Placebo Power Grows, Perplexing Big Pharma

[villager]

Placebo Power Grows, Perplexing Big Pharma


It's a real challenge developing better drugs for loads of common conditions because there are already so many effective treatments.

But another problem that might surprise you is that placebos, the dummy pills that are the gold standard for comparison in drug studies, seem to be getting more powerful. A provocative piece in Wired describes the evolving science behind placebos and the relatively recent finding that patients' response to sugar pills in many studies appears stronger than it used to be.

Psychiatrist and drug researcher William Potter, now at Merck, found that antidepressants, including Prozac, were more likely to fail when compared to placebos in trials conducted recently than in studies a decade earlier. Results also varied by location and according to doctors' subjective interpretation of supposedly standardized measures of response.

<snip>

http://www.npr.org/blogs/health/2009/08/placebo_power_grows_perplexing.html

[WingDinger]

1. We trust experts more than we used to. Is knowledge of a plecebo in a test

likely to lessen drug effects?

[tama]

2. Evolving, perhaps

towards better and better self-healing potential.

[gateley]

3. It shows the power of the mind. I always cite a show I watched

on stigmata. The finding was that it wasn't a Divine occurrence, but just "In their minds". I screamed at the TV -- JUST in their minds?!?!? If my mind can make me spurt blood from different parts of my body, shouldn't we explore what else my mind can do?

Too much faith has been put in pharmaceuticals and we've entirely overlooked our own power.

[HockeyMom]

6. Heard this from a doctor myself

many years ago. I had surgery for a ruptured ectopic pregnancy. I had so much internal bleeding the operating staff was "amazed" that I had not gone into a coma. The day after I was up and walking around by myself. I had all these doctors coming in to "talk" to me. I was not supposed to be able to do this. There was one young doctor in the group who was from Jamaica. I felt like some kind of freak with them all talking ABOUT me in my presence. In a lull of the their comments this one doctor piped up and said, "The MIND is the most powerful medicine there is." They all just stared at him. He smiled and nodded at me. Yeah, he KNEW.

[bmbmd]

4. When Prozac first came out,

the sales reps touted it as "twice as effective as placebo", which begs the question "Why not just double up on your placebo?"

[OKIsItJustMe]

7. I heard from a friend

Years ago, he worked in a facility for “at risk youth,” and the house psychologist had an especially powerful drug, “Obecalp,” he would occasionally give to kids who needed a little extra help.

My friend told of one boy who was asked in a session how he was doing after he’d been taking Obecalp for a little while. He was coping better, thanks to the drug, but he thought he needed just a little higher dose. The psychologist asked him if he was sure, because it was a very powerful drug, and the boy solemnly thought it over, and nodded his head. So, the psychologist doubled the dosage, and the boy improved.

After a while at double the usual dosage, they slowly weaned him off Obecalp entirely, and he was fine.

[hedgehog]

5. Until we have a physical test for depression and/or can sort out all

the varieties of depression, I think the classic drug vs. placebo test is going to give faulty results.

Among depressives - it is well known that some people will respond to drug A but not B, some to B not A, some to a combination of A+B, etc. If say you test A and happen to 85 out of 100 people who respond to A, A will be the new miracle drug. If say you randomly select 80 people who respond to B not A, not so much.

[HuckleB]

8. This was discussed extensively a couple years ago, and some important context needs to be added.

These pieces give the Wired/NPR piece some very necessary context:

What is the Placebo Effect, and is it getting stronger?
http://scienceblogs.com/gregladen/2009/09/what_is_the_placebo_effect_and.php

Placebo is not what you think it is
http://scienceblogs.com/whitecoatunderground/2009/09/placebo_is_not_what_you_think.php

Despite centuries of investigation, scientists still have much to learn about the origins and meaning of the placebo effect
http://seedmagazine.com/content/article/overhyped_placebos_of_doom/

[villager]

10. Context always needs to be added, regardless of who is making the claims, yes?

A profit motive would be, for example,a necessary context.

[HuckleB]

11. "A profit motive" could be a part of the context, but that's not what these pieces address.

These pieces address some typical misconceptions that journalists put into print, and corrects the over-hyped headline, among other things. First, one needs to move to a better understanding of placebo before going into other human nature issues. These articles stick with the bit about what a placebo is versus what it isn't. That's really the starting point.

[villager]

12. One assumes you're not arguing for *selective* context, though

Since that wouldn't be very empirical or even scientific.

[HuckleB]

13. Have you read the links?

Either way, what's your point?

[villager]

14. The point is, since you're arguing for context here -- with your blog links -- you must for context

...in any discussion involving medicine, pharmaceuticals, healing, etc.

Rather than just selectively?

[HuckleB]

15. That really explains nothing about the issue of placebos.

Heck, it doesn't explain anything except in a vague way that could be taken in almost any direction.

Can you discuss placebos in the context of the knowledge provided in the pieces to which I linked? If not, why did you post this OP in the first place?

[Speck Tater]

9. Science tries to eliminate the placebo effect. "Magic" tries to harness it.

In a sense, "faith healing" is an attempt to enhance and control the placebo effect. So instead of condescendingly dismissing attempts at faith healing, perhaps science should take a look at trying to discover ways to make the placebo effect work better. Maybe that way we could take this potentially powerful tool out of the hands of crackpots and quacks and put it in the hands of real science. Wouldn't that be of benefit to everyone?

[jberryhill]

16. Logic fail

Someone taking an effective medication receives both the placebo "effect" and that of the medication.

Science does not attempt to "eliminate the placebo effect". The point is to determine whether the relative effect of the investigational drug is greater than that of the act of being given a drug of any kind.

Quite obviously, when someone takes an approved drug, that effect is in no way "eliminated", so your point makes no sense. Taking an approved drug does indeed include the element of faith that it will work.