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Placebos Are Getting More Effective
Wired is reporting that the well-known "placebo effect" seems to be increasing as time goes on. Fewer and fewer medications are actually making it past drug trials since they are unable to show benefits above and beyond a placebo. "It's not only trials of new drugs that are crossing the futility boundary. Some products that have been on the market for decades, like Prozac, are faltering in more recent follow-up tests. In many cases, these are the compounds that, in the late '90s, made Big Pharma more profitable than Big Oil. But if these same drugs were vetted now, the FDA might not approve some of them. Two comprehensive analyses of antidepressant trials have uncovered a dramatic increase in placebo response since the 1980s. One estimated that the so-called effect size (a measure of statistical significance) in placebo groups had nearly doubled over that time."
You keep saying that word, I do not think it means what you think it means.
There are plenty of other reasons for this to be occurring. Better testing procedures among them.
I am a science fantasy fan
I know that it's hard to believe, but it would seem that the human race is actually EVOLVING. Personally, I've always thought that humans were moving towards stupidity, ala Idiocracy, but I can't figure out what else would cause this... People seem to be able to better use their brains to keep their bodies healthy, which would actually be an evolutionary factor. Is it possible?
I don't respond to AC's.
Drug companies should never have started advertising directly to end users.
Many people would believe in whatever advertisement and commercials make them believe.
Particularly, when diagnosing and treating psychological disorders such as depression.
I mean if people can associate an operating system to "coolness", what else can you expect?
I suspect it may be because people expect drugs to be more effective now.
It seems to me that placebos aren't getting better at fixing people, just that statisticians are becoming more efficient at modifying the numbers. Soon they will rule the universe.
Here's an excellent rebuttal to this article by Peter Lipson on the Science Based Medicine blog: Science Based Medicine: Placebo Is Not What You Think It Is
Considering Dubya got elected...TWICE, and how many people believe in death panels, is it really any surprise that people have become more gullible and suggestible?
One of these days I'm going to cut you into little pieces. - PF
This was on the local evening news last week. Slashdot is a week behind the Associated Press? Sorry, but this isn't such new news any more.
If we are easier to be convinced that that junk in fact is medicine and will heal us (and in a so strong way that it will even work), in what other fields are we swallowing "placebos" giving us the feeling that they work?
The biggest problem is that if well our brain could control somewhat our body, i.e. lowering pain, in other fields reality could be strongly against what our brain feels. Unfortunately the only example that comes to my mind right now is the "safest operating system on earth", signal that im accepting all the other placebos.
Oblig. article from The Onion
from your article:
"Just about any explanation that doesn't involve aliens is better than "placebo is getting stronger"."
People from other countries, (other than the native people) might have something to do with it. Aliens are an other race and react different to medications. meds that are effectieve to alien races and and the mysterious race called "women" are more difficult to create.
People are more and more diagnosed with depression. A high placebo effect in treating depression is, in my uneducated opinion, at least partially indicative of over-diagnosis. While in the past only the truly sick were diagnosed as depressed, today perhaps some of the patients aren't really that depressed, and thus can be treated with placebo/happy thoughts. To what degree is depression caused by "wrong" behavioral and mental patterns, and to what degree is it born of a chemical imbalance? Of course, they may cause each other, but I do believe that some depression cases are not that deep-seated. If it's a deep, recurring or continuous depression, then use real drugs that changes brain chemistry and how the brain functions. If it's not that bad, a pep talk and placebo just might push the brain towards solving it's own imbalances.
Oh, and I am/was depressed. Yes, I did use medication, Zoloft to be precise.
Let's look at multiple sclerosis for example. When the initial medications were tested (betaseron, refib, copaxone) the majority of patients entering the trials did not have the option to go onto approved therapies and there only hope of therapy was to enter a trial. Now, as a physician, if I have a patient who is at higher risk of progressing from multiple sclerosis, I can offer than 5 approved therapies before they have to consider entering a trial to get an "experimental therapy" or ending up in the placebo group.
Having not participated in trials for antidepressants, I suspect patients with more severe depression are being placed on approved therapies and more mild depressed patients are being placed into trials. Antidepressants have always been shown to have a more robust response (at least as measured by the non-linear systems used) to severe depression than more mild depression.
You could, this is how they discovered placebos. Some army nurse gave a guy a water shot and he quit complaining right away
Soon, the only drug we will need in Placebo(tm). This is to be expected since it has appeared in more clinical trials for more ailments than any other drug in history.
"His name was James Damore."
Eat sensibly and exercise. Stay off the meds if you can help it.
Maybe he was dehydrated?
"They were pure niggers." – Noam Chomsky
Is anyone testing these drugs being used on the tests??
Let's retest 'drug whose patent has expired' to see if it still works the same, so maybe when they find out it doesn't, hey, what about this new one?!
how long until
Perhaps participants in antidepressant trials are just happier to be part of something constructive. Perhaps the more isolated and fragmented a society we become, the more positive the reaction subjects have to being among others and given so much attention?
That the past studies were fudged beyond belief in order to create hundreds of new "treatments" for a host of newly created "maladies". The psychiatric field in particular seems to be rather fond of calling something a disease based on..whatever crap they dream up. Like kids, especially little boys, actually acting like little boys. Now they are "diseased" with adhd and add and need to be forced drugged. People undergoing normal stress are "diseased", like our ancestors way back had it easy having to drag home the mastodon steaks and protect themselves from sabre toothed tigers with flint tipped sticks. No, that wasn't "stressful" at all, nope...
(lawn, git off, etc)
A lot of people -- like the author of Talking Back to Prozac -- claim that some drug trials (especially for popular antidepressants) are compromised to the point that getting drugs like Prozac approved required requires a surprising amount of massaging of the data from drug trials just to get to the point where the drug seems to perform better than placebo. This New Scientist article from last year about how antidepressants' effects may have been exaggerated, has a good definition of a particular form of publication bias that is apparently common:
If that's true, then it's a gambit that would get less and less effective over time. Certainly, drug companies have a very large commercial interest in boosting the apparent effectiveness of their drugs by "enhancing" the results of their trials through selectively ignoring results they don't like. It does sound somewhat conspiracy theory-ish, but it seems like there's increasing evidence. Plus, if it's true that antidepressants are less effective than many doctors believed in the past, that's more evidence that the trials drew incorrect conclusions.
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I seriously doubt his leg healed and bone knit because of that water shot. If he was stupid enough to buy it, it might have taken away some of his pain, but that's it.
Might not matter, depending on where she gave him the "water shot."
Time to buy stocks in whatever companies are selling placebos, or patenting them. Hmmm, now that I think about it most health food stores have a whole section devoted to placebos, though they oddly labeled as homeo something-or-other. These guys knew all along that you didn't need anything beyond water and/or sugar to be effective!
Haven't heard about that last one but I'm pretty sure my neighbor's kid has ADD/OCD/MOUSE
A bullet may have your name on it but splash damage is addressed "To whom it may concern."
If I really believe in the efficacy of the placebo effect, can I benefit from it while knowing the truth?
ever see a wheelchair with a 800cc engine? i bet you never saw something with two wheels w/o training wheels
http://overtoke.viscidity.com/morons/wheelchair.jpg
For me is that the original tests were "helped" to better numbers, as they meant billions of dollars in profits. Now the interest is not so big and so the numbers are closer to reality.
Rome taught me patience and assiduous application to detail. Virtues which temper the boldness of great, general views.
Have they stopped to think that today, they have much better placebo manufacturing processes than they did 20 years ago? Clearly, they are able to manufacture placebos today with much greater purity than they were 20 years ago. This, of course, results in better placebo absorbtion, greater availability to your body, and overall faster and better effectiveness.
I suspect, with time, our placebo manufacturing processes will continue to improve and the placebos will be more and more effective. It wouldn't surprise me at all if at some point we can buy a single bottle of placebo pills to cure such things as cancer, diabetes, alzheimers (providing people remember to take their placebo pills), arthritis, etc. Placebos will in effect be like physics' "grand unified field theory" but applied to medicine -- a single cure for everything.
Placebo also has the most side effects of any drug on record.
"I have a headache."
"Here, have this. It's a placebo"
Why would this be surprizing? The scientific method and the belief that your beliefs need to be examined and their truth verified are recent inventions. For most of human history the vast majority always believed what they were told. As rationality is dying out, due to schooling and various other factors, so is skepticism and science. As time goes on, we can all expect people to increase blind faith and achieve whatever natural healing their bodies can provide.
read 'Bad Science' by Ben Goldacre
turns out that the placebo effect is hugely influenced by beliefs. So - if people are in a trial to treat mental illness, then the placebo will be more effective now than it was 20 years ago simply because people on average believe that mental illnesses are treatable.
In a similar vein, Cimetidine (one of the first ulcer drugs) has become much less effective over time. It suffered a dramatic drop in success rate when the new ulcer drug Ranitidine came on to the market. It seems that as doctors stopped thinking of it as the best drug, it became less effective.
No big surprise that placebos are working better in some contexts. It doesn't show that the placebo effect is generally getting stronger though.
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No, that's how some American physician got the idea that the placebo effect was something you had to control for in a drug study. I realize the article makes it sound like the concept of placebos originated in WWII but it's simply not true.
Surgeons in Napoleonic times were well aware that their patients responded better if their medication tasted as badly as possible (and preferably produced other effects, like severe diarrhoea). Ships carried various substances specifically to make the surgeon's preparations taste bad.
The concept of the sugar pill is even older than that.
I know anecdotes != proof, but I think this is worth mentioning anyway.
I consciously ignore almost all health-related things I hear on the news, having lost faith in their accuracy a long time ago. (Drug commercials, diet-of-the-week, etc. are getting old.) I haven't been to the doctor in years. Now, there could be a million things wrong with me, but I feel great. And I'm pretty sure that until I am told what's wrong with me, I'll continue to feel great.
What's my point here? I reckon that the pharmaceutical industry has long ceased to do the average person any good*. If you pay attention, you realise how pathetic many of the drugs they push are (for example, one of the side effects of depression meds is thoughts of suicide. What?). I'd rather take my chances with God than with half of the drugs I see advertised - AFAIK God hasn't been known to cause nausea, heart attack, or death as a side effect. The point being, 'laughter is the best medicine' seems to be holding true, at least in my case.
* I realise that some medicines do work, and have saved lives. But the industry has extended far beyond that in search of profit. What business do they have advertising prescription drugs in the first place? It should be up to the doctor to decide what to give, not the patient.
Funny may not give karma, but +5 Informative never made anyone snort coffee out their nose.
Note that the only actual evidence for a more robust placebo effect referred to in the article is two studies looking at antidepressants. There are also a couple of anecdotes (from companies looking for a scapegoat for their failure) about Parkinson's and Crohn's, but that's hardly evidence.
It would be interesting if there was data for conditions that can be assessed objectively.
The article needed to be about two paragraphs and could certainly have stood to lose all the gushing about how powerful and neglected the placebo effect is. On the bright side, I see Wired is hiring people with no photography or design experience to generate their figures.
There does seem to be some evidence to support the idea that human immune response is impacted in a significant way by attitude. If you make the patient happy and give them the expectation they are going to get well then instances of opportunistic infection seem to decrease somewhat and secondary aliments that would be expected to heal on their own seem to do so faster.
Repeal the 17th Amendment TODAY! Also Please Read http://www.gnu.org/philosophy/right-to-read.html
Are more people than ever getting over diagnosed, or is the power of thought becoming more powerful?
...
I have suffered from chronic back pain for 25+ years. I was recently given a 'sample' drug by my doctor to determine if it was helpful.
The first dose was about 75% effective. It eliminated some of the pain but not all. The subsequent dosages (which included increasing the # of pills) had ZERO effect on pain levels. I do not doubt that placebo effect accounted for the initial pain relief, but I am usually very logical and calm about drug actions on my psyche.
"The price good men pay for indifference to public affairs is to be ruled by evil men." ~Plato (427-347 BC)
Hmmm...maybe we already have so many of these pharmaceuticals in our water supply through excretion that the test doses aren't good enough any more...like all the supposed estrogen in the water supply through women taking the Pill?
For the last 20yrs or so about half of the USA has been crying out for tax payer funded health care - essentially the magic pill for all their ills. This demographic is so eager for a quick solution, they seek salvation through pharmaceuticals. They will believe anything that comes in a pill bottle. Its practically a cult-religion! Its Hope. Its Change. Delivered by any effort other than their own.
But if you are measuring a drug's effect to cure something like say Restless Leg Syndrome, then surprise surprise the placebos work WONDERS.
When you have idiots defining healthy active children as suffering from attention deficit disorder, surprise surprise, a sugar pill (yeah, irony) works to cure them.
This particular case, the disease was depression. Depression is a real disease, but it is exactly the kind of thing I would expect a placebo to work really well on.
excitingthingstodo.blogspot.com
IF making the patient happy works, then give them blowjobs or something. The point is, only stupid people are made 'happy' by a sugar pill. Smart people realize they are being tricked.
Placebos work better if they are shoved up your ass.
Placebos are no more effective than they ever have been, but now:
1) More meds are available now than in the past (say, 60 years ago), i.e., there's probably some type of medication for any kind of problem, even if it doesn't cure the disease. So, people expect to get pills to make them better, and this belief is enough to start your body recovering (not unlike prayer, etc). Also note, I'm saying receiving real medication also has a placebo effect associated with it.
2) Direct correlation with #1: because there are more meds available, there are fewer radically new medications to be found via research. Big paradigm-shifting treatments have been found (e.g., antibiotics) and now the majority of new research is going to be to find incrementally small improvements. I'm not saying major breakthroughs are impossible because they do happen (cancer of X, HIV/AIDS); I'm saying that generally the most effective treatment for some disease has already been found, and now there are just a few minor tweaks left with its current medication to get that last few percent of successful recoveries -- until something entirely different is discovered.
-- Tolos
This is all very well but it comes from research involving Big Pharma products - bought and paid for!!! To test these new placebos we need some kind of control. Like, some kind of substance that has no effect on the patients so that we can use it to gauge the placebos agains......
Arse.
"'I pass the test,' she said. 'I will diminish, and go into the West, and remain Galadriel.'"
- JRR Tolkien.
If anything the diagnostic criteria for some illness have been loosened, if not in print then in practice (depression, ADD, Bipolar, various allergies). Some "ailments" weren't really considered that big of a deal 20-30 years ago, or were at least considered rare (Restless Leg Syndrome, Premenstrual dysphoric disorder, fibromyalgia). Perhaps, and I say this more to be devil's advocate, we are treating people with symptoms, or not, of diseases that they don't have, or don't really exists in the manner we think they exist. At least in terms of treatment. As such, the treatment is wrong (either by lack of disease or bad targeting), and of course would be expected to be no better than placebo.
Argh. The laws of science be a harsh mistress.
In fact, there is no evidence that the placebo response has any relationship to intelligence, or that stupid people are any more suggestible than smart people.
You can't set a broken leg with a placebo, but you might be able to make it hurt a little less.
Remember "kiss it and make it better?" Or the miraculous analgesic effect of a Band-Aid (especially one with pictures of cartoon characters)?
Some evidence suggests that part of the placebo response to pain is related to release of opiate like substances in the brain.
Sure. Or it could be that the control group getting the sugar pill, is also getting prozac (or whatever) some other way, like, in their water supply.
If you mod me down, I shall become more powerful than you could possibly imagine.
In fact, there is no evidence that ... stupid people are any more suggestible than smart people.
Of course they are.
Here's an simple example: If you give a stupid person a placebo, they 'think' it works, so it works. Give a placebo to a smart person, and they (because they are smart and want to expend their knowledge) look up the active ingredient, see that it's worthless, and aren't fooled.
Wrong, those are dildos
Here, you make two unfounded assumptions. First, you assume that you can look up all ingredients and determine for certain whether they work. In real life, however, very few substances have been adequately tested for clinical efficacy. Even for those that have been tested, the literature is often somewhat ambiguous (has it been tested for people just like you, with your specific medical condition?) In the studies described in the Wired article, the compounds being tested are new drugs that might or might not work. Moreover, your assumption that a smart person would look up the ingredient seems questionable. Assuming that you yourself are a smart person, it follows that you would have looked up the ingredients of all of the medications you are taking. Yet you seem surprisingly unaware of the limitations of the medical literature when it comes to obtaining a definitive answer to this kind of question.
You are also assuming that the placebo effect works at the level of conscious knowledge. But not all physiological reactions depend upon conscious knowledge. For example, if you are used to hearing a dinner bell just before the meal is served, you will salivate when you hear the bell--even if you happen to know for a fact that dinner is not being served tonight.
Acording to Legend. Vulcans early on, discovered the so called Placeboo effect and decided to investigate it's effectiveness. Turns out that the mind really does affect the body in many disparate ways and yet here on earth, people are only now beginning to realize that the mind affects the body and that the body affects the mind.
Mod me up/Mod me down: I wont frown as I've no crown
Time was you went to the drug store with your Rx in hand, you knew you'd be getting quality product. BigPharma was big for good reason. They created magic bullets like Foolemol, Aniaffect and Imaginomycin that did precisely what was advertised -- exactly what you wanted it to do.
Now days if you try to get one of these, you're more likely than not going to receive some generic placebic acid formulation made in a factory by some company where they can't even spell "BM p.o., cf p.r." or "agit vag, admov adlib, w/o disc w/o disc w/o disc" properly. (http://en.wikipedia.org/wiki/List_of_abbreviations_used_in_medical_prescriptions)
This is a serious problem! If you can't get decent placebos, what are you going to use to treat factitious disorders?
"I may be synthetic, but I'm not stupid." -- Bishop 341-B
The pharmaceutical industry is reeling from the news that more and more new drugs do no better than a placebo. Despite historic levels of industry investment in research and development, the FDA approved only 19 new drugs in 2007 and 24 in 2008.
The placebo effect has been little-understood. Trials in different countries and cultures can show different results. Ratings by trial observers can vary significantly from one test site to another. Advertising has conditioned people into thinking a little branded pill will make them all better.
"This throws R&D spending into significant doubt," said Cylon Number Six of GlaxoSmithPfizerMonsanto. "It's clear that marketing has always been the way to go, and that spending four times as much on marketing as research was the best thing we could possibly have done for humanity."
Researchers are now going full steam to discover new forms of nothingness to apply to new diseases. Explorers have been sent into the Amazonian rainforest to find new plant species to dilute to the point of no molecules of the original being present. Traditionally ineffective tribal remedies from around the world have been patented in Western countries. "If '4'33'' can be copyrighted, we can patent the placebo gene!" The treatments will be publicised in the new Elsevier journal, The Australasian Journal of Nothing Whatsoever. Homeopaths are up in arms at the pharmaceutical industry "muscling in on our territory," said Ravenwoo Granola of the Specialist Homeopathic Institute of Technology. "We developed the finest, most refined and provably harmless snake oil in existence! There's nothing homeopathy can't cure! Er, there's nothing that isn't brought to us for consideration and helping the patient trigger the placebo effect themselves. A snip at £5.99 a bottle and fifty quid a consultation! And we absolutely proved it harmless! We did double-blind tests against placebo ... Bugger."
http://rocknerd.co.uk
It's a testament that the drugs being tested are of marginal value. This is a phenomenon that's being going on for awhile. Lots of cancer drugs fall into this category.
Or we have become more weak-minded and susceptible to Jedi mind-tricks...
or both...perhaps they're the same?
weak-minded, to me, means believing that Human Authorities always have your best interest in mind. A Human Authority is any 'expert'...politician or researcher.
Aliens are an other race and react different to medications. meds that are effectieve to alien races and and the mysterious race called "women" are more difficult to create.
You keep using that word. I don't think it means what you think it means.
weinersmith
Now, you need to learn some history, and from people who were there, such as me, and there are plenty of other boomers here who can tell you similar.. All this one quarter or one third of young males were not "diseased" back then like they are termed now back when I was a kid. It didn't exist, this was known as normal childhood stuff and they get over it given a chance. This is a *new* thing they thought up for profit, it is just reclassified as a disease where they force addict them to *speed* for a *cure* and the poor little dude's brains get permanently warped from the drugging during their critical development stage, and they grow up thinking they are sick when all they are is just being normal little boys. Same as a lot of adults now are finally faked out into taking prozac and similar because of "stress". Geez loweez, how did humans we ever make it to the late twentieth century without this crap.
Now I'll be the first to admit that *some* people really need the chemical help, I will not dispute that at all, but such a HUGE proportion of the children, and now the adults? No freekin way, not even close, it's a scam, and the more they inflict it on people the more "normal" it gets to think of your child as "diseased" because some expert claims they are, said expert profiting handsomely from the diagnosis, then some big pharmco for "the cure", same as they will tell YOU that.
We managed hundreds of millions of kids to get through school, starting with our first schools way back when the nation was first established, going all the way until the very late twentieth century, without the state and state approved for profit medical industrial establishment forcing them to become addicted to drugs..how did we do that then? The answer is obvious, this is a newly created mostly scam "disease".
BTW, please, you just never know, run to see your doctor right now, throw gobs of cash on the counter, and in a trembling shaky desperate and hysterical voice beg them to RIGHT NOW see if the purple pill with chartreuse polka dots is *right for you*! Hurry up, you might have it! Whatever *it* is! Look out, it's spreading, why half your neighbors might have *it* already! And rest assured, these esteemed professionals would never abuse a position of trust and "scientific studies" for mere money in the tens of billions, that's just a *coincidence*.
If there's HUGE money and power involved, corruption occurs, it just happens. No one class of employment or guild or profession is "immune" to that corruption either, we are all human. A lot of modern medical stuff is just great, a lot of it is a scam and just designed to separate you from your cash. Same as any other stockholder driven, for-profit, nothing matters but seeing bigger numbers on your quarterly reports industry. Just is, is all. Get your swine flu shot, the one where they got a special law passed so they aren't responsible and you can't sue them for anything bad happening down the road. Ya, that shot. More billion$.
Sorry, I am just jaded, after decades of seeing corrupt industry and government and them working hand in glove...you get jaded. And it has only gotten worse over the years, not better, despite every election cycle liar A or liar B says vote for them and things will get better. Bah, and humbug
You are also assuming that the placebo effect works at the level of conscious knowledge. But not all physiological reactions depend upon conscious knowledge.
Are you suggesting that pain relief after popping a pill is the same as drooling after hearing a bell?
Anyone can be 'tricked' into reacting a certain way. But smart people are 1) aware that it may be a trick and 2) can do research to see if it is a trick, and 3) have an open mind to experimental results. This means fewer smart people are tricked than dumb people.
It's like a Nigerian 419 scam. It ain't the smart people who are getting tricked- it's the dumb ones. The smart people realize the email from "Mr. Mombasa" sounds... wrong. The smart people Google for a few key phrases and see that the email is a scam. Smart people, despite their wish to become rich, accept the evidence they find, and don't fall for it.
Dumb people don't realize "Hey, I don't own a business, why does this email refer to me as a business owner?" or "How'd some dude in Nigeria find out about me?". Dumb people don't bother fact-checking. Dumb people, even if they are told it's a scam, don't listen because their stupidity and greed blinds them.
Basically, dumb people have blind faith, smart people are open minded, but skeptical. Guess which group placebos work better on?
In the sense that they both may be conditioned responses that do not depend upon conscious knowledge, yes. Indeed, that is one of the current hypotheses regarding the biological mechanism that is responsible for the placebo effect.
Operant conditioning operates below the level of conscious awareness. People, even intelligent people, can be conditioned to do things without being aware that they are being conditioned. Indeed, if challenged as to why they are behaving in a certain way, they will confabulate a rationalization. A classic practical joke on the part of students in science classes is to condition the professor. It is very simply done. All that is necessary is to for all of the students to conspire to reinforce the behavior by giving the appearance of being more interested when the professor does a certain thing, and less interested when he does not. I knew one case in which the professor was conditioned to deliver his lectures from outside the door of his classroom. In another instance, the professor was reinforced when he used a certain word. The class tracked his usage of that word, and after it increased to a high level, they then extinguished the behavior by wittholding reinforcement. At the end of the term, they presented the data as a class project. The professor was not amused...
Intelligent people, such a doctors, are often the prey of con artists. One reason why they are particularly vulnerable is that they often have an exaggerated idea of how well their intelligence will allow them to see through scams. Notice how many otherwise intelligent people invested in Madoff's scheme.
So what happens when the person learns that everyone they've trusted has been lying to them the entire time ?
Is the psychological damage that is likely to cause any better than any possible side-effects of non-placebo medications ?
Wanna fight ? Bend over, stick your head up your ass, and fight for air.
Could it be that as increasing numbers of people have become convinced of the efficacy of popping pills to cure/control all manner of illnesses, that the placebo effect inevitably increased along with that familiarity? Isn't the placebo effect truly nothing more than a very specific form of self-delusion and self-fulfilling prophecy? It hardly seems shocking that, as anecdotal stories of successful pill-popping mount, people would become increasingly delusional about what they expect when they pop one, such that even when a pill is a phony it still appears to have an effect because their own body is doing the work to fulfill the prophecy.
They might want to identify highly skeptical people and test both medications and the placebo effect on them, and then compare that to the average; what they might find is that neither pills nor the placebo effect work nearly so well on skeptics as on the general population. This seems to be true for me, in any case; drugs that were expected to work had no effect, quite possibly because I wasn't nearly so convinced of it as the doctors prescribing them, nor am I inclined to blindly accept what doctors tell me.
Maybe we should stop calling it 'the placebo effect' and call it something more descriptive, if indeed it is a type of self-delusion.
check out the book "pills a go go" by jim hogshire. one of the most popular placebos is merely putting a drug into pill form. much more effective that way ;) peoples likes pills!
Stupidity is its own reward.
An Alien is a person from a foreign country. What do you think it means?
As always, The Onion predicted this. Unfortunately, the screamingly funny "FDA Approves First Prescription Placebo" is not available online.
http://www.imdb.com/title/tt0078748/
any questions? yeah, i thought so...
weinersmith
I used to work in sponsored research into new drug entities. There are a couple other reasons that placebo may be becoming more effective, which is a clever way of saying new drugs are less effective.
First, developing a new drug is a very high-risk undertaking. Even if you don't buy the oft-cited US$800million figure for developing a new drug, it's still a tough sell to the MBA's who manage R&D and production operations. None of these managers wants to lose their jobs for missing quarterly numbers, so even though it often takes several years to recognize return on R&D investment, there is little incentive to strike out into something completely new. A number of new drugs I have seen are merely tweaks of existing compounds (e.g. Lexapro) that promise only marginal improvement over the existing compound (Celexa), but extend patent protection over the brand name. Truly novel compounds are being developed, but lately these are very specialized compounds in "hot" fields like cancer.
Speaking of cancer drug development, another reason that placebo effect may seem stronger is that the patients who might benefit the most may be excluded from trials for liability reasons. The Vioxx lawsuit has spooked everyone in the field. When a new compound shows even the possibility of cardiac side effects, it won't even be offered to patients with cardiac complications. It's becoming safer to let them die naturally of leukemia than offer them a novel treament that might risk scuttling a study and possibly an entire project because of a small possiblity of side effects that could expose the sponsoring company to a lawsuit.
Could you follow up that article with another one that provides analysis on the impact these tests will have on the patents for these drugs? I understand that the patents for drugs may have been issued for the manufacturing process used to make them. But I would think that they are issued for the claimed function(s) of the drug. If the patent claims are for cures of diseases (or relief), then perhaps such patents are ripe for re-examination once it is discovered that placebos work better.
Thanks for the article. It was very informative.
The diversity and expression of human opinion is essential to human survival.
The specific test of a double-blind drug trial is to measure the effectiveness of the drug under study. The point of using a placebo for control is that it mirrors the drug--same size and color for the pill, same presentation and language from the doctor, etc. In fact the doctor does not themselves know whether they are administering the drug or placebo. This controls for all those extraneous factors that might affect "normality". Since all the details are the same, any "pleasing effect" (no matter how strong) will confer upon the drug as much as on the placebo, creating a common baseline.
The only controlled--and thus meaningful--result of a drug test is how the drug performs vs. the placebo. If the drug-takers do not show significant improvement compared to the placebo-takers, all that tells you is that the active ingredient in the drug does not have much effect--thus answering the trial.
If both the drug-takers and placebo-takers show significant improvements, that is an interesting result but it is of questionable scientific value if it is not properly controlled itself. To study WHY they all improved would take another, different test. The Wired article gets into the aspects of really testing the placebo effect scientifically.
Basically because the controls are so different, you can run a good study of the effectiveness of a drug, or a good study of the strength of the placebo effect, but not both at the same time. You can't use a placebo as both the independent and dependent variable simultaneously and expect to get a good result. It's got to be one or the other.
Build a man a fire, he's warm for one night. Set him on fire, and he's warm for the rest of his life.
Because I don't take Viagra. I just take something blue, and it works every time.
I see a fundamental issue with the central storyline, which is that drug companies are seeing a stronger placebo response in drug trials. But drug trials are not designed to measure the placebo response; they are designed to measure the drug against the placebo. It would be like comparing 100 different scales for accuracy, and then going back into the data set to try to discover any differences in the standard weights that were used. A placebo can either be a control or an effect; you can't run one experiment and then treat it both ways. Based on your article it sounds like this is what the drug companies are trying to do though.
Build a man a fire, he's warm for one night. Set him on fire, and he's warm for the rest of his life.
Bunch of Hypocondriacs!
Intelligent people, such a doctors, are often the prey of con artists.
That's because there are different kinds of intelligence. "Street smarts" vs "book smarts", basically.
Since anyone who can read can find out what's written in books, 'street smarts' are better.
Placebos are inert. Many factors would produce such results but not the placebos becoming "better" at what they do. Then again, Wired recently reported that they had found landing tracks of "flying dinosaurs", when they meant pterosaurs. Wired should stay out of reporting science news. They suck at it big time.
When testing the application of a particular drug a placebo should nt be used unless there is no alternative.
The new drug should be tested against an already existing drug in the same application so as to
1. Remove or reduce the variability that exists in the placebo effect.
2. Prove that the new drug is more effective than older medicines.
Current FDA regulations only require that a new drug be effective, not more effective than older medications. Perhaps new drugs are not getting that much better which is leading to an increased (flase) perception of the placebo effect.
Holy shit - have you seen the discussion that follows the blog you've cited? If the discussions in /. were even half that articulate and intelligent, modding would be redundant.
Meta will eat itself
Now you better understand how it sometimes feel to be french...
In my language there's even a specific saying on this topic: "le ridicule tue" ('being ridiculous kills you'), which is regularly reminded on issues like this...
[mandatory related /. sig should be: 'in soviet russia you kill ridiculousness' ]
Herve S.
I've heard of catalogs from back in the 50's that let doctors order placebos in small pills, large pills, solid, gel, capsule, liquid, of all colors.
You want a 500 mg clear capsule filled with granules of red, white, and blue? You could buy it.
I also heard there was a code that would allow the doctor to tell the pharmacy what kind of placebo to use in a prescription, including how much to charge.
Done right, the placebo effect is sufficient for effective treatment in some cases. That it's essentially utilizing psychology doesn't necessarily detract, though I'm hesitant to approve of the necessary deceiving of the patient in order to do it.
I don't read AC A human right
You stole my idea before I had it.
But it was the first thing I thought when I read the article header...
Either that or the big pharma companies have been lying to us and faking results after all these years.
But what po$$ible reason would they have to do that?
As usual, many of the commenters assume the placebo effect is some sort of false healing. It isn't. It is real healing (which is probably the basis of Christian Science, meditiation and many of the so-called 'quack' cures).
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In the Wired article, one group of irritable bowel syndrome patients were parsed into 3 categories. Group one had their names silently put on a list for treatment. Group two was given information about their problem but with the emphasis on how to alleviate the 'suffering' they could expect in the future. Group three was told they were too late for the study and too late for any drugs but the interviewer spent an hour listening to the patient and talking hopefully about how they will get better.
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The patients in group 3 got better--actually physically better--which is the definition of the effect of placebos.
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Drug companies have supposedly brain-washed us that drugs will improve our lives; but advertising isn't that effective. We all want something that will make our lives better, especially when we are in pain. We are considered gullible when it doesn't work and insightful when it does work, but for some reason we distrust things that work when they shouldn't.
This attitude is why bipolar disorder is the #1 killer of teenagers.
There's nothing holistic or attitude-related about chemical imbalances in your brain. That's like trying to "attitude" your way into being "not drunk" with a blood-alcohol level of 0.29
Sometimes, a psychologist will tell the patient "try this one, it's done amazing work" and it will end up making the problem worse -- the patient ends up killing themself when they were expecting positive results. Telling them to just smile their way through things leaves millions of teenagers dead, and millions more becoming emo or otherwise burning up what plans they had for their future.
I am the richest astronaut ever to win the superbowl.
I never said those symptoms didn't exist back then, of course they did, most young kids and especially boys for some reason had them, me included. Just that they weren't considered ADD or a malady. I never took speed then though, so can't comment if it would have calmed me down or not, but I can tell you for several years as a young guy I only really slept much *every other night* I had so much spare energy. That is 100% the honest truth, did that for years, all the way until my late 20's I'd sit up and read. I was resting, but not sleeping.
The "remedy" back then for hyperactivity and lack of focus in class, etc., was to encourage a lot more sports and vigorous outdoor activity, plus healthier food, more raw fruits and veggies, etc. Ya, we had junk food back then as well.
Which would probably do wonders today, seeing as how the practice of eating almost exclusively junk food and pre packaged heavily laced with assorted non food chemicals the modern diet has become. I call that food junk food as well, and the bulk of the population, kids included, only eat junk food. I would imagine there are kids out there now who primarily eat just the junkiest of food, which are mostly saturated fats, corn syrup, food additives and dyes, preservatives, etc etc with very little actual food nutrition to it. It looks like food, they sell it as "food", but it's BS profits at any cost chemicals with some food sprinkles in it, sold in over advertised and overpackaged "packages" full of "fun colors"..
We as humans are designed to eat mostly raw and/or very simple basic foods. You get a host of problems healthwise when you don't. And it really is that simple in a lot of cases. You see it in adults, you see it in kids, the rise of gross obesity, ADD stuff, diabetes, hardening of the arteries in teens, etc. Heck, I had a lady boss once in a wheelchair, with the shakes, I forget which, she had MS or MD..anyway, she was simply a soda addict, diet soda, you never saw her without a huge glass of diet crap she was sucking on. I told her, "worth a shot, lay off that diet pop, or any pop, switch to water and fruit juice, do it for one month, see what happens". She DID do that, and actually was starting to get better when I moved and lost track. she could get out of the chair easier and she said she felt loads better. Simple diet change, get the crap out, give you bod a chance to be normal.
Kids today also take a lot more "shots" then we used to take, perhaps that is a contributory reason for this surge as well.
But I still think a lot of it is misdiagnosed and a part of that is the forced politically correct extreme feminization of young males, they are told they are "sick" when they act like young boys. I didn't bring that up at first, but bet I am right on that, given the PC makeup of most modern public school systems.
Here's another example of this run amok correctness and medical mental health *pure* propaganda misdiagnosis. I am a heavy 2nd amendment supporter, as such I keep up with the news and so on there. Back then, you could bring your .22 or shotgun to school with you to go shooting with friends after school, etc, just put it in your locker. It was NO big deal, absolutely not (and no school massacres either) we did it all the time. Now, a kid *drawing a picture of an army dood, maybe his dad or uncle, with a rifle*..it becomes "zero tolerance" panic time, he is classed as a potential little terrorist or something, sent home immediately, picture confiscated for evidence, all sorts of emergency panic time crap are thrown at him, he gets "detained" by the paramilitary thug patrolling the halls, all negative stuff he now gewts to absorb. It is drummed into his head "guns R bad, you must be sick". And all these big news school massacres? Check the facts, pretty much all committed by kids forced drugged, on "legal" prescribed psychoactive drugs. Coincidence? That's the only thing different from now and then..
Prescription drugs are a bunch of crap!
Indeed. One of the things "street smarts" teaches you is, in the words of Richard Feynman,
What some of us fail to notice is that, for some of the head drugs, we have no idea how they work! A few nights ago I read a press release for some new ADD pill that said that no one knew how it works, but they "proved" that it made ADD better.
It's as if we're just trying random chemicals until something works. Yikes.
No, I will not work for your startup