Placebo study frames depression treatment puzzle

Aug 01, 2006

Treating major depression can be quite a puzzle, and a newly published UCLA study suggests medication is just one of many potential pieces.

Published in the August 2006 edition of the American Journal of Psychiatry, the study used electroencephalogram (EEG) measurements to demonstrate an association between eventual clinical outcome and regional changes in brain activity during a placebo lead-in phase prior to antidepressant treatment.

The findings suggest that factors such as patient beliefs and expectations, doctor-patient relationships, or treatment history help complete the treatment picture.

In this study, all subjects received blinded treatment with placebo for one week prior to receiving antidepressant medication. A "placebo lead-in" phase is commonly used to familiarize patients with study procedures and to minimize the effect of any pre-existing treatment for depression. The placebo lead-in includes patient care, participation and treatment with placebo; the clinical impact is largely unknown.

This study is the first to assess the relationship between brain changes during the placebo lead-in phase and later clinical outcome of antidepressant treatment.

"Treatment results appear to be predicted, in part, by changes in brain activity found during placebo lead-in--prior to the actual use of antidepressant medication," said lead author Aimee M. Hunter, a research associate at the Semel Institute for Neuroscience and Human Behavior at UCLA. "More research is needed to identify the impact of other 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.

Quantitative EEG cordance measures were taken at baseline and at the end of the placebo lead-in period. Cordance is a quantitative EEG (QEEG) imaging technique developed at UCLA to measure brain function. Measurements are performed by placing recording electrodes on the scalp. The electrodes connect to the body through conductive paste or gel. It does not hurt and involves no radioactivity. The electrodes are connected to a computer, which measures the signals coming from the brain and processes them into colorful patterns.

Relationships between regional cordance changes at the end of the placebo lead-in period and clinical outcome were examined using a statistical tool called multiple linear regression analysis. Final outcomes were determined using Hamilton Rating Scale for Depression scores.

The study found that decreases in cordance in the prefrontal brain region during the placebo lead-in period were associated with lower depression-scale scores after eight weeks of antidepressant treatment. In subjects randomly assigned to medication, prefrontal changes during placebo lead-in explained 19 percent of the variance in final depression scores.

Source: University of California - Los Angeles

Explore further: Less than 1 percent of UK public research funding spent on antibiotic research in past 5 years

add to favorites email to friend print save as pdf

Related Stories

Social Security spent $300M on 'IT boondoggle'

9 hours ago

(AP)—Six years ago the Social Security Administration embarked on an aggressive plan to replace outdated computer systems overwhelmed by a growing flood of disability claims.

Cheaper wireless plans cut into AT&T 2Q profit

10 hours ago

(AP)—AT&T posted lower net income for the latest quarter due to cheaper cellphone plans it introduced as a response to aggressive pricing from smaller competitor T-Mobile US.

Awarded a Pell Grant? Better double-check

10 hours ago

(AP)—Potentially tens of thousands of students awarded a Pell Grant or other need-based federal aid for the coming school year could find it taken away because of a mistake in filling out the form.

Recommended for you

Monitoring the rise and fall of the microbiome

3 hours ago

Trillions of bacteria live in each person's digestive tract. Scientists believe that some of these bacteria help digest food and stave off harmful infections, but their role in human health is not well understood.

Common blood thinner for pregnant women proven ineffective

7 hours ago

It's a daily injection to the belly for pregnant women at risk of developing blood clots and it's ineffective, according to a clinical trial led by researchers at The Ottawa Hospital and published today by the prestigious ...

Shift work linked to heightened risk of type 2 diabetes

8 hours ago

Shift work is linked to a heightened risk of developing type 2 diabetes, with the risk seemingly greatest among men and those working rotating shift patterns, indicates an analysis of the available evidence published online ...

User comments : 0