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A placebo can yield a clinical response that is indistinguishable from that seen with active antidepressant treatment. Inside the brain, however, the responses diverge. Mayberg's team found that patients treated with placebo or with Prozac (fluoxetine hydrochloride) showed a metabolic increase in the cortical region and a decrease in the limbic-paralimbic region. But patients given Prozac also showed brain-stem increases along with a drop in hippocampal and striatal metabolism, which "may convey additional advantage in maintaining long-term clinical response and in relapse prevention." The magnitude of change also was greater for Prozac recipients.
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