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Comment by Fradow | Hacker News Reader

> Research suggests antidepressants work only a bit better than placebos

That really undermine the credibility of that article. They work extremely well for some people. Others might need to try several before they find one that works. And a minority might not be able to find one that works (I don't know, I'm not a professional).

Another anecdotal evidence: I started taking anti-depressants 1.5 months ago, and after the acclimating period (which was hell for me, I wish I had been better warned, I had to take a week off), it's a night and day difference on how my brain works.

My SO had the exact same experience: it changed her life, from a miserable struggle every day to a life she can enjoy.

If this article makes you reconsider taking anti-depressants or not, please talk to a healthcare professional instead.

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I don't think it's possible to tell if your or your partner's acclimatisation period and subsequent improvements were caused by the effect of the antidepressants or by a placebo effect

The placebo effect is not ever that big of an effect. Similarly, the Dunning-Kruger effect is not actually very large.

1. I don’t think that the argument hinges on one single person.

2. Sure there’s a way to tell! Just have her stop taking the pills; that’d show if it really worked before. (Note: do not do this.)

Only if you don't tell her, and replace them with fake ones. Other wise the placebo effect is activ again

1. Indeed, there were serious trials before those were made available and prescribed. Those trials have to demonstrate that the medicine is better than placebo effect. I personally don't like to hand-wave away those trials to "big pharma bought them".

2. Yes, I inadvertently forgot to take a pill one day and only realized the next day. Coincidentally I felt depressed that day. It could only be a coincidence but I'm firmly convinced it's not. I'm not going to try to replicate the experiment though (especially since doing it on purpose could induce a placebo effect).

Edit: see answer, I'm probably wrong on that 2.

On your number 2: SSRIs have to build up in the system before they are effective and take a lot of time to ween off when you stop them. If you only missed one day, any change should be considered psychosomatic.

> Within that average is a group of people who experience much better results on antidepressants - doctors just don't have a good way of knowing who those people are when prescribing.

not really...

Perhaps I could have been more precise: the article answers the title and big question "So do antidepressants work?" with "Research suggests antidepressants work only a bit better than placebos", then bury the actual detail you outlined later.

That's at least misleading if not downright a lie. "a group of people who experience much better results on antidepressants" is, in my opinion, simply not compatible with "work only a bit better than placebos".

If you tell me the later, I'll probably forgo the treatment. If told the former, I'm willing to give it a try to see if it works. (luckily for me, it did)

Imho, the insight is that placebo work well for many people.

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