GLOBAL ADVANCES IN HEALTH AND MEDICINE
editorial: perspectives on the placebo effect
The Placebo Effect: A Conversation With Dr Irving Kirsch
安慰剂效果：与 Irving Kirsch 博士的谈话
El efecto placebo: una conversación con el doctor Irving Kirsch
William Scott, United States
William Scott is
the media and
legislative liaison for
Christian Science in
Correspondence William Scott
Citation Glob Adv Health Med.
2012;1(5):8-9. Key Words
Explosive” was the word 60 Minutes reporter Leslie
Stahl used to describe the scientific conclusions of
Dr Irving Kirsch, MD, in the episode titled “Treating
Depression: Is There a Placebo Effect?,” which aired
February 19, 2012. Dr Kirsch, the associate director of
the Program in Placebo Studies and the Therapeutic
Encounter hosted at the Beth Israel Deaconess
Medical Center of Harvard Medical School, Boston,
stated that any benefit from antidepressants is from
the patient’s belief in the drug and not from the
drug’s chemical composition. 1
Given the legions of patients spending a com-
bined billions of dollars each year on antidepressants,
Dr Kirsch’s research and the 60 Minutes interview
have caused patients and members of the medical
community to reconsider the treatment of depression.
(The episode also cautioned, “If you’re already on
these powerful drugs, you shouldn’t stop taking them
on your own.”)
In May 2012, Dr Kirsch was a featured speaker at
the International Research Congress on Integrative
Medicine and Health (IRCIMH) in Portland, Oregon.
More than 1000 attendees, physicians, and scientists
from 23 countries heard Dr Kirsch share his findings
that antidepressants, when used in cases of mild to mod-
erate depression, have no statistically measurable effect.
I have always been interested in the mental nature
of health, so I attended Dr Kirsch’s presentation in
Portland and met with him the next morning to discuss
Mr Scott: In your conference presentation, you men-
tioned that the 60 Minutes episode made you a hero to
some and a villain to others.
Dr Kirsch: The drug companies have not been hostile
to our findings, and medicine overall seems open to
what we’ve found. I work at Beth Israel Deaconess
Medical Center Hospital in Boston, and they have
been very supportive, but those who have been
trained to prescribe antidepressants don’t seem very
happy. A large part of their education and practices is
based on drug-based treatments and the perceived
benefits of antidepressants.
Mr Scott: I’m very interested in your work because the
founder of Christian Science, Mary Baker Eddy, studied
the placebo effect in the 1870s and came to similar
8 Volume 1, Number 5 • November 2012 • www.gahmj.com
conclusions. She wrote about layers of the placebo effect
or the faith placed on drugs. For any one drug today,
these layers might include the clinical scientists devel-
oping the drug, the US Food and Drug Administration
approving it, the commercials promoting it, the physi-
cians prescribing it. These represent placebo layers that
promote the mental acceptance of the drug’s effective-
ness experienced by patients. Can you share more
about the science behind placebos?
Dr Kirsch: Emotions, expectancies, and behavioral
conditioning like that of Pavlov’s dog have long been
known to affect the body. This is the basis of the pla-
cebo effect. Timothy Walsh has done a meta-analy-
sis on the effects of placebo and drugs over time. He
showed that as public awareness of antidepressants
increased, the response to drugs and placebos
for depression also increased. 1 This shows how beliefs
about the effectiveness of a drug can change the effect
of prescribing it.
Mr Scott: Would you say your placebo studies are in
tandem with those of Italy’s Dr Benedetti, or does each
of you focus in different areas of placebo research?
Dr Kirsch: I’d say our work is supportive. We have built
on each other’s findings.
Mr Scott: Since your interview with 60 Minutes aired,
have you noticed a general shift in thought regarding
Dr Kirsch: Change comes slowly. I have received doz-
ens of emails from people asking me to help them get
off their dependency of antidepressants since the 60
Minutes episode. Unfortunately, I don’t know enough
psychiatrists who are willing to work toward easing
them off the drugs.
Mr Scott: What do you feel should be done for the mil-
lions who now feel dependent on antidepressants?
Dr Kirsch: In the United Kingdom, there is an organiza-
tion called NICE (The National Institute for Health and
Clinical Excellence) that has written new public health
guidelines that discourage prescribing antidepressants
except in severe cases. Unfortunately, there is no simi-
lar organization in the United States.