Veronica de Jong and Amir Raz
- Published in print:
- 2015
- Published Online:
- March 2016
- ISBN:
- 9780199680702
- eISBN:
- 9780191760679
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199680702.003.0003
- Subject:
- Psychology, Cognitive Psychology, Clinical Psychology
This chapter sheds light on the hollows between active drugs and pure placebos in the context of a medical condition of rising global concern: depression. Drawing on the placebo antidepressant ...
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This chapter sheds light on the hollows between active drugs and pure placebos in the context of a medical condition of rising global concern: depression. Drawing on the placebo antidepressant literature and interviews conducted with academic psychiatrists, this chapter explores the use, as well as the conceptualization of, below threshold (“sub-therapeutic”) doses as placebos. It appears that although psychiatrists do not report intentionally prescribing sub-therapeutic doses to elicit placebo effects, many forms of complex communication and expectation-shaping techniques relating to dose seem to permeate the use of such treatments. Through the investigation of intimate practice patterns and the current scientific literature, this chapter uncovers tacit professional attitudes and sketches conceptual challenges in the contemporary treatment of depression. It highlights how clinical practice would benefit from a greater appreciation among physicians and policy makers that at low, if not any, dose, antidepressants may be closer to active placebos than efficacious drugs.Less
This chapter sheds light on the hollows between active drugs and pure placebos in the context of a medical condition of rising global concern: depression. Drawing on the placebo antidepressant literature and interviews conducted with academic psychiatrists, this chapter explores the use, as well as the conceptualization of, below threshold (“sub-therapeutic”) doses as placebos. It appears that although psychiatrists do not report intentionally prescribing sub-therapeutic doses to elicit placebo effects, many forms of complex communication and expectation-shaping techniques relating to dose seem to permeate the use of such treatments. Through the investigation of intimate practice patterns and the current scientific literature, this chapter uncovers tacit professional attitudes and sketches conceptual challenges in the contemporary treatment of depression. It highlights how clinical practice would benefit from a greater appreciation among physicians and policy makers that at low, if not any, dose, antidepressants may be closer to active placebos than efficacious drugs.
