Why Psychiatric Drugs “Work”: The Attribution of Positive Effects Due to Psychological Factors

While outcome research has attempted to elucidate the real benefit of any treatment through randomized, double-blind studies, the role of placebo and other psychological reactions has been given scant but growing attention. This article examines the nature and power of the placebo in the context of antidepressant therapy. Other factors influencing patient reports of positive response are considered, including emotional blunting, victimization, and rebound. It is concluded that the attribution of healing properties to antidepressant drugs is complex and multifaceted, and that the modest advantage of these drugs over placebo may well derive from psychological, not physiological, factors.