The Emperor's New Drugs
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The Emperor's New Drugs

3.96 of 5 stars 3.96  ·  rating details  ·  181 ratings  ·  40 reviews
A devastating argument that most antidepressants are little better than souped-up sugar pills, with far-reaching implications for how psychiatry treats depression
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Published January 26th 2010 by Basic Books (AZ) (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.
(DO NOT ATTEMPT REMOVING YOURSELF FROM YOUR MEDS WITHOUT MEDICAL SUPERVISION!)
3. It has a very se...more
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...more
K
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,...more
Matt
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
Kelly  Maybedog
Feb 12, 2011 Kelly Maybedog marked it as to-read  ·  review of another edition
Shelves: to-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...more
Jenny
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...more
Megatherium
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
Karen
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...more
Pat
May 13, 2010 Pat rated it 3 of 5 stars  ·  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
Jenifer 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...more
Kyndra
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
Kate
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
Sally
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...more
Yong Yi
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
Matt Kimball
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
AJ
Interesting, but poorly written.
P Chulhi
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
Sami Sundell
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...more
Joseph
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...more
Doug
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
Jason Demidoff
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
Elenute
This should be required reading for every student of psychiatry/psychology as well as for every prescriber of meds.
Mia
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
Emily
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
Margaret Heller
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.
Judy
Even though I agree with a lot of his premise (it's best to avoid drugs and use counseling [especially cognitive-based therapy), St. John's Wort, exercise, self-help, and social change), I doubt whether anti-depressant effects are almost ALL placebo. Otherwise, why would they sometimes work with animals?

A lot of tedious reading, which is why I skimmed (read some parts more thoroughly, though).
Robert Flaxman
The book's key contention - that antidepressants essentially only work because people believe they do - is interesting and relatively well supported, but I was a bit disappointed that the author had no real alternate explanation for what causes depression once he ruled out the standard biochemical hypothesis. Still, it's a brisk read and will give you some things to think about if nothing else.
Trisha
A very interesting glimpse at interpreting research, studies, trials and analyses - none to be taken for granted at face value again! He makes a strong case against the theory of depression as a chemical imbalance, and sprinkles excellent points about the human psyche in between. Some of his suggested alternatives, however, would employ methods of socialism.
David Hirning
A very well-evidenced discussion of the placebo effect as it relates to modern anti-depressants. Will make you wonder about the billions of dollars people spend every year on these unproven medications--do we feel better because we take a sugar pill that the doctor tells us will make us feel better? This book answers: Yes, in many cases, that's exactly what happens.
Charlotte
An interesting read. I was fascinated by the clinical studies, the effects of placebos, and how powerful the mind really is. I was a little disappointed by the end and the push for psychotherapy. I was also left with many questions and hope this book results in further studies and developments for the treatment of depression.
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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.” 17 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.” 9 likes
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