A recent University study found that people with depression whose symptoms are decreased by placebo drugs are also more likely to respond when they are given real antidepressants. Those who don’t respond to the placebo are less likely to find relief with medication.
The research team, led by Jon-Kar Zubieta, a former University faculty member who is now chair of the psychiatry department chair at the University of Utah, has been studying the placebo effect for more than 10 years through brain scanning techniques.
The study was conducted with 35 participants, all with untreated major depression. The participants were told they were being given a new drug to treat depression that researchers were looking to test.
Psychiatry Prof. Marta Pecina, one of the study’s lead authors, said the study had two phases in which the patients were first given the placebo drugs, and then actually treated.
Using Positron Emission Tomography, which is a brain scanning technique, the researchers were able to monitor the participant’s brain activity throughout the study to determine the reaction to the placebo and actual drug. Researchers saw the same changes in brain chemistry in patients who responded to the placebo pill as they saw in patients who actually took the antidepressant.
Pecina said the patients responding to the placebo could essentially “generate their own medicine,” which could lead to alternative treatments in the future, though she acknowledged the study wasn’t necessarily representative of the whole population.
“These people may in general have more resilience, and that’s a good point,” Pecina said. “Certainly research like this may help us to stratify patients who would either benefit from lower doses of antidepressants or even alternative treatments.”
In a press release, Zubieta said he thinks it is important to enhance the resiliency people already have.
In this way, he said if people are responsive even to a placebo drug, any progress they make will be dependent on themselves and they may feel better using more personalized treatment options like therapy.
Rackham student Patrick Pruitt, who studies neuroscience and wasn’t involved in the study, said he thinks placebo response is an exciting topic because the theory of it has been studied for a long time, and the field is now beginning to explore practical applications of that research.
“Now we’re starting to understand — even if it’s just glimpses — what is going on in the brain when someone is responding to placebo,” he said.
Pruitt also noted the complications associated with placebos in research and said in some situations, such as when testing the effects of a new drug, researchers actually seek to minimize the effect.
“Part of what makes it tricky is that there are situations like drug trials where we want the placebo effect to be minimized,” he said. “In drug trials you want to know if the medication is effective — you want to look purely at how the medication is working and how it isn’t working. But then in the clinic, you want to maximize it.”
Moving forward, the research team said they hoped to continue these types of studies with a larger population.
Pecina said the size of this study in particular was a limitation, and she hopes to expand what the team can do in the future.
“This is a small study with just 35 patients and the placebo phase is short — just one week,” she said. “We’re looking forward to doing studies that involve fully randomized trials where we can give patients longer placebo treatments.”
Either way, Pruitt said he thinks continued research into placebo response will open new doors in research in the coming years.
“Having a better understanding of how the placebo response works and what type of person is going to respond to placebo is really going to open up our understanding of how to account for that in drug trials as well as to boost that in the clinic, to provide additional relief for those suffering from depression,” he said.