Q: Do antidepressants work by the placebo effect?
A: The placebo effect occurs when belief in a remedy or in the power of a trusted and caring practitioner actually helps the remedy work and triggers an improvement in symptoms and health. A placebo (Latin for “I will please”) is a “fake” or simulated treatment, such as a dummy pill or sham procedure, administered to someone who is unaware that it’s not a “real” treatment. As far back as ancient times it was known that the hope and expectation people experience when treated—even with a placebo—can play a large role in recovery.
Virtually all drugs work at least in part via the placebo effect, and antidepressants apparently more so than most—at least for mild or moderate depression and in the short term. To be approved by the FDA, however, antidepressants and other drugs have to demonstrate effectiveness beyond placebo effects.
The short duration of studies that have suggested that antidepressants rely heavily on the placebo effect may understate the drugs’ true benefits, which may take months to occur. People who improve on antidepressants likely get some placebo benefit and some benefit from the drug. Simply receiving attentive care (part of the placebo effect) and facing one’s problems has benefits that are hard to separate from those of medications.
This article first appeared in the UC Berkeley Wellness Letter.
Also see Should You Take a Placebo?