Sep 09, 2011 Karen rated it really liked it  ·  review of another edition
Shelves: educational
I think we all like to read things that support the way we feel, so, I liked this book. Clearly I now need to go and read the other side of the viewpoint to balance it all out.

I was unaware of the details about the anti-depressant drug studies, but I have always felt that we JUST DON'T KNOW ENOUGH about any of it, and I really have had a hard time believing in the 'depression as a simple medical problem' theory. Clearly there is a medical aspect, but the human brain is such a magnificently comp
May 13, 2010 Pat rated it liked it  ·  review of another edition
Recommended to Pat by: Emma
Shelves: non-fiction
Interpreting data from a meta-analysis, Kirsch sets out to debunk the myth put forth by the multi-national pharmaceuticals that antidepressants are revolutionary, blockbusters drugs. He looked at clinical trials that compared the efficacy of various treatments for depression. "Drug effect," the response to drug minus the response to placebo minus the response to spontaneous response or doing nothing, was surprisingly, significantly small. Rather, he claims, the efficacy of these drugs in managin ...more
Jan 06, 2015 Laurel rated it really liked it
This book confirmed what I had long suspected - antidepressants don't really do what they are touted to do.

Years ago, when I was prescribed an antidepressant after being diagnosed as having chronic clinical depression, I had serious doubts that a tiny pill would be able to help me feel better. Despite some initial unpleasant side effects, I kept taking the little buggers in the hopes they would subside and the benefits would kick in.

Some weird stuff I was experiencing did go away, so I figured t
Oct 30, 2011 Kyndra rated it really liked it  ·  review of another edition
I'm not sure what bothers me more about antidepressants, the fact that they have so many side effects or the fact that they hardly work. But I think the one that takes the cake is that drug companies aren't spending all of their time and money on making the drugs work better (which is impossible, since the chemical-imbalance theory is utter nonsense), but they're spending all of their time and money on making the side effects less bad. Meaning, they're spending time and money on a drug that does ...more
Aug 26, 2012 Kate rated it really liked it
Very interesting book (if you can muddle through some of the more dry statistical paragraphs). Kirsch makes a compelling argument really in the effectiveness of placeboes. Beyond the anti-depressant research, there are fascinating notes about placebo knee surgeries and even placebo heart surgery and more that may make you question the efficacy of healthcare as we know it. Note to other "readers" who had a few negative comments- this is a book that you should read through to the end before tossin ...more
Yong Yi
Mar 06, 2013 Yong Yi rated it really liked it  ·  review of another edition
Shelves: non-fiction
Kirsch makes a rather convincing argument for the controversial claim that antidepressant medication works no better than placebo, and may even be due to an active placebo effect rather than the result of a biochemical change caused by the medication. I was fairly sceptical when I read the claims of the book, but he has presented the evidence for his argument well and in an easy-to-read fashion. I still wonder if his hypothesis will be embraced by the broader scientific community. Only time will ...more
Oct 20, 2013 Mia rated it it was ok
Compelling, important information in this book but it should have been called "THEY'RE JUST PLACEBOS!!!!" because at least 75% of the book is just an explanation about the placebo effects of psychiatric and other medications. Although the author is a psychotherapist(though not an MD and so not able to prescribe meds himself) he doesn't include case studies, real life experiences, interviews with other doctors or people in the pharm industry. This is strictly about the studies the pharm industry ...more
A specialist in the placebo effect discusses his findings, based on extensive reviews of pharmaceutical trials by manufacturers and regulators, that antidepressants' effects are no better than placebos -- that, in fact, they are active placebos. He also discusses the placebo effect more generally and gives a critical evaluation of the chemical-imbalance theory of depression.

A persuasive scientific argument that came as no surprise to drug manufacturers though it has been upsetting and controver
Interesting, but poorly written.
Kaye Bewley
Feb 11, 2016 Kaye Bewley rated it it was amazing
Shelves: reviews
GETTING to the truth that lies behind the widely promoted and, apparently, scientifically validated view that depression derives from a chemical imbalance in the brain may seem a daunting task. But to Professor Kirsch, author of this impressive book, it appears to have been an enjoyable ‘feather-ruffling’ exercise. From the book’s bold title right through to the final paragraph under the heading, “Don’t ask, don’t tell”, Professor Irving Kirsch’s use of the Hans Andersen metaphor is surprisingly ...more
Carole Davis
Sep 20, 2016 Carole Davis rated it really liked it
A fascinating look into the procedures used for antidepressant drug trials and further evidence that the pharmaceutical companies are solely driven by profit motive. If you, or any of your friends and family take these medications you should read this book and talk to your doctor. Sobering and eye opening, for certain. A must read for the person who wants to be an informed patient.
Matt Kimball
Apr 23, 2014 Matt Kimball rated it it was amazing
As I've been reading The Emperor's New Drugs: Exploding the Antidepressant Myth, I've found that when I mention the book and its ideas to friends, those ideas generate a healthy amount of skeptical resistance. The claims the book makes are rather surprising -- that there is no difference in clinical efficacy between SSRI drugs used to treat depression (such as Prozac) and an active placebo (i.e. a placebo with active biochemical side effects), that depression is a condition which responds partic ...more
Sami Sundell
Nov 20, 2011 Sami Sundell rated it really liked it
Kirsch starts the book by stating some simple facts from his original metastudy of efficacy of the antidepressant drugs, then continues deeper into the possible meanings of those results, and ends up debunking the whole chemical imbalance theory. Nice job!

The whole book is interesting read. It gives insight on how the drug approval process works, and also about the double standards evident in the field. Even if you take out the debunking of antidepressants, it has plenty of information about how
Денис Бурчаков
Mar 25, 2016 Денис Бурчаков rated it it was amazing
Shelves: science, therapy
I found this book almost 5 years ago on now defunct internet library. Despite being therapist and therefore the target audience of this tome, it took me so long to finally begin reading it. Why so? Because I judged the title and expected some pompous yabba-dabba against antidepressants. When I began the book I was happy to find, that I was wrong. Inside I found a clever and concise analysis of antidepressants history and evidence both pro and contra. I am familiar with the field and was highly s ...more
P Chulhi
Sep 09, 2011 P Chulhi rated it really liked it
Shelves: biomedical
Based on his analysis of all of the published and unpublished clinical trials submitted to the FDA, Kirsch argues that antidepressants (SSRIs) do work but aren't better than placebos. This in itself isn't a problem except that antidepressants come with a host of undesirable side effects including increased risk of suicide, sexual dysfunction, seizures, anxiety, increased cost to patients, etc. He also explains the "theory" of chemical imbalance and why it isn't a plausible explanation for depres ...more
Sep 06, 2011 Doug rated it liked it
Shelves: nonfiction
I don't know what to think, it's hard to believe that the antidepressant drugs basically amount to a $19 billion/yr placebo effect but the evidence he brings is persuasive. It still boggles the mind - and it's hard to get my head around the face that this guy might have been right about antidepressants all along. His explanation of the placebo effect was really interesting, I was having a conversation with a friend a couple weeks ago about The Secret and how it her ideas seem so ridiculous, but ...more
Mar 04, 2013 Joseph rated it it was amazing
The most exciting book on psychology I have read since graduate school. Written primarily for a lay audience, but meticulously cited, Kirsch does exactly what his subtitle promises. This is an absolutely incredible account of the placebo effect and its enormous role in the healing of depressed individuals who are on psychoactive medications. Here is a too-simple account of his more controversial (but incredibly substantiated) claims:

His claim most controversial to scientists: anti-depressants a
Valters Bondars
Sep 07, 2016 Valters Bondars rated it it was amazing
Jason Demidoff
Oct 17, 2013 Jason Demidoff rated it it was amazing
should be required reading for all doctors that prescribe antidepressants and anyone on them or considering taking them. absolutely decimates the myth that depression is caused by a chemical imbalance and effectively proves that at best antidepressants are no better then placebo pills, CBT or exercise for treating depression, but of course with many, many more side effects. some of which can be lethal. I am a 20 year survivor of the mental illness house of mirrors, or should I say horrors and I ...more
Mar 12, 2012 Emily rated it it was ok
What I liked about this book was the Kirsch's actual conclusions that antidepressants are a multi-billion dollar scam. What I disliked was his repetitive way of backing up the conclusion. I felt like he kept writing the same thing in slightly different ways. He analyzed data, he conducted studies, he formed conclusions. These three steps happened over and over throughout the book with only slight variations. I understand that this method is probably the official scientific way to prove his theor ...more
Sheng-chieh Su
Mar 18, 2016 Sheng-chieh Su rated it really liked it  ·  review of another edition
Different perspectives

As a psychiatrist, I'm fully aware of the limitation of psychopharmacology and hence turned to functional medicine few years ago. But I'm against author's notion which implies that no need for biological treatment for depression. For example, postpartum depression could be caused by copper overload and can be treated by chelation or zinc supplement. My point is you can't treat some physical problem by talking. Since depression is heterogeneous by nature, the treatment shou
Margaret Heller
Nov 15, 2011 Margaret Heller rated it liked it
Shelves: science
I skimmed most of this. It wasn't quite what I was expecting. I guess I thought it would be more exciting. Anyway, drug trials show that antidepressant medications don't really work better than placebo, depression is complicated and not caused by just one thing, and it's better to learn coping skills than become reliant on a not-chemically-helpful medication. I think I have to delve into the literature more before I really understand this concept.
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“Depression is not caused by a chemical imbalance in the brain, and it is not cured by medication. Depression may not even be an illness at all. Often, it can be a normal reaction to abnormal situations. Poverty, unemployment, and the loss of loved ones can make people depressed, and these social and situational causes of depression cannot be changed by drugs.” 21 likes
“Like antidepressants, a substantial part of the benefit of psychotherapy depends on a placebo effect, or as Moerman calls it, the meaning response. At least part of the improvement that is produced by these treatments is due to the relationship between the therapist and the client and to the client's expectancy of getting better. That is a problem for antidepressant treatment. It is a problem because drugs are supposed to work because of their chemistry, not because of the psychological factors. But it is not a problem for psychotherapy. Psychotherapists are trained to provide a warm and caring environment in which therapeutic change can take place. Their intention is to replace the hopelessness of depression with a sense of hope and faith in the future. These tasks are part of the essence of psychotherapy. The fact that psychotherapy can mobilize the meaning response - and that it can do so without deception - is one of its strengths, no one of its weaknesses. Because hopelessness is a fundamental characteristic of depression, instilling hope is a specific treatment for it it. Invoking the meaning response is essential for the effective treatment of depression, and the best treatments are those that can do this most effectively and that can do without deception.” 14 likes
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