Placebos (sugar pills) can provide a significant physical and psychological improvement in depressed patients, proving the medicinal power of positive thinking.
"We have always thought that the positive effect of placebos on patients was based on a psychological process, not a physical process," Dr. Andrew Leuchter, the lead lead author of the study published in the American Journal of Psychiatry.
Using a cutting-edge brain scan technique called "quantitative electroencephalography (QEEG) imaging," researchers at UCLA's Neuropsychiatric Institute conducted a nine-week examination of electrical activity in the brains of patients treated for depression with a placebo and of those treated with antidepressant medication.
Many approaches to depression may be effective. The UCLA study indicates that there may be multiple pathways to improvement for sufferers of depression -- some involving medication to suppress abnormal brain activity and others using different or complimentary treatments. Both medicines and placebo are effective in relieving symptoms in patients, said Dr. Andrew Leuchter lead author of the study published in the American Journal of Psychiatry, but they work through different and possibly complementary mechanisms.
"There may well be other treatments that have the same effect as placebo, which involves a positive attitude in the patient who seeks out treatment and believes that it will work and is in continual contact with a physician," Leuchter said. "We need to determine which aspects of this treatment are particularly effective and apply them."
Though little is understood about this placebo effect, 30 percent to 60 percent of patients report a significant improvement in their symptoms after receiving a bogus drug.
In the UCLA study, 52 percent (13 of 25) of the subjects receiving antidepressants -- either fluoxetine (Prozac), or venlafaxine (Effexor) responded to treatment, while 38 percent of those receiving placebos responded, the study states.
After eight weeks the subjects were told either that they had been given a placebo or medication. The individuals taking a placebo lost all of the improvement they had made and had a recurrence of their symptoms. The researchers believe that a belief in treatment is an important component of the placebo response. That means that the expectation of getting better contributed greatly to improvement.
The expectation of getting better might be as important in a response to real medication as it is to placebos. A positive expectation may also be valuable in the application of many alternative and complimentary therapies.
