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Related Experiment Video

Updated: Jul 17, 2026

How to Study Placebo Responses in Motion Sickness with a Rotation Chair Paradigm in Healthy Participants
08:50

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Published on: December 14, 2014

Placebo response and antidepressant response.

George S Alexopoulos1, Dora Kanellopoulos, Christopher Murphy

  • 1Weill-Cornell Institute of Geriatric Psychiatry, Weill Medical College of Cornell University, White Plains, NY, USA. gsalexop@mail.med.cornell.edu

The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry
|February 3, 2007
PubMed
Summary

Worsening depression during a placebo lead-in phase predicts better outcomes with escitalopram treatment in older adults. This finding may help distinguish true antidepressant effects from placebo responses in clinical trials.

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Area of Science:

  • Psychiatry
  • Clinical Pharmacology
  • Neuroscience

Background:

  • Placebo response significantly confounds antidepressant drug trials.
  • Current methods for excluding placebo responders are insufficient.
  • Identifying predictors of pharmacologic response is crucial for understanding antidepressant mechanisms.

Purpose of the Study:

  • To investigate if changes in depressive symptoms during a placebo lead-in predict response to escitalopram.
  • To differentiate pharmacologic antidepressant effects from placebo effects.

Main Methods:

  • Older adults (60-85 years) with major depression (Hamilton Depression Rating Scale score ≥ 18) underwent a two-week placebo lead-in.
  • Eligible patients received 10 mg escitalopram for 12 weeks.
  • Change in depression severity during placebo was analyzed as a predictor of escitalopram response.

Main Results:

  • Worsening or minimal improvement in depression during placebo predicted subsequent improvement with escitalopram.
  • Limited changes in anxiety, melancholia, helplessness, and paranoia during placebo were strong predictors of escitalopram response.

Conclusions:

  • Findings may help identify older patients likely to respond to antidepressant pharmacologic action, refining biomarker study methodologies.
  • Clinically, older patients showing improvement during placebo evaluation might benefit more from nonpharmacologic treatments.