Placebo Effect May Predict Antidepressant Response

Woman comparing two medicationsPlacebos can be highly effective, and many drug studies compare real drugs to placebos to assess whether participants are responding to the drug itself or simply getting better because they believe they will.

A new study published in JAMA Psychiatry suggests that the way a person with depression reacts to a placebo may predict how well he or she will respond to the real thing. Previous research testing antidepressants against placebos suggests 40% of antidepressant response may be attributable to the placebo effect.

Using Placebos to Predict the Effectiveness of ‘Real’ Drugs

The team has been studying the placebo effect for more than a decade, and their research has demonstrated that the brain’s mu-opioid system—the pain relief center—responds to pain when given a placebo.

For this study, researchers used positron emission tomography (PET) scans to look at the brains of 35 people with major depression. Participants were not taking antidepressants and were told they were going to take a new depression drug. Instead, they received a placebo for the first week. When participants came in for a brain scan, they also received a saline injection but were told the injection might have the power to rapidly relieve depression symptoms. Many participants reported some improvement in their symptoms with the aid of the placebo.

Researchers provided participants with a real antidepressant after the placebo. They found that people who responded well to the placebo were also more likely to respond well to the antidepressant. Brain imaging revealed that these participants had the strongest mu-opioid response in areas of the brain associated with emotion and depression.

What These Findings Could Mean for People with Depression

These findings suggest the body’s own pain alleviation system might work more effectively in people who respond well to placebos, and some people may have more natural resiliency that could lead to a greater improvement in depression symptoms. The next step, the researchers say, is to figure out how to enhance that natural resiliency.

Worldwide, more than 350 million people struggle with depression, making it the leading cause of disability. It is a major contributor to suicide, which claims the lives of a million people each year, according to the World Health Organization.

References:

  1. Depression. (2012, October). Retrieved from http://www.who.int/mediacentre/factsheets/fs369/en/
  2. Placebo power: Depressed people who respond to fake drugs get the most help from real ones, U-M study finds. (2015, September 30). Retrieved from http://www.uofmhealth.org/news/archive/201509/placebo-power-depressed-people-who-respond-fake-drugs-get

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  • Big

    Big

    October 6th, 2015 at 10:33 AM

    This would sort of be like playing with fire. Even if you know that the placebo effect is real and can make a real difference in many patients I would never want to take that chance that you are leaving them without medication and just hoping that even the thought that they are taking medication will be enough to spur them to recovery. What if they are one of those people for whom this would not work and something terrible happened as a result that they really received no treatment?

  • trey

    trey

    October 7th, 2015 at 2:34 PM

    It could be that those who don’t already believe that there is anything that is going to help them feel better are going to be the ones that are less likely to have any kind of placebo effect.

  • Cassidy

    Cassidy

    October 12th, 2015 at 1:09 PM

    I wonder if that means that even more people than we would suspect would be okay without taking medication. It’s risky but if they are going through other treatment then I guess it would be okay.

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