programme). One of the talks was by Professor Ian Anderson entitled 'Are antidepressants really placebos?' As he himself said, as might be expected, his answer was no.
I'm not sure if the talk really had much more in it than a letter he had published in the British Journal of Psychiatry several years ago. Anderson makes a lot of the fact that continuation studies show high relapse rates. Following the results of the meta-analysis by Geddes et al (2003), the average rate of relapse on placebo is 41% compared with 18% on active treatment. In other words, continuing treatment with antidepressants reduces the odds of relapse by 70%. Anderson doesn't think this could possibly be a placebo effect.
Doctors have always underestimated the difficulties of discontinuing antidepressants (see my Antidepressant discontinuation reactions website). If patients are significantly unblinded in discontinuation studies, the negative placebo (nocebo) response could explain these results because of how reliant people have become on their medication. Any change threatens an equilibrium related to a complex set of meanings that their medication has acquired.