Hot Comments
- About time! (5 points, Informative) by sackvillian on Tuesday February 09, @09:50AM attached to Call For Scientific Research Code To Be Released
- Re:Be careful using the P2V tool. (5 points, Informative) by klocwerk on Tuesday February 09, @03:41PM attached to The Hidden Treasures of Sysinternals
- W.A.G. (5 points, Insightful) by ipb on Tuesday February 09, @01:17PM attached to How Do You Accurately Estimate Programming Time?
- Re:Surprise (5 points, Insightful) by Anonymous Coward on Tuesday February 09, @04:38PM attached to Microsoft Says Windows 7 Not Killing Batteries
- No problem (5 points, Insightful) by rastoboy29 on Wednesday February 10, @05:27AM attached to Appeals Court Rules On Internet Obscenity Standards
5817325
story
Comments: 349 +- Science: Placebos Are Getting More Effective on Monday September 07, @10:58AM
Posted
by
ScuttleMonkey
on Monday September 07, @10:58AM
from the time-to-start-treating-with-placebos dept.
from the time-to-start-treating-with-placebos dept.
background: url(//a.fsdn.com/sd/topics/topicmedicine.gif); width:64px; height:80px;
medicine
background: url(//a.fsdn.com/sd/topics/topicscience.gif); width:62px; height:75px;
science
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."
Related Stories
Antidepressants Work No Better Than a Placebo 674 comments
: by
Placebo Effect Caught In the Act In Spinal Nerves 167 comments
It is sweet to let the mind unbend on occasion.
-- Quintus Horatius Flaccus (Horace)
All trademarks and copyrights on this page are owned by their respective owners. Comments are owned by the Poster. The Rest © 1997-2010 Geeknet, Inc.
WTF (Score:4, Informative)
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 (Score:5, Interesting)
Parent
Re:WTF (Score:5, Insightful)
It's not anything to do with the placebo, it's that the drugs that are being developed currently don't do anything.
Parent
Re:WTF (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.
Parent
Re:WTF (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.
Parent
Re:WTF (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?
Parent
Re:WTF (Score:5, Funny)
I believe it. Have you seen antidepressant ads? The morose horn section alone is enough to make you want to pack it in.
Parent
Re:WTF (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".
Parent
Re:WTF (Score:5, Insightful)
Parent
Re:WTF (Score:4, Insightful)
The rise of the "effectiveness" of placebo's might simply indicate a rise in purely psychosomatic, and/or mis-diagnosed "illnesses"...
The great thing about this, in a properly controlled double blind test is that it doesn't matter. The real pill gets the same psychological boost as the placebo. Both pills have the same base line. Now the difference between the two pills is due to the differences in the active ingredients.
This all sounds like total bullshit by pharmacological companies to escape from some cheating they were doing back in the 1990s or something.
Parent
Re:WTF (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.
Parent
Re:WTF (Score:5, 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).
Parent
Re:WTF (Score:5, 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.
Parent
Re:WTF (Score:5, 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.
Parent
Re:WTF (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?
Parent
Re:WTF (Score:5, Insightful)
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.
Parent
Re:WTF (Score:5, 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.
Parent
Re:WTF (Score:5, Interesting)
Parent
Re:WTF (Score:5, Informative)
Parent
Re:WTF (Score:5, Informative)
You keep saying that word, I do not think it means what you think it means. [scienceblogs.com]
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.
Parent
Re:WTF (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.... :-)
Parent
Re:WTF (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".
Parent
Shooting themselves in the foot (Score:5, Insightful)
Drug companies should never have started advertising directly to end users.
Oblig. (Score:5, Funny)
Parent
Re:Shooting themselves in the foot (Score:5, Interesting)
Parent
Re: (Score:3, Funny)
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 (Score:5, Informative)
It does. Read the article.
Parent
Re: (Score:3, Funny)
And frozen pizza manufacturers...
Grunt (Score:4, Funny)
Re:Grunt (Score:5, Funny)
What they reveal is suggestive, but what they conceal is critical.
Parent
Or not. (Score:3, Informative)
Re:Or not. (Score:4, Interesting)
Urgh, what a crappy article. He dismisses the well-documented placebo effect - out of ignorance presumably.
Parent
Believing (Score:3, Interesting)
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: (Score:3, Informative)
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 (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.
Placebos future (Score:5, Funny)
Re:Placebos future (Score:4, Funny)
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?)
Parent
Re:Placebos future (Score:4, Informative)
Here [chestjournal.org] 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.
Parent
Ok, tin-foil idea here (Score:3, Interesting)
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?!
Maybe drug trials are becoming less compromised (Score:4, Insightful)
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:
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.
On the Flip Side (Score:3, Interesting)
Bad Science (Score:3, Insightful)
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.
Actual evidence (Score:3, Informative)
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: (Score:3, Informative)
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? (Score:4, Insightful)
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.
Parent
Re:Human race evolving? (Score:5, Interesting)
Went on Lexapro and I've been totally fine ever since.
Parent
Re: (Score:3, Informative)
Re: (Score:3, Interesting)
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 preparat
Re:Personal Anecdote (Score:5, Insightful)
You haven't read much of the old testament have you?
Parent
Re:Dangerous ? (Score:4, Funny)
They usually develop symptoms of depression and paranoia, but we've got a pill for that...
Parent