Continuing the antidepressant debate: the clinical (ir)relevance of drug-placebo differences

German psychiatrist, Stefan Leucht and colleagues, have produced another really important paper (1). The results indicate that the small differences usually found between antidepressants and placebo are far below the sort of differences that would be clinically detectable or meaningful. Leucht et al have conducted the first thorough, systematic attempt to provide some empirical evidence…

‘Angels and demons’: the politics of psychoactive drugs

The FIAT (Financial Incentives for Adherence Trial) study, published last year, highlights the paradoxical nature of our current attitude to the use mind-altering drugs. In this randomised controlled trial people with ‘psychotic disorders’ were paid £15 a time to take an injection of an ‘antipsychotic’ drug (1). The payment increased rates of compliance only marginally,…

Antipsychotics and brain shrinkage: an update

Evidence that antipsychotics cause brain shrinkage has been accumulating over the last few yearsbut the psychiatric research establishment is finding its own results difficult to swallow. A new paper by a group of American researchers once again tries to ‘blame the disease,’ a time honoured tactic for diverting attention from the nasty and dangerous effects…

Why there’s no such thing as an ‘antidepressant’

Antidepressants have been in the news recently. The general feeling seems to be that although they are being overused and may have some unpleasant side effects, they certainly ‘work,’ at least in some people (1). So what is the evidence that antidepressants ‘work’? If you compare them with a dummy tablet or placebo in a…

Models of drug action

Drugs are frequently prescribed for people with emotional and behavioural problems – problems we currently label as ‘depression,’ ‘schizophrenia,’ ‘bipolar disorder’ and ‘ADHD.’ In trying to understand more fully what these drugs actually do to people, I have formulated two different ‘models’ of drug action: the ‘disease-centred’ model, and the ‘drug-centred’ model. The disease-centred model…