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on 27 June 2017
This book is a superb explanation of the placebo effect. I have long felt that other 'therapies' are superior and I finally proved it after 20 years of taking anti-depressants alongside running outdoors, I fractured my pelvis which stopped me running and the depression was back with a vengeance. Conclusion, the running NOT the pills controlled my depression. This book is a must for those who want to understand how the placebo effect works
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on 27 March 2017
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on 14 March 2017
Not a very interesting and easy read
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on 10 September 2009
Quite a disturbing book,in its undermining of the 'depression business' and it is a very big business. Very well written demolition job of the chemical imbalance theories. He examines the evidence for anti depressants forensically and finds some worrying signs of science being side tracked by profit. He raises important points about the power of placebo's and unlike many psychologists admits the talking therapies are just as dependant on the placebo effect as the tablets are.Raises a lot of important questions about the mental illness industry and modern evidence based practice.
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on 7 October 2009
Irving Kirsch is a well-known authority on hypnotic suggestion and the psychology of the placebo effect. He has published dozens of peer-reviewed articles in mainstream scientific research journals and is the author of several well-received books, and a contributor to chapters in many co-authored volumes. He is currently professor of psychology at the University of Hull. Kirsch's basic goal in this book seems to have been to take the complexity of scientific and statistical debate and present it in plain English in an accessible "popular science" style, so that as many people as possible are able to process the information. In all honesty, I think he has done an absolutely admirable job. He's a genuine expert in this area and yet this book could be read in an afternoon. If some parts are a little tricky, I think that's just the subject matter, I really can't imagine someone doing a better job of explaining the concepts to the layman. The evidence Kirsch presents is undeniably compelling, and has been subjected to critical scrutiny in peer-reviewed scientific journals. He's basically blowing the whistle on an "open secret", or as one commentator put it the pharmaceutical industry's "dirty little secret". If you take antidepressants (of any kind, Kirsch's analysis of the data shows there's not much difference in their effects) or you prescribe these drugs, or you're a researcher, psychological therapist, or just an interested member of the public, I strongly recommend reading this book. It manages to strike the perfect balance between readability and serious scientific debate.

Donald Robertson, author of,
The Philosophy of Cognitive-Behavioural Therapy (CBT): Stoic Philosophy as Rational and Cognitive Psychotherapy
The Discovery of Hypnosis: The Complete Writings of James Braid the Father of Hypnotherapy
The Practice of Cognitive-Behavioural Hypnotherapy
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on 12 September 2009
Interesting. Very interesting. But should I take his word for it? That's the crux, really. Kirsch says that anti-depressants don't work and he cites studies, reviews and articles which he says backs up his claims. But for me to verify this I would have to read all of those citations AND I would have to read all of the literature that disputes their findings. Not only that, but Kirsch's appraisal and interpretation of the evidence may be biased. He is, after all, a psychologist, and so has a vested interested in finding evidence to support psychotherapies. You should bear that in mind from the beginning.

Having said that, I am indebted to him for illuminating the clinical trial process and all the chicanery that can go on before, during and after it. This text truly confirms the old adage of lies, darned lies and statistics. The manipulation of data is really mind boggling in its subtlety and deviousness. On that basis alone we should view all clinical trials with a pinch of salt. I also learned an awful lot about the placebo effect (or "meaning response") from this book. You might think you know all about the placebo effect already: someone takes a dummy pill and if they think it's real it will work almost as good as the real thing. Well, according to Kirsch it works AS well. But the whole meaning response, like clinical trials in which it is a regular feature, is many layers of subtlety, which the author helps to gently peel away and examine. Thanks again, Irving.

This book could be a seminal work in changing doctors' and patients' opinion about the prescription of anti-depressants. It reminds me in many ways of Return of the Black Death: The World's Greatest Serial Killer by Susan Scott and Christopher Duncan, in which they claim the plagues were not a bacteria Yersinia pestis transmitted by rats' flees, as we have all been taught, but a highly infectious Ebola-like haemorrhagic virus. That, too, was very persuasive, yet since its publication it seems to have sunk without a trace, so maybe this will too. I hope not. If nothing else it should be a platform for some debate.

But there again I can personally testify that venlafaxine (Effexor) and fluoxetine (Prozac) work. But lithium and mirtazapine don't. Or is it all in my mind? Of course it's all in my mind. Kirsch says so. He tells us there is no mind-brain separation, all experience, thoughts and emotions have a physical origin, since the mind has a physical origin. So there is no mind-body distinction. But was it placebo? I would say no. Discontinuation of treatment caused a re-emergence of my symptoms, and these weren't just withdrawal symptoms. I can also testify that self-help books and exercise do have an effect on mood. Also, oddly, I haven't had ANY negative side effects and I've taken just about every psychiatric medication going. I must have the constitution of an ox.

Lastly, it is written well but it does get quite dense at times. In fact, at one point Kirsch cautions the reader against reading a chapter (Ch.6, p.131): "You might find this material tough going ... you could just skip over these parts." He wasn't kidding. The technicalities of clinical trials are quite difficult to grasp and a couple of his charts are obscure. Also there's not much levity in what is a very sober look at a very sober subject. He does crack the odd joke, but it's against the grain of an otherwise straight-laced book. Finally, the cover is very glossy (unusual for a book) and I like the pills arranged to look like an ECG trace. Also a nice big font makes this book easy on the eyes.

Buy it!
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on 7 April 2011
Headline in today's paper... "Recession linked to huge rise in use of antidepressants". It seems that whatever the evidence, there will always be a massive, lucrative market for a pill-based solution to life's woes. This book gives an accessible, compelling account of the science behind antidepressants. The conclusion is hard to dispute: all drug-types used to treat depression alleviate symptoms through the active-placebo effect. That's not to say they don't work - placebos can be very powerful - but it's important and interesting to understand what's going on.

The only criticism I have of this book is that there is no mention of animal studies into the effects of antidepressants. I don't know if there are animal models for depression and its treatment, but the evidence from such trials might shed further light on this subject.
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on 22 November 2011
An intriguing thought provoking book. Speaking as someone suffering from Bi Polarity, it was a long time, and many different drugs ago that I became convinced that Psycho Pharmaceuticals did absolutely no good for my condition. I have tried most of the prescrition drugs believe me. I had at some point bought into the chemical imbalance myth but having read the basis for the existence of that idea I am no longer even convinced by that now.

So is the hypothesis of this book sound - at the end of the day you can eiither buy into it, ignore or go out and do the Meta-analysis yourself. It's just refreshing having somebody pushing something other than chemicals down your neck.

My recommendation is read it and make up your own mind.

Pro's: it's excellent, with compelling argumenents abnd worrying stories about the giant Pharma Industries...

Con's: To be fair it beats taking sleeping tablets to get you off to sleep .....
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on 21 May 2013
Yet another book that explains clearly and simply with a lot of scientfic backup that psychotherapy and "talking therapies" are more effective than medication for depressive conditions. Anti depressants are dangerous and risk lifelong dependency. Thank you Professor Kirsch for explaining this so clearly. Now, WHO is listening? Please send this to as many medical professionals as possible- when we can get them between cruises provided by the large pharmaceuticals to encourage over worked GPs to prescribe zombie producing drugs. GPs need the help to prescribe psychotherapy. - FACT.
Great book.
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on 5 September 2009
The book is long overdue and almost certainly has relevance beyond the class of pharmaceuticals ( antidepressants) that it treats. It provides a disturbing insight into the relationship between drug companies, the regulators and the academic establishment that is so dependent upon funding from these bodies. It demonstrates that antidepressants are no more than enhanced placebos but with nasty side effects. The work of the author is grounded in conventional 'scientific' method, which makes the failure of the authoritative bodies to adequately respond most disconcerting. The book has considerable implications for the validity of the conventional medical model and the assumed mind/body separation upon which it is based. My only criticism is that it asserts the effectiveness of psychological therapies. This will allow critics to divert attention from the main contribution which is the ineffectiveness and dangers inherent in pharmaceutical therapies. Like many, after attaining two degrees in psychology and beginning to study for a third, i remain unconvinced that CBT is the panacea Lord Layard seems to think it is.
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