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.If the anti-depressant effect is largely or entirely a placebo effect, it is impor-tant that we know this.If placebos can make people better, thendepression can be ameliorated without reliance on drugs that havepotentially serious side effects and that foster dependency.For people who are depressed, and especially for those who donot receive enough benefit from medication or for whom the sideeffects of antidepressants are troubling, the fact that placebos canduplicate much of the effects of antidepressants should be takenas good news.It means that there are other ways of alleviatingdepression.As we have seen, treatments like psychotherapy andphysical exercise are at least as effective as antidepressant drugsand more effective than placebos.In particular, CBT has beenshown to lower the risk of relapsing into depression for years aftertreatment has ended, making it particularly cost-effective.For society as a whole, knowledge of what the data on anti-depressants really say should be a clarion call.Resources needto be made available for the provision of effective alternativetreatments, and the social and economic causes of depressionneed to be addressed and overcome.It is my hope that this bookwill contribute to a wider recognition of the need for thesechanges in public policy and attitudes.As you may have gathered by now, I rather enjoy telling talesand ruffling feathers.I also enjoy rocking boats, especially whenthey are in need of sinking.I hope you have enjoyed the ride. NotesPreface1 John P.A.Ioannidis, 2008; Jeffrey Lacasse and Jonathan Leo, 2005; CNS Drug Discoveries: What the Future Holds 2008.2 Irving Kirsch, 1990.3 John D.Teasdale, 1985.4 Irving Kirsch and Guy Sapirstein, 1998.5 Irving Kirsch, Alan Scoboria and Thomas J.Moore, 2002b;Irving Kirsch, Thomas J.Moore et al., 2002a; Irving Kirsch,Brett J.Deacon et al., 2008.6 NICE, Depression: Management of Depression in Primaryand Secondary Care ; CSIP, Choice and Access Programme,2007; Eero Castrén, 2005; H.G.Ruhé, N.S.Mason and AartH.Schene, 2007.1 Listening to Prozac, but Hearing Placebo1 William Schofield, 1964.2 Standardized mean difference between pre-treatment and post-treatment depression scores for each type of treatment, IrvingKirsch and Guy Sapirstein, 1998.3 John P.A.Ioannidis, 2008.4 John W.Williams, Jr, et al., 2000.5 Joanna Moncrieff, 2008b.6 Mark S.Kramer et al., 1998.7 Michael Philipp, Ralf Kohnen and Karl O.Hiller, 1999.8 Carl Sherman, 1998. Notes 1839 J.G.Rabkin et al., 1986.10 Joel R.Sneed et al., 2008; Martin Enserink, 1999; Martin Kelleret al., 2006.11 Roger P.Greenberg et al., 1994.12 James M.Ferguson, 2001.13 Greenberg et al., 1994.14 John F.Kihlstrom, 1998.15 Corrado Barbui, Toshiaki A.Furukawa and Andrea Cipriani,2008.16 Corrado Barbui, Andrea Cipriani and Irving Kirsch, 2009.17 Joanna Moncrieff, S.Wessely and R.Hardy, 2005; JoannaMoncrieff, 2008b.2 The Dirty Little Secret1 Peter Nathan and Martin E.P.Seligman, 1998.2 Larry E.Beutler, 1998; Donald F.Klein, 1998.3 Russell Joffe, Stephen Sokolov and David Streiner, 1996.4 Hans Melander et al., 2003.5 Irving Kirsch and Guy Sapirstein, 1998; Richard A.Hansenet al., 2005; Gerald Gartlehner et al., 2007.6 Irving Kirsch, Thomas J.Moore et al., 2002a; Irving Kirsch,Brett J.Deacon et al., 2008.7 NICE, Depression: Management of Depression in Primaryand Secondary Care.8 Ibid.9 Kirsch, Deacon et al., 2008.10 Anton J.M.de Craen et al., 1999.11 Carl Sherman, 1998.12 Otto Benkert et al., 1997.13 David O.Antonuccio, David D.Burns and William G.Danton, 2002; Roger P.Greenberg, 2002; Walter A.Brown,2002; Michael E.Thase, 2002.14 Steven D.Hollon et al., 2002.15 Melander et al., 2003.16 Wayne Kondro and Barbara Sibbald, 2004; MajorPharmaceutical Firm Concealed Drug Information , 2004.17 Kondro and Sibbald, 2004. 184 The Emperor s New Drugs18 Martin Keller, Neal D.Ryan et al., 2001.19 Major Pharmaceutical Firm Concealed Drug Information , 2004.20 Gardiner Harris, 2004.21 Alex Berenson, 2005.22 B.J.Deacon, Kimberlee Glassner and Irving Kirsch, 2006;Melander et al., 2003.23 Melander et al., 2003.24 NICE, Depression: Management of Depression in Primaryand Secondary Care.25 Catherine DeAngelis, Jeffrey M.Drazen et al., 2004.26 Paul Leber, 1998.27 Shankar Vedantam, 2004.28 Jerry Avorn, 2007.29 Ibid.30 EMEA, 2008; Rob Evans and Sarah Boseley, 2004.31 Hans Melander, Tomas Salmonson et al., 2008.32 Irving Kirsch and Joanna Moncrieff, 2007.33 Thomas P.Laughren, 1998
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