In a recent study conducted at Stanford’s School of Medicine, researchers set out to investigate the antidepressant effects of ketamine — and were surprised by a fascinating discovery.
The double-blind study involved recruiting patients undergoing planned surgery who also suffered from depression. Each patient agreed to receive ketamine while under anesthesia and report its effects on their mood during recovery.
“Our interest as anesthesiologists was to optimize patients before their surgeries, and we knew about ketamine’s rapid antidepressant properties,” explains Theresa Lii, a clinical scholar at Stanford University and one of the study’s lead authors.
To properly evaluate the results, half of the participants received a placebo of saline. Since they were asleep during the administration, none of the participants were aware of whether they’d received the real drug or the placebo.
The researchers expected to find that patients who had received ketamine would experience reduced depression post-surgery, while those who received the placebo would show no change. However, it turned out that both groups had similar positive results after the treatment, leading to an unexpected discovery.
What the research team stumbled upon was the placebo effect, a type of antidepressant that is hardwired in the brain. Placebos are often thought of as “fake” drugs used in research to measure the effects of real drugs, but in certain cases, they can yield surprisingly effective results.
Based on brain mapping studies, it has been determined that the placebo effect occurs within the same dopamine-linked mechanisms of the brain that respond to opiates or ketamine. This effect can improve various health conditions, including nausea, pain, depression, and more.
Dr. Luana Colloca at the University of Maryland emphasizes that placebo responses are influenced by genetics, psychological tendencies, and cultural beliefs. Furthermore, patients’ personalities and doctors’ bedside manners play critical roles in the placebo effect.
It has been observed that patients who believe in a treatment’s effectiveness or feel they are being cared for properly tend to have higher placebo responses. Dr. Jeremy Howick from the University of Leicester stresses that empathy is a significant factor in enhancing the placebo effect.
Despite the stigma surrounding placebos, recent studies have shown that transparently administering placebos can also produce the desired placebo effect. This approach, known as open-label placebo, may have the potential to reduce reliance on medications with negative side effects.
While the use of placebos as a formal intervention may still be met with skepticism, there’s potential for larger scale changes in health care as a response to placebo research. These changes highlight the importance of doctors showing more empathy and taking the time to listen to their patients.
Looking ahead, researchers hope to personalize the use of placebos in medicine, allowing patients who are prone to positive placebo responses to supplement traditional medications with the natural responses produced by their bodies.