There are millions of Americans who suffer with horrible, debilitating depression and millions who take antidepressants daily.
Antidepressants have been available since the 1950s. Still, unbelievably, few studies have focused directly on how the pills affect people with milder symptoms.
"After all these years -- and all those prescriptions -- you'd think we'd know everything there is to know about how antidepressants affect the people who take them," writes Alix Spiegel on National Public Radio's blog.
MOST DEPRESSION IS MILD TO MODERATE
In fact, almost 70 percent of depressed people on medication have moderate to mild symptoms. Why haven't we studied these folks?
"Because drug companies fund the vast majority of clinical trials, and obviously drug companies are interested in having their clinical trials show the efficacy of their antidepressant medications," Brett Deacon, a psychologist at the University Wyoming told NPR's All Things Considered.
A recent study finds that, for people with mild to moderate depression, taking an antidepressant is no better than swallowing a placebo. Pharmaceuticals versus sugar pills and sugar wins.
AN ETHICAL CONUNDRUM
This presents us with an ethical conundrum.
How about doing right by the patients involved in research, the ethical obligation toward those who are randomly assigned to get a placebo?
Will the pharmaceutical manufacturers admit to the public that their drugs are only helpful for severe depression? Don't bet on it.
Will physicians stop prescribing the drugs and increase prescribing placebos ?
Who makes all the profit from placebos? The pharmacies or manufacturers? Numerous other studies have found that patients believe a medicine's value is evidenced by its cost. A drug that is cheap doesn't work nearly as well as an expensive drug, most of us think. The same applies to placebos.
Do the pharmacies or manufacturers split the profits from sugar pills with the prescribing doctors?
And the big one -- Is lying to a patient ethical -- Telling her that you're prescribing a real drug and withholding the fact that it's really a placebo?
Will any of the above-mentioned tell us the truth?