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Scientists Present First Genetic Evidence For Why Placebos Work

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    Message 1 of 1 , Jul 21, 2009
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      SCIENTISTS PRESENT FIRST GENETIC EVIDENCE FOR WHY PLACEBOS WORK
      PhysOrg
      July 20, 2009

      http://www.physorg.com/news167331550.html

      Usually mere sugar pills designed to represent "no treatment" in a clinical
      treatment study. The effectiveness of the actual medication is compared with
      the placebo to determine if the medication works.

      And yet, for some people, the placebo works nearly as well as the
      medication. How well placebos work varies widely among individuals. Why that
      is so, and why they work at all, remains a mystery, thought to be based on
      some combination of biological and psychological factors.

      Now, researchers at UCLA have found a new explanation: genetics. Dr. Andrew
      Leuchter, a professor of psychiatry at the UCLA Semel Institute for
      Neuroscience and Human Behavior, and colleagues report that in people
      suffering from major depressive disorder, or MDD, genes that influence the
      brain's reward pathways may modulate the response to placebos. The research
      appears in the August edition of the Journal of Clinical Psychopharmacology
      (currently available online by subscription).

      Placebos are thought to act by stimulating the brain's central reward
      pathways by releasing a class of neurotransmitters called monoamines,
      specifically dopamine and norepinephrine. These are the brain chemicals that
      make us "feel good." Because the chemical signaling done by monoamines is
      under strong genetic control, the scientists reasoned that common genetic
      variations between individuals -- called genetic polymorphisms -- could
      influence the placebo response.

      Researchers took blood samples from 84 people diagnosed with MDD; 32 were
      given medication and 52 a placebo. The researchers looked at the
      polymorphisms in genes that coded for two enzymes that regulate monoamine
      levels: catechol-O-methyltransferase (COMT) and monoamine oxidase A (MAO-A).
      Subjects with the highest enzyme activity within the MAO-A polymorphism had
      a significantly lower placebo response than those with other genotypes. With
      respect to COMT, those with lower enzyme activity within this polymorphism
      had a lower placebo response.

      "Our findings suggest that patients with MDD who have specific MAO-A and
      COMT genotypes may be biologically advantaged or disadvantaged in mounting a
      placebo response, because of the activity of these two enzymes," said
      Leuchter, who directs the Laboratory of Brain, Behavior and Pharmacology at
      the UCLA Semel Institute.

      "To our knowledge, this is the first study to examine the association
      between MAO-A and COMT polymorphisms and a response to placebo in people who
      suffer from major depressive disorder," he said.

      Leuchter noted that this is not the sole explanation for a response to a
      placebo, which is likely to be caused by many factors, both biological and
      psychosocial. "But the data suggests that individual differences in response
      to placebo are significantly influenced by individual genotypes," he said.

      Including the influence of genotype in the design of clinical trials could
      facilitate more powerful testing of future treatments, Leuchter said.

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      THE PLACEBO EFFECT: THE POWER OF NOTHING (5/26/2001):
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      Published by David Sunfellow
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