Placebo beats pill for all but most severely depressed, study shows

Blair Johnson, a distinguished professor of social psychology at the University of Connecticut, said his research has shown placebos have the same effect as anti-depressants for all but the most severely depressed patients. (E-magine art/Flickr)

Depression is the second most common disability worldwide and scientists have been searching for a remedy. The solution, however, may not be found in a pill bottle.

Blair Johnson, a professor of social psychology at the University of Connecticut, said his research has shown placebos to have the same effect as anti-depressants for all but the most severely depressed patients.

Johnson, who was recently recognized as a Board of Trustees distinguished professor, spoke Tuesday evening in Oak Hall at “Pills, Placebos, Exercise and Interventions: How Best to Improve Mental Health.” He said that while drug trials have shown anti-depressants to improve patients outcomes, the difference between a pill and a placebo was only discernible when his team used statistics to “torture the data.”

“Antidepressants are little better than placebos except for in severely clinically depressed samples,” Johnson said. “The implication was that medical doctors are overprescribing antidepressants because most patients are not severely depressed.”

For most patients, “the power of belief” is enough. In a study of cancer survivors, who have an elevated risk of anxiety and depression, Johnson found that aerobic exercise improved their self-reported quality of life across the board.

“The side effects of exercise are a pure delight, so why not go there?” said Johnson.

In fact, the benefits of exercise run almost entirely counter the side effects of antidepressants, which can result in sexual dysfunction, headaches, insomnia, nausea, seizures and increased risk of suicide, just to name a few.

Antidepressants are little better than placebos except for in severely clinically depressed samples.
— Professor Blair Johnson

Professor of behavioral neuroscience John Salamone said this means that antidepressants, particularly SSRIs or selective serotonin reuptake inhibitors, often contribute to the very symptoms they are intended to treat.

“When people look not at broad measures of depression but at specific systems it turns out that SSRIs don’t work well at all,” Salamone said. “There’s an irony there that a lot of people are getting medication which can actually make the symptoms worse.”

Johnson said that while he doesn’t condemn antidepressant use across the board, his research has suggested that many of the indicators for depression are social, not chemical. Anxiety is more common, for example, among millennials, women, those with less education and whites than in other populations.

Davita Silfen Glasberg, professor of sociology and associate dean of UConn’s College of Liberal Arts and Sciences, said she thinks it’s important to recognize how behavior emerges from social context in the discussion of mass shootings and mental health.

“What jumps out at me is that the shooters tend to be overwhelmingly white and male, and what that signals to me is that there is something that defines masculinity in terms of violent behavior coupled with access to weapons,” Glasberg said.

We want the truth to be known.
— Professor Blair Johnson

Johnson recognized, however, that the media often shapes society’s perspective on these issues. He said campaigns extolling the benefits of pharmaceuticals may be at the root of the placebo effect’s increasing influence.

“They’re really trying hard to maintain this faith in antidepressants,” Johnson said, whose studies have faced vocal opposition from the pharmaceutical community.

This is not the first study where patients believed a placebo in lieu of real treatment. In one daring series of studies, referred to by the New York Times as “sham surgeries,” researchers performed fake knee surgery on patients, going so far as to create an incision in the kneecap… and then closing it up without changing anything at all. Post-op, these parody patients reported the same level of knee pain as those who actually received arthroscopic surgery, Johnson said.
 
“My message is not anti-antidepressant, it’s more like embrace the placebo because the placebo is powerful and can do wonderful things for you,” he said. “We want the truth to be known.”


Kimberly Armstrong is a staff writer for The Daily Campus. She can be reached via email at kimberly.armstrong@uconn.edu.