Depression, dementia and placebos – not such a bitter pill

Depression among people dementia is very common and has a negative impact on people's quality of life and well being.

Recent research led by Professor Sube Banerjee of Brighton and Sussex Medical School has shown that treating people with dementia with anti-depressants reduces symptoms of depression. However, the research used a placebo, meaning that some people in the study took a pill that had no psychoactive or mood altering ingredients.

Participants were not told whether they were taking a real anti-depressant or the placebo. People who took the placebo experienced the same reduction in depressive symptoms as those who took the anti-depressant, but with less unpleasant side effects. This reflects findings from other studies that tested anti-depressants where the placebo was just as effective as the actual anti-depressant.

Two question emerge. Are anti-depressants that have been tested against placebos where the placebos have been just as effective, a waste of time and money? And would it be ethical to give people with depression placebos, telling them that “this medication should help you”, without telling them it’s not actually an anti-depressant?

Maybe placebos are a form of anti-depressant but psychological factors in the interaction is more important than what’s in the pill – potentially not good news for the drug companies.