The website behaviortherapist.com has posted an interview with Irving Kirsch (pictured right), the well-known critic of the efficacy of antidepressant pharmaceuticals. Kirsch made a name for himself with a series of studies that showed that most of the effect commonly attributed to antidepressants is actually a placebo effect. Although the difference between the effect of antidepressants and placebo alone attains statistical significance, the size of the difference is, Kirsch says, “vanishingly small.” He also argues that this near-non-effect holds for different levels of depression, and for different classes of antidepressants,such as SSRIs (e.g., Prozac) and SSRE(nhancer)s. He says the reasons for the widespread belief in the effectiveness of antidepressants include (1) the lack of placebo control groups in early research, (2) the typical clinician’s inability to distinguish between placebo effect and real pharmaceutical effect in any given patient, and (3) the fact that a large amount of (presumably negative) research data has never been made public by the pharmaceutical companies that sponsored the research.
Kirsch argues that the effects of cognitive-behavioral therapy are better (perhaps not surprisingly, given the sponsor of the interviewer), but he also claims that simple physical exercise has an important effect on depression.
The interview runs about 30 minutes in length.