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Placebo Study Finds Brain Activity Predicts Antidepressant Response Before Medication Begins

A UCLA study that explored the relationship between changes in brain activity during a placebo lead-in phase and later outcomes of antidepressant treatment suggests that medication is just one of many variables in the effective treatment of depression.

Published in the August 2006 issue of the American Journal of Psychiatry, the findings imply that factors such as patient expectations may play a role in priming the brain for antidepressant therapy.

“Treatment results appear to be partly predicted by changes in brain activity during placebo lead-in—prior to the actual use of antidepressant medication,” says Aimee Hunter, a research associate at the Semel Institute for Neuroscience and Human Behavior at UCLA. “More research is needed to identify the impact of non-drug factors that affect brain activity and clinical improvement in patients receiving antidepressant treatment.”

Semel Institute researchers examined data from 51 adults with major depression who were involved in two independent, double-blind placebo-controlled trials. The subjects received blinded treatment with placebo for one week prior to receiving antidepressant medication. The scientists measured electrical brain activity at baseline and at the end of the placebo lead-in period. The research linked changes in activity in the prefrontal brain region during placebo use to less depression after eight weeks of antidepressant treatment.

In subjects randomly assigned to medication, prefrontal changes during placebo lead-in predicted 19 percent of the variation in antidepressant response.

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