Different types of placebo response in patients receiving antidepressants

Article Abstract:

In a previous study, depressed patients who improved after treatment with placebo demonstrated two distinct types of improvement. Those who improved abruptly demonstrated only transient improvement. Improvements that occurred gradually tended to persist over time. In an attempt to compare abrupt versus gradual placebo-related improvement to improvement related to treatment with antidepressant medication, 263 patients who were diagnosed with either moderate or severe depression were studied. The patients ranged in age from 18 to 65 years and participated in a series of four drug-trials, each lasting for a period of six-weeks. The 180 moderately depressed patients and the 83 severely depressed patients were randomly assigned to receive appropriate classes of antidepressant medications. Of the moderately depressed patients, 22 percent improved abruptly, while 49 percent improved gradually. Among the more severely depressed patients, 28 percent improved abruptly while 48 percent demonstrated gradual improvement. These findings were consistent with the earlier study of abrupt versus gradual improvement among placebo-treated patients, in which the percentages of rapid versus gradual improvement were virtually identical. Abrupt improvements among the antidepressant-treated patients proved to be transient. However, gradual improvements in both placebo- and drug-treated patients were persistent and similar in nature. Results indicate that similar processes operate in abrupt and gradual improvements among placebo- and drug-treated depressed patients, although the mechanisms underlying this phenomenon are not yet understood. (Consumer Summary produced by Reliance Medical Information, Inc.)

Placebos

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Occurrence and management of depression in the context of naltrexone treatment of alcoholism

Article Abstract:

A case study describing the difficulties of treating depression that is comorbid with treating alcoholism with naltrexone. The subject was a 53-year-old married Caucasian woman who drank half a gallon of vodka a week. She sometimes suffered from shaking and sweating but not from delirium tremens. She also showed symptoms of mild alcohol-induced depression at the start of treatment that cleared after a period of abstinence from alcohol. She also had two episodes of alcohol-independent depression that required antidepressant medication. Naltrexone, used in treating her alcoholism, was observed to be effective and well-tolerated during the treatment course.

Evaluation, Naltrexone, Alcoholism

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