Tag: placebo

Reading of the Week: Placebo & Mental Disorders – the New JAMA Psych Study; Also, Children Who Lost a Parent to Overdose, and the Latest in the News

June 6, 2024 /

From the Editor 

It’s day three of his hospitalization, and he insists that the medication trial (a low dose of an SSRI) has been transformative. It’s difficult to explain his experience pharmacologically. 

How significant is the placebo response? How much does it vary among mental disorders? These questions aren’t new. In the first selection, Dr. Tom Bschor (of the Technical University of Dresden) and his co-authors tread on a familiar path with a study just published in JAMA Psychiatry. Focusing on nine psychiatric disorders, they examined high-quality RCTs for a systematic review and meta-analysis, finding “significant improvement under placebo treatment for all 9 disorders, but the degree of improvement varied significantly among diagnoses.” We consider the study and its implications.

In the second selection, Christopher M. Jones (of the Substance Abuse and Mental Health Services Administration) and his co-authors used US databases to calculate how many children have lost a parent to drug overdoses. The resulting JAMA Psychiatry study is haunting. “We estimated that more than 320 000 US children lost a parent to drug overdose between 2011 and 2021, providing new insight into the multigenerational impacts of the ongoing overdose crisis in the US.”

Finally, we explore the latest news with recent articles from The Guardian, The Globe and Mail, and The New York Times. Among the topics: the mental health struggles of a cancer patient, the beliefs of Marshall Smith, and whether we are talking too much about mental health.

DG

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Reading of the Week: Do Antidepressants Work? The New Cipriani Study

March 1, 2018 /

From the Editor

Last week, I spoke to a patient about antidepressants. “But do they really work?” she asked. While antidepressants are commonly prescribed, many patients wonder about them. That’s not surprising: in popular culture, these medications are often portrayed as risky and unhelpful. Just a few weeks ago, the most popular women’s fitness magazine in the world described fawningly how a woman quit her medications and felt better (“I felt more alive and in control of my emotions with each passing day”). A few years ago, a major study suggested that antidepressants basically match placebo in efficacy; 60 Minutes covered it.

And now there is the new Cipriani et al. paper. “We found that all antidepressants included in the meta-analysis were more efficacious than placebo in adults with major depressive disorder…”

Is this the biggest psychiatry paper of the year? Certainly, it may be one of the most impressive. It took six years of effort. Oxford University’s Andrea Cipriani and his co-authors drew from all available data – published and unpublished, and covering more than 500 trials.

The media coverage has been incredible. The Guardian summarized the paper with the first two words of its article: “Antidepressants work.”

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In this Reading, we look at the big study and mull the big implications.

DG

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Reading of the Week: Can a Fake Intervention Help Real Pain? Also, Preventing Depression

March 30, 2017 /

From the Editor 

“To a degree which has never been suspected, what powerful influence upon diseases is produced by mere imagination.” British physician John Haygarth wrote those words more than two centuries ago when considering the placebo effect.

Is it possible to successfully treat people with placebo in an open-label trial? That is, if people know they are taking placebo, will they still experience the benefit of placebo?

painCan a fake intervention help real pain?

In this week’s selection, we look at a new study where participants were offered placebo for back pain. Spoiler alert: it worked.

And, in a new feature for the Reading of the Week, we include an invited letter to the editor from Dr. Albert H. C. Wong who writes about the best way of preventing depression.

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Reading of the Week: Of Pills and Placebo – The Pecina et al. paper

October 15, 2015 /

High rates of placebo responses are consistently reported across medical conditions, notably mood disorders, Parkinson disease, and pain, but also schizophrenia, substance use disorders, and surgical procedures. Placebo response rates in antidepressant trials average 31% to 45% compared with approximately 50% responses to antidepressants, and they have increased over the last 30 years. The failure of antidepressant responses to separate from placebo has contributed to the reduction or discontinuation of research on new treatments for depression and other neuropsychiatric illnesses, hindering the development of novel neuropsychiatric treatments.

So begins a new paper considering the relationship between placebo and depression treatment.

This week’s Reading: “Association Between Placebo-Activated Neural Systems and Antidepressant Responses Neurochemistry of Placebo Effects in Major Depression” by Dr. Marta Peciña et al., which was just published “online first” by JAMA Psychiatry.

Dr. Marta Peciña

Here’s a quick summary: this is a big paper in a big journal that seeks to better understand the placebo effect and antidepressants, and taps neuroimaging to do so. There is, however, a catch: the number of patients involved is small. Continue reading