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designed to make it extraordinarily easy to get a drug approved. All you have to do is produce two trials--any time, anywhere in the world--that suggest some positive effect of the drug. If there are two, and there is some effect, that's enough. So you could have a situation in which there are one thousand scientific trials, and 998 find the drug doesn't work at all, and two find there is a tiny effect--and that means the drug will be making its way to your local pharmacy.

The people who turn up at this center have a strong incentive to pretend to have any condition they happen to be studying there--and the for-profit companies conducting the clinical trials have a strong incentive to pretend to believe them. Peter looked on as both sides seemed to be effectively bullshitting each other. When he saw people being asked to rate how well the drugs had worked, he thought they were often clearly just giving the interviewer whatever answer they wanted. So Peter concluded that the results from clinical trials of antidepressants--all the data we have--are meaningless. That means Irving is building his conclusion that their effect is very small (at best) on a heap of garbage, Peter declared. The trials themselves are fraudulent.

"publication bias."7 Of all the studies drug companies carry out, 40 percent are never released to the public, and lots more are only released selectively, with any negative findings left on the cutting room floor.