No Long-Term Harm From Short-Term Placebo in Adolescent Depression Trials

Delaying active therapy for teens with major depression didn't impair long-term outcomes in the context of a clinical trial.

Patients on placebo for 12 weeks before switching to antidepressants or cognitive behavioral therapy showed no difference in 36-week response rate (82% versus 83%) compared with those on active treatment from the start of a large randomized trial, said Betsy D. Kennard, Psy.D., of the University of Texas Southwestern Medical Center at Dallas, and colleagues.

The 12-week delay in active therapy also had little impact on rates of suicidal events and symptom worsening, the researchers reported online in the American Journal of Psychiatry.

Although these findings support placebo treatment as an ethical course of action in a well-run pediatric clinical trial, Dr. Kennard emphasized that its use was not simply a matter of "wait and see" if a teen gets better.

READ MORE @ MEDPAGE TODAY

Half of Doctors Routinely Prescribe Placebos

Half of all doctors in the United States regularly prescribe placebos to patients despite clear professional rules that forbid the practice, according to a nationwide survey. The results troubled medical ethicists, who said that more research is needed to determine whether doctors must deceive patients for placebos to work.

In response to three separate questions included as part of the larger survey, about half of 679 internists and rheumatologists chosen randomly from a national list of doctors reported recommending placebos on a regular basis.

The most common placebos the doctors reported using were headache pills and vitamins, but a significant number also reported prescribing antibiotics and sedatives. Although these drugs are not all inert, the usual definition of placebos, doctors reported using them for their effect on patients’ psyches, not their bodies.

READ MORE @ NY TIMES

Doctors commonly enlist the power of placebos

Doctors prescribe placebos more often than patients might imagine.

A survey of Chicago-area physicians found that 45 per cent report they have given a patient a placebo at least once, according to a study published in this month's Journal of General Internal Medicine.

Past surveys of Israeli and Danish doctors revealed that 60 per cent and 85 per cent, respectively, admit they've relied on the "placebo effect" to heal patients.

So, should patients worry about their doctors shamming them?

Maybe not. Though prescribing dummy pills is viewed as ethically shady, the placebo effect can work. Brain-scan research indicates that placebos trigger pain-relieving endorphins in the brain. Indeed, anyone who has ever felt better after taking cough syrup may have enjoyed the placebo effect - some studies suggest that sugar water is just as good at healing sore throats. Belief in medicine can contribute heavily to its success.

Doctors turn to placebos for a variety of reasons, according to the Chicago study, including to calm the patient, as a last resort when nothing else works, or simply to get a patient to stop complaining.

READ MORE @ GLOBE AND MAIL