Tuesday, February 2, 2010

Gedolim & Placebos: Danger of destroying false expectations

While this article deals with the significance of the placebo effect on depression - it is equally valid concerning revealing the truth in other areas. If a person is happy and functioning well - should you provide him with information that some of his foundation beliefs are simply not true? For example that investments that return 30% interest are probably ponzi schemes or that all rabbis will protect your children from being harmed or that rabbis don't give into lust and greed or that gedolim are infallible or that if you think you have bitachon - the physical world  never matters? These are very real questions as is clear that all people have fundamental beliefs about reality which are not true. In other words does the requirement of "not standing idly by the blood of your brother" include protecting their illusions or to pop them?


Although the year is young, it has already brought my first moral dilemma. In early January a friend mentioned that his New Year's resolution was to beat his chronic depression once and for all. Over the years he had tried a medicine chest's worth of antidepressants, but none had really helped in any enduring way, and when the side effects became so unpleasant that he stopped taking them, the withdrawal symptoms (cramps, dizziness, headaches) were torture. Did I know of any research that might help him decide whether a new antidepressant his doctor recommended might finally lift his chronic darkness at noon?

The moral dilemma was this: oh, yes, I knew of 20-plus years of research on antidepressants, from the old tricyclics to the newer selective serotonin reuptake inhibitors (SSRIs) that target serotonin (Zoloft, Paxil, and the granddaddy of them all, Prozac, as well as their generic descendants) to even newer ones that also target norepinephrine (Effexor, Wellbutrin). The research had shown that antidepressants help about three quarters of people with depression who take them, a consistent finding that serves as the basis for the oft-repeated mantra "There is no question that the safety and efficacy of antidepressants rest on solid scientific evidence," as psychiatry professor Richard Friedman of Weill Cornell Medical College recently wrote in The New York Times. But ever since a seminal study in 1998, whose findings were reinforced by landmark research in The Journal of the American Medical Association last month, that evidence has come with a big asterisk. Yes, the drugs are effective, in that they lift depression in most patients. But that benefit is hardly more than what patients get when they, unknowingly and as part of a study, take a dummy pill—a placebo. As more and more scientists who study depression and the drugs that treat it are concluding, that suggests that antidepressants are basically expensive Tic Tacs.[,,,]


  1. Depression is a real disease that requires real treatment.

    Living under an illusion can be just as harmful, albeit in a different way.

    Allowing someone to live under an illusion is no more acceptable or advisable than turning a blind eye to depression.

    More later.

  2. This is not a good comparison.

    In terms of depression, the goal is to feel better. If a red M&M taken every morning does it, who cares? If I give a patient a placebo and it later comes out then when the patient complains I can at least point out that he got better and thus reached the goal. What's more the knowledge that the patient ultimately got better by himself empowers him.

    In terms of 30% returns on a Ponzi scheme, this is entirely different. Ponzi schemes don't make you rich, they ultimately bankrupt you and leave you poor and bitter.

  3. It's good to know that man was not, in fact, created with a Prozac deficiency. Now I can rest easy at night; thank G-d for modern medical research.

  4. A placebo/prozac is a false treatment that sometimes works.

    A ponzi scheme or a belief that gedolim are infallible is a false treatment that never works.

  5. I think they are different problems.

    For those suffering from mild depression where a placebo could help them, it might be best to leave them on a placebo (even if the placebo is a powerful drug until it can be switched to a real placebo). Experts should at that time fight the pharma industry to bring down the drugs' prices in line with the rewards of the drug.

    When it comes to crooked or ineffectual rabbonim, mature healthy adults should be presented with all the facts and allowed to make their own decisions. (Even presented with the facts, I think most people won't change their behavior one iota anyway.)

    If you never are allowed to make decisions for yourself, you don't get the practice required to make the correct decisions.

    PS: Could somebody please post how one can sign a post without sending contact information.

    For now just call me "shqueezh_me"

  6. PS: Could somebody please post how one can sign a post without sending contact information.
    click option name/url and type in any name you want. No contact information is sent


please use either your real name or a pseudonym.