The Role of the Placebo Effect

Placebo-controlled trials have shown that antidepressants are only slightly more effective than placebo. According to research, up to 80–90% of the effect of antidepressants can be replicated by placebo alone. In other words, people often feel better not because of the drug’s pharmacological properties, but because of expectation, hope, support, and the meaning attached to taking a medication.

This small difference seen in drug versus placebo groups is often clinically insignificant. That is, it doesn’t amount to a meaningful change in how someone feels or functions in daily life.

What This Means for Treatment

This doesn’t mean that people who feel better on antidepressants are imagining it. Rather, it suggests that the context in which medication is prescribed — including the belief in its effectiveness — plays a powerful role in recovery. Feeling heard, receiving care, and taking action to improve one’s situation are potent psychological factors, which may be as important as, or more important than, any chemical intervention.

Unfortunately, the dominance of the biomedical model has often led to the neglect of these deeper psychosocial and relational dimensions. People are routinely prescribed antidepressants without being informed about the placebo effect, the limits of the chemical imbalance theory, or the full range of non-drug options — including therapy, community connection, purposeful activity, and addressing structural causes of distress such as poverty, trauma, or inequality.

Rethinking Informed Consent

Given the growing skepticism in the scientific community about the actual mechanism and effectiveness of antidepressants, informed consent becomes crucial. Patients deserve to know:

• That the serotonin deficiency theory is unsupported

• That most of the benefit from antidepressants may be placebo-related

• That withdrawal can be difficult and prolonged for many people

• And that there are many alternative paths to addressing depression-related mental health condition.

Acknowledging the role of the placebo effect doesn’t diminish people’s experiences. On the contrary, it empowers individuals to explore a fuller picture of what helps them feel well — and why.