Placebo Drugs Can Predict Successful Depression Treatment

If a depressed patient responds well to a placebo, that may determine how well they’ll respond to a real medicine, according to new research.

People who can marshal their brain’s own chemical forces against depression, it appears, have a head start in overcoming its symptoms with help from a medication. But those whose brain chemistry doesn’t react as much to a fake medicine, or placebo, struggle even after getting an active drug.

The findings, published in JAMA Psychiatry and made at the University of Michigan Medical School, help explain the variation in treatment response and resiliency that bedevils depression patients and their care teams.

The discovery also opens up the door to new research on how to amplify the brain’s natural response in new ways — to improve depression treatment for the estimated 350 million people worldwide who have depression at any given time.

The findings could also help those developing and testing new drugs, helping them correct for the placebo effect that gets in the way of measuring a drug’s true effect.

The study comes from a team that has studied the placebo effect for more than a decade, using sophisticated brain scanning techniques in healthy people.

For the new study, they studied the brain chemistry of 35 people with untreated major depression, who agreed to try what they thought was a new depression drug, before receiving actual drugs already approved to treat depression.

According to a news release from the university, the team found that participants who reported improvement of depression symptoms after getting the placebo were also more likely to experience even fewer symptoms once they got a real drug.

In fact, response to placebo predicted nearly half of the variation between individuals in total response to the entire study, including actual drug treatment.


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