Alan Cassels

What was probably the biggest drug story in the last five years broke in late February. A study in the Public Library of Science reported that antidepressants – drugs like Prozac, Paxil and Effexor – don't work much better than a placebo. (Search online for Irving Kirsch and PLoS antidepressant study.) This story comes right on the heels of another recent nail in the coffin antidepressant saga, which reported that most of the negative studies related to antidepressants are buried and don't see the light of day.

Basically, on the antidepressant front, our doctors have been prescribing while under the influence and it's not a pretty sight. We should all be pretty outraged at this state of affairs, including the 100,000 people in BC taking ineffective drugs and spending their tax dollars (and ours) to the tune of about $200 million and perhaps eschewing other equally effective but non-drug things that do work.

This story is huge and should shake the medical world to its very foundations, but I predict it won't. Here's what will happen instead.

For starters, stand by for some major ass-covering by the drug makers, who'll blame Kirsch and colleagues for being biased, liberal, anti-innovation rat bags. Then listen as an army of patients sing a common "if I didn't have these drugs, I'd die" tune. That's not to say all those people are lying; the drugs may very well be helping them. They're only lying if they say these drugs work better than a placebo, which this study has shown is crap.

Doctors will snap into action and (appropriately) warn people not to suddenly stop taking their antidepressant. The withdrawal effects of suddenly nuking your antidepressant can make life so miserable for many people that the only rational course of action is to keep taking it. The drug companies will then fan out to physicians' offices, conferences, workshops and hospitals, pigeon-holing the doctors and pharmacists, telling them in caring and sympathetic tones that these drugs "help a lot of people."

So would placebos, at a fraction of the price. And what about seriously funding the alternatives? Don't tell me we can't afford treatments that do work (talk therapy, counseling, etc) when we're throwing away $200 million per year on stuff that doesn't work.

You might be wondering what's next. What big drug class is headed for the toilet like these common antidepressants? Stand by for the cholesterol storm – the subject of my column this month in Common Ground.