Is placebo useful in the treatment of major depression in clinical practice?

Carlo Marchesi, Chiara De Panfilis, Matteo Tonna, Paolo Ossola University of Parma, Department of Neuroscience, Psychiatric Unit, Parma, Italy Background: For many years, placebo has been defined by its inert content and use in clinical trials. In recent years, several studies have demonstrated its...

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Autores principales:	Marchesi C, De Panfilis C, Tonna M, Ossola P
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/92c7205e6761455cbbaf4950435a73d1
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spelling	oai:doaj.org-article:92c7205e6761455cbbaf4950435a73d12021-12-02T06:29:28ZIs placebo useful in the treatment of major depression in clinical practice?1176-63281178-2021https://doaj.org/article/92c7205e6761455cbbaf4950435a73d12013-06-01T00:00:00Zhttp://www.dovepress.com/is-placebo-useful-in-the-treatment-of-major-depression-in-clinical-pra-a13468https://doaj.org/toc/1176-6328https://doaj.org/toc/1178-2021Carlo Marchesi, Chiara De Panfilis, Matteo Tonna, Paolo Ossola University of Parma, Department of Neuroscience, Psychiatric Unit, Parma, Italy Background: For many years, placebo has been defined by its inert content and use in clinical trials. In recent years, several studies have demonstrated its effect in the treatment of major depression. The aim of this paper is to present the conclusions of recent meta-analyses of the placebo effect in major depression, to explain the mechanism by which placebo exerts its effect, and to discuss whether placebo can be used in the treatment of patients with major depression in clinical practice. Recent meta-analyses have demonstrated that the placebo effect is estimated to account for 67% of the treatment effect in patients receiving antidepressants, and furthermore that placebo is as effective as antidepressants in patients with mild to moderate major depression (reporting a Hamilton Depression Rating Scale score lower than 25), whereas placebo is less effective than antidepressants in severely depressed patients. However, several limitations make the translation of these conclusions into clinical practice impracticable. Clinicians should learn from the "placebo lesson" to maximize the nonspecific effects of treatment when they prescribe an antidepressant, particularly in less severely depressed patients, who show a higher placebo response in randomized controlled trials. This strategy can increase the antidepressant effect and may reduce nonadherence with treatment. Keywords: placebo effect, major depressive disorder, subthreshold depressive disorder, antidepressantsMarchesi CDe Panfilis CTonna MOssola PDove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2013, Iss default, Pp 915-920 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Marchesi C De Panfilis C Tonna M Ossola P Is placebo useful in the treatment of major depression in clinical practice?
description	Carlo Marchesi, Chiara De Panfilis, Matteo Tonna, Paolo Ossola University of Parma, Department of Neuroscience, Psychiatric Unit, Parma, Italy Background: For many years, placebo has been defined by its inert content and use in clinical trials. In recent years, several studies have demonstrated its effect in the treatment of major depression. The aim of this paper is to present the conclusions of recent meta-analyses of the placebo effect in major depression, to explain the mechanism by which placebo exerts its effect, and to discuss whether placebo can be used in the treatment of patients with major depression in clinical practice. Recent meta-analyses have demonstrated that the placebo effect is estimated to account for 67% of the treatment effect in patients receiving antidepressants, and furthermore that placebo is as effective as antidepressants in patients with mild to moderate major depression (reporting a Hamilton Depression Rating Scale score lower than 25), whereas placebo is less effective than antidepressants in severely depressed patients. However, several limitations make the translation of these conclusions into clinical practice impracticable. Clinicians should learn from the "placebo lesson" to maximize the nonspecific effects of treatment when they prescribe an antidepressant, particularly in less severely depressed patients, who show a higher placebo response in randomized controlled trials. This strategy can increase the antidepressant effect and may reduce nonadherence with treatment. Keywords: placebo effect, major depressive disorder, subthreshold depressive disorder, antidepressants
format	article
author	Marchesi C De Panfilis C Tonna M Ossola P
author_facet	Marchesi C De Panfilis C Tonna M Ossola P
author_sort	Marchesi C
title	Is placebo useful in the treatment of major depression in clinical practice?
title_short	Is placebo useful in the treatment of major depression in clinical practice?
title_full	Is placebo useful in the treatment of major depression in clinical practice?
title_fullStr	Is placebo useful in the treatment of major depression in clinical practice?
title_full_unstemmed	Is placebo useful in the treatment of major depression in clinical practice?
title_sort	is placebo useful in the treatment of major depression in clinical practice?
publisher	Dove Medical Press
publishDate	2013
url	https://doaj.org/article/92c7205e6761455cbbaf4950435a73d1
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Is placebo useful in the treatment of major depression in clinical practice?

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