The Bastard Placebo
This chapter examines the complex relation between drug and placebo in randomized clinical trials for antidepressants. It shows that there have been long-standing attempts to differentiate the actions of a placebo from those of a drug; indeed, good clinical practice is now based on the presumption that such a distinction can be reliably made. This chapter argues that there is a fundamental affinity between drug and placebo. It focuses on empirical data that show a mutuality between drug and placebo: a good drug response appears to be related to a good placebo response (drug and placebo are parasitic on each other). Feminist and critical commentators who turn away too quickly from pharmaceutical treatments of depression miss a number of opportunities afforded by these data. Rather than calling for less compromised treatments, the chapter advocates for the adulterated nature of psychopharmaceuticals.