Study offers more proof for the power of placebo, say UCLA researchers
Individuals with major depressive disorder (MDD) often undergo multiple courses of antidepressant treatment during their lives. This is because the disorder can recur despite treatment and because finding the right medication for a specific individual can take time.
While the relationship between prior treatment and the brain’s response to subsequent treatment is unknown, a new study by UCLA researchers suggests that how the brain responds to antidepressant medication may be influenced by its remembering of past antidepressant exposure.
Interestingly, the researchers used a harmless placebo as the key to tracking the footprints of prior antidepressant use.
Aimee Hunter, the study’s lead author and an assistant professor of psychiatry at UCLA’s Semel Institute for Neuroscience and Human Behavior, and colleagues showed that a simple placebo pill, made to look like actual medication for depression, can “trick” the brain into responding in the same manner as the actual medication.
The report was published online March 23 in the journal European Neuropsychopharmacology.
The investigators examined changes in brain function in 89 depressed persons during eight weeks of treatment, using either an antidepressant medication or a similar-looking placebo pill. They set out to compare the two treatments — medication versus placebo — but they also added a twist: They separately examined the data for subjects who had never previously taken an antidepressant and those who had. [continue reading…]
Do antidepressants work? Since the introduction of Prozac in the 1980s, prescriptions for antidepressants have soared 400 percent, with 17 million Americans currently taking some form of the drug. But how much good is the medication itself doing? “The difference between the effect of a placebo and the effect of an antidepressant is minimal for most people,” says Harvard scientist Irving Kirsch. Will Kirsch’s research, and the work of others, change the $11.3 billion antidepressant industry? Lesley Stahl investigates. Read Story: Treating Depression: Is there a placebo effect?
CautionIf you are depressed you should see your doctor. If you are already on Anti-depressants you should not stop taking them
Placebos reduce pain by creating an expectation of relief. Distraction—say, doing a puzzle—relieves it by keeping the brain busy. But do they use the same brain processes? Neuromaging suggests they do. When applying a placebo, scientists see activity in the dorsolateral prefrontal cortex. That’s the part of the brain that controls high-level cognitive functions like working memory and attention—which is what you use to do that distracting puzzle.
Now a new study challenges the theory that the placebo effect is a high-level cognitive function. The authors—Jason T. Buhle, Bradford L. Stevens, and Jonathan J. Friedman of Columbia University and Tor D. Wager of the University of Colorado Boulder—reduced pain in two ways – either by giving them a placebo, or a difficult memory task. lacebo. But when they put the two together, “the level of pain reduction that people experienced added up. There was no interference between them,” says Buhle. “That suggests they rely on separate mechanisms.” The findings, published in Psychological Science, a journal of the Association for Psychological Science, could help clinicians maximize pain relief without drugs. [continue reading…]
Psychologist Irving Kirsh aims to “explode the myth” of Prozac and its ilk, arguing that there’s little evidence that they actually work for most patients.
The following article is a sample from DISCOVER’s special Brain issue, available only on newsstands through June 28.
Depression is a chemical imbalance, most people think. Researchers, drug manufacturers, and even the Food and Drug Administration assert that antidepressants work by “normalizing” levels of brain neurotransmitters—chemical messengers such as serotonin. And yet hard science supporting this idea is quite poor, says Irving Kirsch, professor of psychology at the University of Hull in the U.K. An expert on the placebo effect, Kirsch has unearthed evidence that antidepressants do not correct brain chemistry gone awry. More important, the drugs are not much more effective against depression than are sugar pills, he says. To support these controversial claims, Kirsch conducted a meta-analysis, digging up data from unpublished clinical trials. When all the evidence is weighed together, Prozac, Paxil, and other such popular pills seem to be at best weakly effective against depression—an argument Kirsch presses in his new book,The Emperor’s New Drugs. Some other research backs up his claims. A study published this winter in the Journal of the American Medical Association found that psychoactive drugs are no better than placebos for people suffering from mild to moderate depression. link to continue reading
