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Placebos Are Getting More Effective

ScuttleMonkey posted more than 4 years ago | from the time-to-start-treating-with-placebos dept.

349

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."

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WTF (4, Informative)

Xeriar (456730) | more than 4 years ago | (#29340971)

You keep saying that word, I do not think it means what you think it means. [scienceblogs.com]

There are plenty of other reasons for this to be occurring. Better testing procedures among them.

Re:WTF (0, Flamebait)

Anonymous Coward | more than 4 years ago | (#29341087)

Keep in mind, grammar nazis out there, people define the language. Possum is spelled without the O now because it was stupid and most people forgot it. Likewise, placebo means whatever the majority of folks say it means. Most people think sugar pill, so it IS a damn sugar pill. Shut up.

Re:WTF (5, Insightful)

MrNaz (730548) | more than 4 years ago | (#29342101)

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".

Re:WTF (4, Interesting)

bistromath007 (1253428) | more than 4 years ago | (#29341105)

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.

Re:WTF (5, Insightful)

je ne sais quoi (987177) | more than 4 years ago | (#29341379)

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.

Re:WTF (5, Interesting)

commodore64_love (1445365) | more than 4 years ago | (#29341541)

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.

Re:WTF (5, Insightful)

dintlu (1171159) | more than 4 years ago | (#29341887)

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.

Re:WTF (5, Interesting)

smaddox (928261) | more than 4 years ago | (#29342123)

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?

Re:WTF (1, Funny)

Anonymous Coward | more than 4 years ago | (#29342051)

The little pill that makes men feel good is blue, not purple.

Re:WTF (4, Interesting)

Firethorn (177587) | more than 4 years ago | (#29341571)

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).

Re:WTF (4, Interesting)

gadget junkie (618542) | more than 4 years ago | (#29341931)

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.

Re:WTF (4, Insightful)

Requiem18th (742389) | more than 4 years ago | (#29342033)

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.

Re:WTF (1)

bistromath007 (1253428) | more than 4 years ago | (#29341667)

Big Pharma, in particular the guys pushing psych meds, are certainly not the most trustworthy guys around. They frequently play very stupid games with patents and advertisement. They are not, however, releasing inert garbage. The new stuff is, like anything else, based on conceptual refinement of the old stuff, which worked before this giant public marketing machine was in place. The relationship between thought process and chemical mechanism is so nuanced that it is often hard to tell which one it's more effective to try to change in any given patient, and as a treatment affects a person, one will change the other, so that treatment must be modified. I've said it before, and I'll say it again: in psychiatry, you can do the most rigorous and exacting studies possible, with the tightest controls, and your results will still be equivalent to a mildly educated guess in any other field. This doesn't mean that the science is bad, the drugs are useless, or the researchers are corrupt and lazy. They are working with data that changes when watched by its very nature. Sometimes they can only make the subtlest change vs. placebo, but that is what they need to do in many cases where a person has a stubborn problem with brain chemistry.

Re:WTF (0)

Anonymous Coward | more than 4 years ago | (#29341977)

I for one think it is because we are becoming more "psychic" our brains getting stronger - we are getting our super-hero powers :D
To prove it - go out and by a new device - if you keep the box and the receipt, you will have no problems with the device - if you throw away the box or the receipt, you just broke your device. It is becoming a universal law, i just hope they kept the box for the ISS... that's gonna be hell to return to Walmart.

Re:WTF (5, Insightful)

Anonymous Coward | more than 4 years ago | (#29341109)

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?

Re:placebo means... (1)

leuk_he (194174) | more than 4 years ago | (#29341129)

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.

Re:WTF (1, Interesting)

characterZer0 (138196) | more than 4 years ago | (#29341191)

Huh. I read that and found out that placebo means exactly what I thought it meant.

And that Wired articles are exactly as poor as I thought they were.

Re:WTF (4, Insightful)

abigsmurf (919188) | more than 4 years ago | (#29341299)

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.

Re:WTF (0)

Anonymous Coward | more than 4 years ago | (#29341463)

Thank you. There's so much nonsense talked about the "placebo effect", as though sugar pills magically cure people. There *may* be a benefit to placebos in some cases, but the presence of a positive response in the placebo group of a trial does not show this, any more than a positive response (by itself) in the active drug group shows that the active drug is beneficial. There's a very simple reason [wikipedia.org] for a placebo group, and it's not because placebos have magical healing powers.

Re:WTF (5, Interesting)

dgatwood (11270) | more than 4 years ago | (#29341847)

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.... :-)

Re:WTF (1, Flamebait)

Hurricane78 (562437) | more than 4 years ago | (#29341503)

No shit, Sherlock? Guess what: We already knew that, and yet still understood the article. Because we knew what was meant. We took for granted, what you highlighted, and parsed the article in that context.

You act like a typical white coat, expecting that everyone around you is an idiot, and you're the all-knowing god!

So who's the idiot here? ^^

Re:WTF (4, Interesting)

bondsbw (888959) | more than 4 years ago | (#29341597)

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.

Re:WTF (4, Interesting)

Darkness404 (1287218) | more than 4 years ago | (#29342011)

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.

Re:WTF (0)

Anonymous Coward | more than 4 years ago | (#29341683)

And why should I believe the opinion of an intern?

Re:WTF (5, Informative)

digaman23 (807313) | more than 4 years ago | (#29341813)

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 [scienceblogs.com] -- 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 (0)

Anonymous Coward | more than 4 years ago | (#29341843)

One reason is that it could be that the definitions of the condition are broader, so that those without the condition fall within the group. An example of this is dyslexia.

Re:WTF (1)

RichDiesal (655968) | more than 4 years ago | (#29341925)

They also defined effect size (a measure of the magnitude of a difference) as a measure of statistical significance (a decision based on the probability that an observed effect size would have occurred due to chance). But I suppose math/statistic confusion is even more common than experimental design confusion.

Re:WTF (3, Insightful)

dlthomas (762960) | more than 4 years ago | (#29341961)

That guy misses the point.

There is an apparent change here, evidenced by the fact that new tests of old drugs are giving poorer relative results while giving similar absolute results.

It may be due to better testing methods. It may be that there was fraud in the earlier tests which has been gradually weeded out. It may be that people in studies are culturally more eager to please and so are (consciously or unconsciously) making larger lifestyle changes when they enter the study. It may be (as stipulated in TFA) an increased confidence in pharmacology leading to a larger impact of those "other less clear and tangible effects" that PalMD nods to. It is not simply representative of the failure of pharma to find worthwhile new drugs - the fact that old drugs wouldn't pass muster puts the lie to that. What is interesting is that standards have implicitly risen, and no one understands why. This is news, this is interesting, and this should be investigated.

Re:WTF (2, Interesting)

Anonymous Coward | more than 4 years ago | (#29341987)

You keep saying that word, I do not think it means what you think it means. [scienceblogs.com]

There are plenty of other reasons for this to be occurring. Better testing procedures among them.

Perhaps the real reason efficacy of trial drugs has declined is Big Pharma is trying to treat conditions that aren't actual problems? "Over-active bladder syndrome" comes to mind immediately -- stop drinking caffeine, only drink water when you're thirsty, problem solved.

As the above URL observes:
"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."

I think the CEOs have done exactly that. It's pronounced "advertise directly to the US public."

Human race evolving? (1)

DogDude (805747) | more than 4 years ago | (#29340979)

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?

Re:Human race evolving? (2, Informative)

MightyMartian (840721) | more than 4 years ago | (#29341091)

1. Of course we're still evolving and always will.

2. It's very likely nothing to do with our brains, and a lot to do with more rigorous testing.

Re:Human race evolving? (3, Insightful)

shic (309152) | more than 4 years ago | (#29341249)

2. It's very likely nothing to do with our brains, and a lot to do with more rigorous testing.

I don't buy the 'more rigorous testing' argument - I think that pre-supposes that testing was not performed diligently in the past. I think the most likely explanation is that the diagnoses were always flawed. Depression, mentioned in the blurb, for example has physical symptoms, but no known physical cause. My hunch is that many of the ailments we have are caused by factors outside the control of drugs, and it is the extent to which taking regular medication alters behaviour that makes a difference. For example, medication that can't be taken with alcohol presents a positive side-effect for heavy drinkers if taken diligently. Any regular activity has the same positive effects as observing a ritual.

Perhaps a larger proportion of ailments today are not the result of an illness? I'd find that easy to believe.

Re:Human race evolving? (4, Interesting)

frieko (855745) | more than 4 years ago | (#29341573)

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.

Re:Human race evolving? (1, Informative)

Anonymous Coward | more than 4 years ago | (#29341313)

Speak for yourself; I've got Wolverine's powers.

Re:Human race evolving? (2, Insightful)

ILuvRamen (1026668) | more than 4 years ago | (#29341481)

You've got to be kidding me. Which do you think is the most likely explanation. 1, we're all becoming regenerative super-mutants. 2, psychosomatic illnesses are increasing. In other words, people cause stomach aches and heartburn and fast heartbeats and migraines and everything else there is out there to treat and then when they're convinced that they're taking something to help it, tada, it goes away.

Shooting themselves in the foot (5, Insightful)

Wonko the Sane (25252) | more than 4 years ago | (#29340987)

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

Re:Shooting themselves in the foot (0, Offtopic)

reboot246 (623534) | more than 4 years ago | (#29341077)

Agreed. And the same goes for lawyers and law firms.

Re:Shooting themselves in the foot (2, Funny)

MightyMartian (840721) | more than 4 years ago | (#29341297)

And frozen pizza manufacturers...

Re:Shooting themselves in the foot (1)

reboot246 (623534) | more than 4 years ago | (#29341355)

:) And Geico & Progressive insurance companies . . .

Re:Shooting themselves in the foot (0)

commodore64_love (1445365) | more than 4 years ago | (#29341693)

Allowed???

(scours through Constitution). I can not lay my hand on any law that grants power to Congress to decide who can and cannot advertise their products. Now granted you might say "well those are corporations and corporations don't have rights," okay, but the People do still have rights. If I discover the sheep growing in my backyard produce a natural skin oil that is great for preventing wrinkles, why can't I advertise that to my neighbors via television?

On the contrary the Constitution states that the power to regulate ads, belongs not to the Congress, but to the 50 State governments.

Re:Shooting themselves in the foot (1)

poopdeville (841677) | more than 4 years ago | (#29341851)

Nobody said "allowed" but you.

Oblig. (5, Funny)

Anonymous Coward | more than 4 years ago | (#29341107)

Re:Shooting themselves in the foot (5, Interesting)

T Murphy (1054674) | more than 4 years ago | (#29341165)

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).

Re:Shooting themselves in the foot (3, Funny)

Anonymous Coward | more than 4 years ago | (#29341469)

I would be curious if testing a group of Americans and a group of Europeans will give different strength placebo effects.

What the hell would you test against? A placebo placebo?

Re:Shooting themselves in the foot (1)

PIBM (588930) | more than 4 years ago | (#29341965)

The test for two population would be simply to find how what is the ratio of the placebo effect in each. With that I mean take the 2 population, for a number of different illness. Offer them each the placebo, and see, for each of the illness, what's the ratio of people that it helps. With this kind of test, you could even differentiate between type of illness, thus seeing if the advertisement or way of life were causing the most change.

Re:Shooting themselves in the foot (4, Informative)

ceoyoyo (59147) | more than 4 years ago | (#29341613)

It does. Read the article.

Re:Shooting themselves in the foot (1)

Mephistro (1248898) | more than 4 years ago | (#29341673)

That's old news. Nowadays they don't need to advertise. They just create hype about a disease, and let the mass media do the hard work. See the 'swine flu' case for details on the complete procedure.

Re:Shooting themselves in the foot (1)

barzok (26681) | more than 4 years ago | (#29342141)

USA & New Zealand are the only 2 "first world" countries that allow such advertising.

The US changed a law back in the late 90s which opened the floodgates for this crap.

Marketing? (0)

Anonymous Coward | more than 4 years ago | (#29340991)

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?

Re:Marketing? (0)

Anonymous Coward | more than 4 years ago | (#29341237)

Dude, it wasn't just Mac users in the study...

Why? (1, Insightful)

Anonymous Coward | more than 4 years ago | (#29340993)

I suspect it may be because people expect drugs to be more effective now.

Grunt (4, Funny)

joaquin gray (596589) | more than 4 years ago | (#29341001)

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.

Re:Grunt (5, Funny)

Kral_Blbec (1201285) | more than 4 years ago | (#29341253)

Statistics are like bikinis.

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

Re:Grunt (1)

spicate (667270) | more than 4 years ago | (#29341491)

Statistics are like bikinis. What they reveal is suggestive, but what they conceal is critical.

And you just keep trying them on until you find a style that fits, right?

Re:Grunt (1, Informative)

Anonymous Coward | more than 4 years ago | (#29341523)

Statistics are like bikinis.

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

Nice to meet you, Aaron Levenstein.

Re:Grunt (0)

commodore64_love (1445365) | more than 4 years ago | (#29341735)

In some cases the bikinis are best left-on (this applies to both women and men).

Idiocracy (-1, Troll)

Anonymous Coward | more than 4 years ago | (#29341023)

It's just that people are stupider. They're getting so stupid that they are afflicted with 'problems' that a sugar pill can 'solve'.

Remember when kids used to run outside and play? Sometimes they'd fall down, and break a leg or something. Try treating a broken leg with a placebo!

No, kids just stay inside and parents whine about ADD, ADHD, AD-EIEIO, and whatnot. All these fake problems are easily 'solved' with fake medicine.

Re:Idiocracy (1)

brilanon (1121645) | more than 4 years ago | (#29341187)

You could, this is how they discovered placebos. Some army nurse gave a guy a water shot and he quit complaining right away

Re:Idiocracy (1)

retchdog (1319261) | more than 4 years ago | (#29341227)

Maybe he was dehydrated?

Re:Idiocracy (0)

Anonymous Coward | more than 4 years ago | (#29341439)

Might not matter, depending on where she gave him the "water shot."

Re:Idiocracy (0)

Anonymous Coward | more than 4 years ago | (#29341417)

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.

Re:Idiocracy (1)

DarkOx (621550) | more than 4 years ago | (#29341957)

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.

Re:Idiocracy (2, Interesting)

ceoyoyo (59147) | more than 4 years ago | (#29341689)

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.

Re:Idiocracy (1)

Shadow of Eternity (795165) | more than 4 years ago | (#29341479)

Haven't heard about that last one but I'm pretty sure my neighbor's kid has ADD/OCD/MOUSE

People are more gullible. (0, Troll)

P0ltergeist333 (1473899) | more than 4 years ago | (#29341027)

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?

Duplicate news? (0)

Anonymous Coward | more than 4 years ago | (#29341071)

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.

Believing (2, Interesting)

gmuslera (3436) | more than 4 years ago | (#29341083)

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.

Re:Believing (2, Informative)

ceoyoyo (59147) | more than 4 years ago | (#29341713)

Yes. This is why we have a procedure we call "science" that attempts to take our subjective biases out of the equation. There are no shortage of examples where people have absolutely convinced themselves of things that aren't true.

Larger sample means different sample (4, Interesting)

Anonymous Coward | more than 4 years ago | (#29341133)

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.

Patients entering trials are different (2, Interesting)

Anonymous Coward | more than 4 years ago | (#29341143)

Patients entering a trial are not the same as they use to be. This is because patients actually have a choice in entering a trial or not.

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.

Re:Patients entering trials are different (2, Informative)

ColdWetDog (752185) | more than 4 years ago | (#29341433)

That, surprisingly enough, was in the FA. He points out that the standard rating scale for depression, the Hamilton-D, was developed and validated among depressed individuals who were institutionalized - a very different population from the ones that the drug companies are studying now.

Placebos future (5, Funny)

Rockoon (1252108) | more than 4 years ago | (#29341209)

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.

Re:Placebos future (1)

TheIndifferentiate (914096) | more than 4 years ago | (#29341611)

Yes, this is why I'm going to market a high-potency placebo that I call Mayfixya (tm). It is simply amazing the spectrum of ailments that Mayfixya (tm) can treat! This will soon be the drug to beat in clinical trials.

Re:Placebos future (3, Funny)

itsdapead (734413) | more than 4 years ago | (#29341655)

That is a dangerous idea. Over-use of placebos could lead to the evolution of placebo-resistant bacteria! Its happened with antibiotics, it could happen with placebo, too!! Worse, the resistance to placebos could spread from pharmaceutical placebos to more common cures!!!

Be afraid!!!! The Pharma industry would love to destroy traditional placebo-based remedies as chicken soup, a nice cup of tea, a double Scotch or "kissing it better" so they could sell you expensive pills as well!!!! Its a conspiracy!!!!!!

(Is that enough !!!!s to ensure that nobody thinks this is a serious comment?)

Screw big pharma (0)

Anonymous Coward | more than 4 years ago | (#29341221)

Eat sensibly and exercise. Stay off the meds if you can help it.

Ok, tin-foil idea here (2, Interesting)

JamesP (688957) | more than 4 years ago | (#29341267)

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?!

Antidepressant trials (1)

shinier (949631) | more than 4 years ago | (#29341309)

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?

It could be (1)

zogger (617870) | more than 4 years ago | (#29341317)

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)

Re:It could be (2, Insightful)

agnosticnixie (1481609) | more than 4 years ago | (#29341519)

ADHD is not kids acting like kids, it's kids acting like hyperactive goldfishes. There have been abuses in diagnosis, but the condition itself exists. The earliest humans were, in fact, scavengers, were not contemporary with saber toothed tigers and hunting/gathering was a group activity that requires fairly little time in the day compared to the workload of settled civilizations, besides the fact that most of the food needs come from trapping, fishing, light hunt (unless you have a party of 50, you ain't going for mastodon) and plants. So get off your ignorant high horse, abuse of diagnosis =/= the disease doesn't exist.

Maybe drug trials are becoming less compromised (3, Insightful)

__roo (86767) | more than 4 years ago | (#29341393)

A lot of people -- like the author of Talking Back to Prozac [psychologytoday.com] -- 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 [newscientist.com] , has a good definition of a particular form of publication bias [wikipedia.org] that is apparently common:

It's called the "file-drawer problem". A study fails to produce interesting results, so is filed away and forgotten - a practice that might mean antidepressants don't work as well as doctors think.

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.

Buy PCLB now! It's rising! (1)

noidentity (188756) | more than 4 years ago | (#29341467)

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!

What I want to know is... (0)

Anonymous Coward | more than 4 years ago | (#29341493)

If I really believe in the efficacy of the placebo effect, can I benefit from it while knowing the truth?

Awesome (0)

Anonymous Coward | more than 4 years ago | (#29341497)

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

Re:Awesome (0)

Anonymous Coward | more than 4 years ago | (#29341907)

Oh you jackass.

The most likely explanation (1)

OpenSourced (323149) | more than 4 years ago | (#29341543)

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.

Have they stopped to think .... (0)

Anonymous Coward | more than 4 years ago | (#29341577)

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.

Re:Have they stopped to think .... (0)

Anonymous Coward | more than 4 years ago | (#29342089)

8/10

On the Flip Side (2, Interesting)

RootWind (993172) | more than 4 years ago | (#29341589)

Placebo also has the most side effects of any drug on record.

Obligatory reference (1)

dandart (1274360) | more than 4 years ago | (#29341617)

"I have a headache."
"Here, have this. It's a placebo"

People are getting more gullible. News at 11! (1)

Chemisor (97276) | more than 4 years ago | (#29341629)

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.

Bad Science (2, Insightful)

ConfusedVorlon (657247) | more than 4 years ago | (#29341657)

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.

Re:Bad Science (1)

digaman23 (807313) | more than 4 years ago | (#29341945)

> turns out that the placebo effect is hugely influenced by beliefs.

Yes, it is. A section of my Wired article is devoted to that research, in fact.

I thank you Zfor your time (-1, Offtopic)

Anonymous Coward | more than 4 years ago | (#29341703)

off the play a8ea

Personal Anecdote (1)

SilverHatHacker (1381259) | more than 4 years ago | (#29341769)

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.

Actual evidence (2, Informative)

ceoyoyo (59147) | more than 4 years ago | (#29341807)

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.

Re:Actual evidence (1)

digaman23 (807313) | more than 4 years ago | (#29341897)

Not "studies," ceoyoyo. Meta-analyses of hundreds of studies. That's evidence.

So (1)

Derosian (943622) | more than 4 years ago | (#29342099)

Are more people than ever getting over diagnosed, or is the power of thought becoming more powerful?

...

Could this be related? (1)

B5_geek (638928) | more than 4 years ago | (#29342165)

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.
   

It's in the water? (1)

tnmc (446963) | more than 4 years ago | (#29342173)

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?

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