Placebo Effects
This is the percentage of improvement placebo groups often show relative to SSRI groups in antidepressant trials.
What is 60–80%?
These uncomfortable symptoms can happen when someone suddenly stops taking an antidepressant and are often mistaken for the depression coming back.
What are withdrawal (discontinuation) symptoms?
This term describes the process by which normal human experiences like grief or stress are reframed as medical conditions requiring pharmaceutical treatment.
What is medicalization (of distress)?
This term refers to the wide variation in symptoms and underlying causes within a single psychiatric diagnosis.
What is heterogeneity?
Nausea, jitteriness, and dry mouth often reveal to patients that they’re taking real SSRIs, leading to this problem in antidepressant trials.
What is accidental unblinding?
This major criticism of antidepressant research argues that because trials last only 6–8 weeks, they fail to capture the long-term risks, benefits, and side-effect profiles of chronic SSRI use.
What is the short-term trial limitation?
This ethical principle is compromised when patients aren't told that antidepressants may work only 15% better than a placebo in mild-to-moderate depression.
What is informed consent?
This disorder includes multiple symptom clusters that may arise from different biological and psychosocial pathways but are all grouped under one diagnosis.
What is major depressive disorder?
This tends to peak in the first 10–14 days of treatment, before SSRIs have had time to produce full neurobiological effects.
What is placebo improvement?
When antidepressant studies remove people who don’t improve in the first few weeks, the remaining group looks more responsive, especially in short 6–8 week trials.
What is excluding early nonresponders?
Critics argue that emphasizing antidepressants over this alternative—which may be equally effective but requires more time and trained professionals—reflects healthcare system priorities rather than evidence.
What is psychotherapy (or cognitive behavioral therapy/talk therapy)?
This problem occurs when multiple distinct conditions are treated as though they are one, leading to less precise research findings.
What is diagnostic oversimplification?
These two common components of antidepressant trials—frequent clinician contact and structured assessments—can unintentionally boost placebo response.
What are supportive visits and structured assessments?
This bias happens when antidepressant studies only include people who improved early on, making the medication look better at preventing relapse than it really is.
What is relapse prevention bias?
This phenomenon occurs when pharmaceutical companies help define the boundaries of mental illness in ways that expand their market, sometimes called 'disease mongering.'
What is the corporate influence on diagnostic criteria (or disease mongering/selling sickness)?
The presence of additional disorders, such as anxiety or substance use, alongside major depression is called this.
What is comorbidity?
This small average difference (in points on the HAM-D scale) is often all that distinguishes SSRIs from placebo in RCTs.
What is about 1.8 points?
Because stopping antidepressants can cause withdrawal symptoms that look like depression returning, researchers may mistakenly conclude that antidepressants prevent relapse more than they actually do.
What is confusing discontinuation symptoms with relapse?
This widely promoted but scientifically questionable explanation for depression has shaped decades of public understanding, despite weak evidence linking serotonin levels to mood disorders.
What is the serotonin/chemical imbalance theory (or hypothesis)?
This factor makes it difficult to isolate the true effectiveness of an antidepressant in clinical trials.
What are confounding variables?