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."

Comments

WTF

[Xeriar]

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.

Re:WTF

[digaman23]

I'm the author of the Wired article, and I would encourage people to read the article itself before taking Peter's post on Science-Based Medicine as the final word on the subject. Peter's blog runs on two sites, and if you visit the other thread here -- http://scienceblogs.com/whitecoatunderground/2009/09/placebo_is_not_what_you_think.php -- you'll see that Peter's well-informed readers offered up many citations supporting my central thesis that he seemed unaware of, many of which were contained in my article. I know that words like "crappy" and "smackdown" feel really bracing to post or read on a blog, but they're no substitute for science-based medicine. Thanks for the link, ScuttleMonkey.

Re:WTF

[ChameleonDave]

You keep saying that word, I do not think it means what you think it means.

No, the guy who wrote that article is wrong. He is using "placebo" where he should be saying "control". A control is what you use to measure the difference between normality and the thing you are testing. In medicine, this may or may not involve a placebo (which means a "pleaser"). For example, I can give 1000 people my new drug, and put another 1000 people in a control group, with no drug. However, I may worry that some of the improvement in my patients is due to the psychological effect of popping a pill; I therefore may give the control group a fake pill to take, called a placebo. If I have enough funding, I may even have three groups: one with the real drug, one control group with the placebo, and one true control group with absolutely nothing. This will often produce three levels of improvement.

A control cannot be described as strong or weak, but a placebo given as part of a control certainly can be. Although it is something designed to have no real effect, the fact is that every aspect of the treatment situation (the colour of the pills, frequency of treatment, the crispness of the white coats...) alters the strength of the pleasing effect, which can have major consequences for health and well-being.

Re:WTF

[Imrik]

The 'original' (as in, the ones used at the time the placebo effect was becoming known) placebos were sugar pills and so sugar has become associated with placebos as a result. Modern placebos are generally inert in the context of the study.

Or not.

[cloudnin]

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

Re:Shooting themselves in the foot

[ceoyoyo]

It does. Read the article.

Re:Placebos future

[DavidTC]

Here it is.

Also, simply inhaling warm vapors when you have a cold, and drinking warm things, especially stuff that 'sticks' to your throat thanks to the fat in the broth, has known medical benefits. That is, in fact, the entire point of cough drops and vapor-rub.

Oh, and don't underestimate the value of just eating something you're sick. Chicken soup provides proteins and carbohydrates in a form that even someone with the worst throat irritation can eat. While they would not, for example, want to eat a cheeseburger, which would have nearly the same nutritional content.

So at the very least, it is a) something warm to drink that will help clear nasal passages, that b) people can actually eat easily while sick and even coughing, and we know both those things already for a fact. Any additional chemical medical benefit is still hypothetical and being tested.