Placebo Response in Major Depressive Disorder.

Placebo Response in Major Depressive Disorder.

Sponsored research to Dr. Anderson through Burroughs Wellcome Fund.

Dr. Anderson has received research support through Burroughs Wellcome Fund.

Roughly 1 in 10 adults in the United States has depression, yet development of interventions is hindered by the placebo response. The placebo response, which is active both in patients taking a genuine and sham intervention, can overwhelm true drug-related changes and block the ability to distinguish between effective and ineffective treatments for depression.

Many factors are known to impact the placebo response experienced by a subject, including the length of the trial, the probability that a subject will receive a placebo intervention, and the mannerisms of a clinician which may lead to an expectation bias in the patient. Previously, research in schizophrenia found that the placebo response is predictable within a subject, and patients who experienced certain symptom domains (e.g. positive) were more likely to be placebo responders. Given that the placebo response may be systematic and predictable within schizophrenia, it similarly may be predictable within major depressive disorder (MDD).

Although the placebo response is known to permeate all clinical trials, the trajectory over time as well as the susceptibility of unique individuals is yet unknown. Here, we will assess the temporal patterns and power of the placebo response in Major Depressive Disorder using the Hamilton Rating Scale for Depression (HAM-D) and the Montgomery–Asberg Depression Rating Scale (MADRS). These patterns will be compared to changes seen in patients receiving an active mediation. Using time series analyses and machine learning predictive modelling, we will assess whether some individuals are disproportionately susceptible to being placebo responders. Moreover, we will assess at which point in the study placebo responders are identifiable. These findings will be communicated to the public in scientific publications.

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