The following paper provides a response to the article, which is devoted to the issue of antidepressants as opposed to placebo usage. The key issue of the article is that antidepressants do not so much cure as they provide the patients with the knowledge that they are being cured. In this respect, placebo pills seem to be more optimal for curing depression since they are harmless, as opposed to psychoactive drugs.
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The response paper supports the article’s viewpoint and provides two peer-reviewed articles on the placebo effect. The first article states the necessity to inform the patients of all treatment possibilities, including placebo. The second, in turn, discuss the ways of placebo effect enhancement, which also subsumes patient-to-practitioner cooperation. The implications of the issue for future psychological studies are also stated. It can be concluded that the placebo is not only ethical but should also be more actively employed in depression treatment.
The original article under consideration was published on January 29, 2010, and came under an unambiguous title that runs “Why Antidepressants Are No Better Than Placebos” (Begley, 2010). In this article, the author explores the moral dilemma of the placebo effect on patients with clinical depression. The dilemma is whether such patients should or should not be aware of what extensive medical research over the late years shows.
The findings suggest that antidepressants might help patients with severe depression; as to those who are lower-grade depressed, the medication effect is mostly based on the assumption that it helps. The author spares a special place in her work for Irving Kirsch and his vast experience in the field. Having devoted the best part of his medical career to placebo investigation, Kirsch was the one to discover the smallish difference between antidepressants and placebo pills in clinical depression treatment.
His research does not, by any means, calls for depressed patients to cease taking their medications. On the other hand, the researcher advocated for psychotherapy and placebo as the primary measures to be taken to refer to drugs if no improvement is visible, as the last instance.
Kirsch has long been shunned for his research that has become one of the many other works attempting to take the rose-colored spectacles off the public’s eyes. Which once again brings up the dilemma that Begley bitterly resolves at the end of her article. It appears that the public cannot accept what might alleviate the placebo effect and proceed taking medications like the one and only solution, which is why any works trying to reveal the truth can be considered callous.
In her work, the author bases her point on empirical evidence. To her credit, it is apparent that she has been closely following the research on the efficacy of antidepressants and the placebo effect. On the other hand, her work can be solely considered argumentative since it is designed to express personal concerns and raise discussion of the issue. As to the argument itself, the author speaks of the power of the medication that is not solely centered on the curing effects it has.
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Rather, in the case of antidepressants, the knowledge that one takes a drug as opposed to a dummy pill is a treatment in itself. This assumption is confirmed by research, and one has to admit that, when a placebo is involved, the human psyche plays a significant part in alleviating the symptoms.
The problem of ethics that Begley’s work encompasses is multifold. The ethics of placebo usage is debatable since patients and practitioners might think there is deception involved. On the other hand, research shows that there is only a slight difference in depressed patients’ outcomes when they are prescribed the actual drugs or placebo. A strong point of the argument is that drugs – any psychoactive drugs – are a potential hazard for the patients. As a result, it can be conceded that the patients should be aware of all treatment opportunities there are.
The patients’ awareness of the possibility of placebo usage might seem to be not quite compatible with the very idea of placebo. On the other hand, there is empirical evidence of placebo perfectly performing its functions when combined with other types of treatment to reduce the damage drugs may cause. For that matter, Irving Kirsch’s persistence in placebo efficacy research has resulted in a series of more recent articles, one of which is devoted to estimating the clinical effects of placebo (Moncrieff & Kirsch, 2015).
The authors argue that since no medications outperform placebo to a significant extent, the treatment course should be planned individually, and the patients should be warned about potential hazards. Another article considers the patients’ involvement to enhance the placebo effect, using Kirsch’s model of improving their expectations about the treatment (Sliwinski & Elkins, 2013). The authors evidentiate that the placebo effect is improved if the patients feel positive about their treatment and are guided by the practitioners. Thus, the treatment requires mutual involvement in the process, positive predisposition, and awareness.
In spite of the possible damage that antidepressants might induce, there is little or no evidence that the public is going to shift from medications to psychotherapy in the feasible future. It might be the case that people are ashamed of referring to psychiatrists, which is why a primary care specialist prescribing a medication would be a more acceptable variant. That persons undergoing psychotherapy are stigmatized is an issue in itself.
On the other hand, the damage from drugs can be reduced by using a placebo. It is ethically justified since such interventions are designed for the patients’ good, and the “deception” is an indispensable part of the cure. Thus, a placebo can be employed in the stead of antidepressants which has its implications for future pharmacological studies. As to the future of psychology, the potential implications of the issue to future psychological studies consist of the assessment and design of placebo usage strategies.
The patients should receive maximum information on the possible treatment planning, meaning that they should be aware of placebo usage as well. As a consequence, the ways of balancing the patients’ consent and the unawareness component of placebo are to be thoroughly studied, basing on existing models of enhancing the placebo effect and, possibly, field research.
To conclude, although the ethicality of open placebo usage seems to be troubling her, Begley considers that antidepressants are potentially hazardous, as well as the fact that their chemical balance impact is understudied, and provides a solid viewpoint. Anyone who ever placed a piece of bandage on a wound and felt better afterward has experienced the placebo effect. Such a powerful tool that the human psyche uses to fix itself should be undoubtedly deployed in curing depression, meaning that future studies are needed to develop the most optimal strategy.
Begley, S. (2010). Why Antidepressants Are No Better Than Placebos. Newsweek. Web.
Moncrieff, J., & Kirsch, I. (2015). Empirically derived criteria cast doubt on the clinical significance of antidepressant-placebo differences. Contemporary Clinical Trials, 43, 60-62.
Sliwinski, J., & Elkins, G. (2013). Enhancing Placebo Effects: Insights from Social Psychology. The American Journal of Clinical Hypnosis, 55(3), 236-248.