Sunday, January 31, 2010

Thing 5d: I do not think that word means what you think it means

I have a soft spot for contrariness. The Catholic Church has always had a "Devil's Advocate" whose job it is to, as it were, "represent the devil" and try to dig up anything untoward or unsavory about a potential candidate for Pope or for Canonization. The point of playing Devil's Advocate really isn't to weaken, but to strengthen. To find better Popes and Saints. To me looking for the downside of everything, if done in proper scale and for the right reason, isn't to tear down, but to ultimately get at the truth by eliminating dead ends. Often contrariness can be taken too far (see for example the thoroughly annoying and intellectually lightweight Malcolm Gladwell) but utilized constructively it serves an important role, particularly as it requires a rigid and, in many ways, irritating personality (guilty as charged).

So I always have a soft spot for the naysayer who gets vindicated. So I was pleased to see this article come across my reader from the Neuroscience blog Mind Hacks. The article (found here) is a commentary of another article in Newsweek entitled "The Rise and Fall of Anti-Depressants." Both articles discuss recent evidence that while Anti-Depressants do work and are life-savers for many people, in general the effects for many more than expected are really nothing more than placebo effect. Money Quote:

The Newsweek article tracks this story but also picks up on many important subtitles in the story, notably that the research doesn't suggest that antidepressants are useless - quite the opposite - just that their effect is only in part due to their direct chemical effect; and that many patients in trials work out that they're not taking placebo because of the side-effects and this realisation can trigger a stronger placebo effect.

But for my personal favorite:

The piece particularly follows the work of psychologist Irving Kirsch who was the first to conduct a meta-analysis of the effects of anti-depressants back in 1998.

Titled "Listening to Prozac but hearing placebo" it suggested that the drugs were hardly more effective than placebo and, for many, marked Kirsch out as a biased and dangerous 'anti-psychiatrist'.

However, later studies in a similar vein by both Kirsch and others have supported his original findings and many countries have now changed their treatment recommendations as a result.


Sweet, sweet vindication. Shine on brother contrarian. Shine on.

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