A study that will appear in European Neuropsychopharmacology found that “the brain’s response to the placebo pill seems to depend … on whether or not the brain has ever ‘seen’ antidepressant medication before.” Similarly, an article in Medical Hypotheses proposes an approach that capitalizes on a “personal (as opposed to superficial or impersonal) encounter between helper and helpee” to potentiate the placebo response. A study in Schizophrenia Research investigates whether interventions can adequately identify and prevent relapse in placebo arms of trials and finds that, though relapse cannot be adequately identified or prevented, this fact is equally true for both placebo and continuous-treatment arms of trials and the longer-term recovery outcomes following relapse in both treatment and placebo conditions justify continued placebo trials.
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Note from Kermit Cole, Resources Editor:
The study in European Neuropsychopharmacology is interesting for its exploration of the role of classical conditioning in the placebo response. Having experienced the effects of an antidepressant, a study subject then given placebo may be more attentive to cues (the act of taking a pill, being in a clinical environment, interacting with medical personnel) that enhance the placebo effect. Though interesting in its hypothesis, this study is limited in its design, but further study of the role that prior experience with drug-taking plays in the placebo response seems warranted.
Placebo studies in general are very problematic, with many variations (treatment-withdrawal misidentified as placebo, for instance) confounding a true understanding of what was discovered. But with a growing awareness of the strength of the placebo relative to “treatment” response, more research seems warranted and appears to be underway.
