People who respond to placebos benefit more from antidepressants.

That's the finding of a study released this week by the University of Michigan Medical School. But that doesn't mean they're any less effective. In fact, it's good news for the drugs.

For people who have strong placebo responses, their brains react positively to being given any treatment, and the patient feels somewhat better without any actual drugs entering their system. So, while the rest of us will get zilch from eating a sugar pill, they will feel better just from doing something – anything – to combat their symptoms. 

According to this new research, if you give a placebo-responsive patient a real pill, they will get that placebo boost as well as the benefits of taking actual medicine. In other words, people with strong placebo responses end up getting way more out of depression medicine than other people do. Those with no placebo response continue to struggle with symptoms even after treatment begins.

That doesn't mean that people who aren't placebo-reactive are out of luck: they still see marked improvement with the drugs. They just aren't the lucky dogs that placebo-reactive folks are.

The placebo response is a well-known but under-studied phenomenon, and a key to all medical research.

When an antidepressant drug first goes to clinical trials, it goes through the standard procedure: Some people get the real drug, some people get a fake drug, and then the researchers examine how everyone does. If everyone gets better at about the same rate, you know the drug is a dud and any improvement is only a placebo effect. If the people who get the real thing do markedly better than the people who got nothing, then you know the drug is really doing something.

These new findings, which were just published in the journal JAMA Psychiatry, may help researchers understand how to stimulate the brain's natural response to treatment in new ways, perhaps improving treatment for depressed patients, whether placebo-reactive or not. They could also help fine-tune the clinical trial process as the placebo effect is better understood.

The team also found that people who reported improvement in their depression after getting a placebo also had the strongest reaction in the parts of the brain that respond to opioids, or painkilling substances. That helps pinpoint that this effect is taking place physiologically in the brain, and isn't just "reporting bias" (patients wanting to please their researchers by overstating their improvement). 

The research team has been studying the placebo effect, in various forms, for over a decade.

Source: Newswise

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