Slashdot Mirror

← Back to Stories (view on slashdot.org)

Placebos Are Getting More Effective

Posted by ryuzaki0 on from the time-to-start-treating-with-placebos dept.

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."

31 of 349 comments (clear)

  1. WTF by Xeriar · · Score: 4, Informative

    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
    1. Re:WTF by bistromath007 · · Score: 4, Interesting

      That guy seems to be ignoring the fact that the placebo effect, being partly psychosomatic, is something that by nature will cloud the results of testing psychiatric drugs as people become more trusting of their effectiveness in general.

    2. Re:WTF by Anonymous Coward · · Score: 5, Insightful

      Or possible the patent is no longer in effect, so no one bothered to fudge any data this time? Perhaps they were too busy "gathering" data for new drugs?

    3. Re:WTF by abigsmurf · · Score: 4, Insightful

      The article seems to be fully of quibbles about simplifications or unscientific use of language rather than the overall point (which it finally gets to in the final paragraph).

      It's not unthinkable that placebos could be having a more pronounced results than they have in the past. In the Prozac example, psychiatry related drugs are especially prone to placebo effects. Given that the average citizen knows a lot more about these drugs than they did 10+ years ago due to ads and the media, they're more likely to believe it'll work for them than people used to.

      Changes attitudes towards drugs having an effect on placebos isn't something that should be dismissed offhand like that writer seems to be doing.

    4. Re:WTF by je+ne+sais+quoi · · Score: 5, Insightful
      The GP's article suggested another reason:

      He goes on to talk about how placebo has become a crisis of the industry, but I have another explanation: it's not "placebo" that's the problem. If drugs in testing cannot outperform placebo, then the researches have done a good job of testing the drugs honestly. If the researchers are failing to develop drugs that beat placebo and the company's bottom line is suffering, it's not the fault of the sugar pill. Sometimes it's either difficult or impossible to develop an effective medication. Failure is inevitable. It's how science works. If the CEOs don't like it, they have to either make up the data, or find a new business model.

      It's not anything to do with the placebo, it's that the drugs that are being developed currently don't do anything.

      --
      Gentlemen! You can't fight in here, this is the war room!
    5. Re:WTF by commodore64_love · · Score: 5, Interesting

      That sill doesn't explain why placebos are now nearly twice as effective as ~1990, but this paragraph from the article might be a factor:

      Potential trial volunteers in the US have been deluged with ads for prescription medications since 1997, when the FDA amended its policy on direct-to-consumer advertising. The secret of running an effective campaign, Saatchi & Saatchi's Jim Joseph told a trade journal last year, is associating a particular brand-name medication with other aspects of life that promote peace of mind: "Is it time with your children? Is it a good book curled up on the couch? Is it your favorite television show? Is it a little purple pill that helps you get rid of acid reflux?" By evoking such uplifting associations, researchers say, the ads set up the kind of expectations that induce a formidable placebo response.

      The frequent ads from the companies are effectively brain-washing Americans to think, "All you need is a little purple pill to feel good," and so the mere act of swallowing that pill, even if it's just sugar, becomes twice as effective as previously.

      --
      "I disapprove of what you say, but I will defend to the death your right to say it." - historian Evelyn Beatrice Hall
    6. Re:WTF by Firethorn · · Score: 4, Interesting

      It's not anything to do with the placebo, it's that the drugs that are being developed currently don't do anything.

      Did you read about how some of the older drugs wouldn't have made it past the trials today?

      I think this might have to do with the FDA's mailed fist choking off anything to do with 'snake oil' for years - we've raised generations that expect medications to be safe and effective, and therefore they are, by golly(placebo effect).

      --
      I don't read AC A human right
    7. Re:WTF by bondsbw · · Score: 4, Interesting

      The placebo affect can also be caused by pride. "I paid $300 for these pills, they work so much better than the generics!" It's the same reason that I can buy an expensive computer/phone/car with the same features as your off-brand, but still act like it's much better.

      But I'm sure that has little to do with testing where you don't have to pay... just saying, in general.

      --
      All my liberal friends think I'm a conservative, all my conservative friends think I'm a liberal.
    8. Re:WTF by digaman23 · · Score: 5, Informative

      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.

    9. Re:WTF by dgatwood · · Score: 5, Interesting

      Actually, when it comes to psychiatric drugs, they often do. In many cases, it's all in your head, so to speak. If you can convince yourself that a medication is working for such things, you will get better, and if you convince yourself that it isn't working, you will stay the same or get worse, whether you're taking a drug that tries to fix the underlying chemical imbalance or not. Why? Because ultimately your brain is controlling the regulation of those neurotransmitters. It can compensate for any "fix" the drugs make, and can similarly correct its own regulation if you convince it that the levels should be improving. Indeed, in the field of psychiatric drugs, it would actually be surprising if such a strong placebo effect did not occur, assuming that people generally believe that psychiatric drugs are effective.

      Unfortunately, too many doctors, including psychiatrists, are too eager to prescribe a pill rather than taking the time to get to the root of the problem and fix what's really wrong. The good news is that prescribing a placebo may be just as effective for many of their less serious patients, but without the harmful side effects.... :-)

      --

      Check out my sci-fi/humor trilogy at PatriotsBooks.

    10. Re:WTF by dintlu · · Score: 5, Insightful

      Alternately, the deluge of ads could be brain-washing Americans to think, "Without a little purple pill you'll feel bad," such that the illness itself is a nocebo effect, which placebos effectively nullify.

    11. Re:WTF by gadget+junkie · · Score: 4, Interesting

      It's not anything to do with the placebo, it's that the drugs that are being developed currently don't do anything.

      Did you read about how some of the older drugs wouldn't have made it past the trials today?

      I think this might have to do with the FDA's mailed fist choking off anything to do with 'snake oil' for years - we've raised generations that expect medications to be safe and effective, and therefore they are, by golly(placebo effect).

      I love it. Gullibility by design (TM), the new prescription. The disturbing part of the equation is that price is part of the effect, so I'd expect that a 50$ pill could have a bigger placebo effect than a 5$ pill of identical composition, provided that the patients know it.

      --
      "If a boss demands loyalty, give him integrity. But if he demands integrity, give him loyalty." (John Boyd, 1927-1997)
    12. Re:WTF by Darkness404 · · Score: 4, Interesting

      Exactly. The human brain doesn't want to be ripped off. The same reason why people swear that baseball hotdogs taste so much better, when they are more or less just the same things that you can buy at every grocery store the only difference is that you aren't paying $3+ per hotdog.

      --
      Taxation is legalized theft, no more, no less.
    13. Re:WTF by Requiem18th · · Score: 4, Insightful

      The question is not if old drugs would pass modern test but if old drugs still pass old tests. Old drugs not making it pass modern tests can mean just better tests.

      --
      But... the future refused to change.
    14. Re:WTF by MrNaz · · Score: 5, Insightful

      Actually no, language is *not* what is defined by the lowest common denominator, if that were the case, then modern science would go out the window as every technical term in every paper completely lost all hope of having intelligible meaning in the anarchy of broken syntax.

      Communication would be damn near impossible if every time I read a text I was not able to refer to a dictionary, but instead had to take a walk outside and poll all the halfwits hanging out the front of the local shopping mall what a given word means in a given context. I can imagine it now:

      "Hey fellas, sorry to interrupt your skateboarding and pot smoking, but would you mind telling me what you understand by the word 'pontification'? I do apologize, but I have a term paper in linguistics due in a week and I need to bring my semantics up to date according to the current popular lexicon."

      "Language evolves" is not the same as "Uneducated dipshits get to set standards".

      --
      I hate printers.
    15. Re:WTF by smaddox · · Score: 5, Interesting

      I know you were moded Funny, but I think there could be some bit of truth to your statement.

      Especially when the drugs are meant to treat depression, this could be part of the effect. We have record levels of depression in this country. Could part of that be due to pharmaceutical advertising?

    16. Re:WTF by ChameleonDave · · Score: 5, Informative

      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.

    17. Re:WTF by LaskoVortex · · Score: 4, Insightful

      That sill doesn't explain why placebos are now nearly twice as effective as ~1990, but this paragraph from the article might be a factor:

      Because if you have an imaginary concocted ailment like restless leg syndrome or hyperactivity, then the imaginary effects of a sugar pill are going to work well to alleviate the imaginary symptoms of the imaginary disease.

      Pharmaceutical companies define disease these days. They advertise diseases and they push doctors to prescribe their poisonous ineffective chemicals to treat the advertised diseases.

      You could probably find a correlation between the number of advertised diseases like restless leg syndrome and this so called "placebo effect".

      --
      Just callin' it like I see it.
    18. Re:WTF by zippthorne · · Score: 4, Funny

      I believe it. Have you seen antidepressant ads? The morose horn section alone is enough to make you want to pack it in.

      --
      Can you be Even More Awesome?!
    19. Re:WTF by martas · · Score: 4, Insightful

      a less sarcastic way to say that would be that confidence in modern medicine is increasing.

      --
      weinersmith
    20. Re:WTF by Imrik · · Score: 5, Informative

      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.

  2. Shooting themselves in the foot by Wonko+the+Sane · · Score: 5, Insightful

    Drug companies should never have started advertising directly to end users.

    1. Re:Shooting themselves in the foot by T+Murphy · · Score: 5, Interesting

      I know some, if not all, Western European countries prohibit advertisement of prescription drugs. I would be curious if testing a group of Americans and a group of Europeans will give different strength placebo effects. I suppose other reasons for this are more likely than advertisement, but I would nevertheless like to see this be proved the reason (through an unbiased source of course).

      --
      My webcomic
    2. Re:Shooting themselves in the foot by ceoyoyo · · Score: 4, Informative

      It does. Read the article.

  3. Grunt by joaquin+gray · · Score: 4, Funny

    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.

    1. Re:Grunt by Kral_Blbec · · Score: 5, Funny

      Statistics are like bikinis.

      What they reveal is suggestive, but what they conceal is critical.

  4. Oblig. by Anonymous Coward · · Score: 5, Funny

    Oblig. article from The Onion

  5. Larger sample means different sample by Anonymous Coward · · Score: 4, Interesting

    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.

  6. Placebos future by Rockoon · · Score: 5, Funny

    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."
  7. Re:Human race evolving? by frieko · · Score: 4, Interesting

    Is that you, Tom Cruise? Things can go wrong in your body and they don't need a cause. You don't need to smoke to get cancer. Same thing with depression. You can bring depression upon yourself, for example with stress, but it's often just a genetic hormone deficiency. My depression hit suddenly, and I tried everything to cure it, over the course of two years. Eating different, fish oil, more vacation, rigorous exercise, more religion, less religion. Nothing worked. Still woke up at 3am wanting to kill myself. On a regular basis.

    Went on Lexapro and I've been totally fine ever since.

  8. Re:Personal Anecdote by BitZtream · · Score: 5, Insightful

    AFAIK God hasn't been known to cause nausea, heart attack, or death as a side effect.

    You haven't read much of the old testament have you?

    --
    Persistent Volume manager for Kubernetes - https://github.com/dwimsey/openshift-pvmanager