* Why antidepressants may be no better than placebos.
* Relatedly, a New Yorker article takes a skeptical look at the field of psychiatry as a whole, and asks whether it can even be considered a science.
* You may be saved on Judgment Day, but what happens to the pets you leave behind?
* A report card citing violations of physical laws in movies.
* In scientific research, the rich get richer -- what can we do about the "Matthew Effect"?
* Eliezer's drawn up a great list of "conversation halters," tactics that stonewall debate.
Rationally Speaking: an archived blog about science & philosophy, by Massimo Pigliucci
Julia,
ReplyDeleteI appreciated your first two "picks" on psychiatry. It makes us question other things that we have regarded as "the assured findings of science."
Your skeptichick-ness went down a notch by uncritically citing the terrible Newsweek article about anti-depressants and the placebo effect. "May be no better than placebos"? Well, a monkey may be my uncle.
ReplyDeleteThe Kirsch paper was taken down by Bad Science in February 2008. Make sure to scroll down to "One More Thing."
The new JAMA article was similarly debunked at Science Based Medicine.
But even if you didn't know about these, just reading the article should have set off alarms. Almost only authors of studies with similar findings are quoted in the story. The one exception: "Even defenders of antidepressants agreed that the drugs have 'relatively small' effects." And the drug company quotes, but they are easily disregarded as biased. There is not one neutral source to evaluate the claims. I'd say this the definition of a puff piece.
It makes us question other things that we have regarded as "the assured findings of science."
ReplyDeleteReally, you just willy/nilly put research with a p of < 0.05 (1 in 20) such as psychiatry with a p of < 0.0001 (1 in 1000) such as physics? Having studied psychology, which is basically psychiatry without the drugs I can see why a lot of it isn't hard science. I mean, I can operationally define emotion as this or as that, then I can ask people but are there responses objective/biased?
But there's no justification for treating the natural sciences (physics/chemistry/biology/geology/etc) which deal with things that kick back when kicked (a rock doesn't try to give you the answer it thinks you're looking for or feel embarassed about your probing and you can quite clearly measure what's going on when you interact with it, unlike a human's emotional state) with sciences that try to deal with intangibles like how one feels such a psychiatry. To conflate the two shows you don't understand what you're saying.
Just dittoing the Norwegian Shooter.
ReplyDeleteWhether antidepressants work or not I just think that they are mostly a bad idea. The use of them, assuming they do something which I think they do, represents a slight of hand technique. One has not really made a problem or difficult situation go away, one has only made the person experiencing the problem perceive that it is less important for that moment.
ReplyDeleteThink the reason that sometimes suicides rise with the use of certain antidepressants is because if people are not super regular in the way they use their meds they're bound to have down time when they must face the way things really are and when that happens those feelings may flood in twice as strong and seem inescapable ???
The psychiatry articles make the rather hyperbolic leap that just because antidepressants are over-prescribed and abused, and just because psychiatry is a "soft science" trying to tackle an inherently nebulous problem, we should distrust the whole endeavor.
ReplyDeleteNot the insightful commentary I'm used to from Rationally Speaking.
"Hyperbolic leap" is Sharon Begley's middle name. She's been taken to task before.
ReplyDelete"sleight of hand", Caliana, not "slight"
ReplyDeleteThanks. You are correct. And English is not even your first language? I guess its not mine either. ;)
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ReplyDeleteJulia,
ReplyDeleteWith respect to the anti-depressant story, I would tend to say myself that modern societies are over medicated. However, the Newsweek article points out this, "In an analysis of six large experiments in which, as usual, depressed patients received either a placebo or an active drug, the true drug effect—that is, in addition to the placebo effect—was "nonexistent to negligible" in patients with mild, moderate, and even severe depression. Only in patients with very severe symptoms (scoring 23 or above on the standard scale) was there a statistically significant drug benefit. Such patients account for about 13 percent of people with depression."
And aren't the severely depressed (those 13 percent) most likely to cause harm to themselves or others?
That makes it truly a tough moral question. What are the side effects of these drugs and how do we weigh those side effects against the benefits of prescribing them to the severely depressed?
Newsweek didn't address that (nor would I really expect them to) but, here on a philosophical blog, I'm curious: Moral Philosophers, Where do you draw the line on prescribing and why?