Placebos are getting more effective and researchers are desperate to know why...

***Semper Fidelis*** · #1 (**permalink**) 09-23-2009, 08:56 PM

http://www.wired.com/medtech/drugs/m...placebo_effect

I found this article fascinating. I think it demonstrates materialisms inability to deal with the soul/body that is man.

Consider these notes:

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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.

It's not that the old meds are getting weaker, drug developers say. It's as if the placebo effect is somehow getting stronger.

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The roots of the placebo problem can be traced to a lie told by an Army nurse during World War II as Allied forces stormed the beaches of southern Italy. The nurse was assisting an anesthetist named Henry Beecher, who was tending to US troops under heavy German bombardment. When the morphine supply ran low, the nurse assured a wounded soldier that he was getting a shot of potent painkiller, though her syringe contained only salt water. Amazingly, the bogus injection relieved the soldier's agony and prevented the onset of shock.

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Assumption number one was that if a trial were managed correctly, a medication would perform as well or badly in a Phoenix hospital as in a Bangalore clinic. Potter discovered, however, that geographic location alone could determine whether a drug bested placebo or crossed the futility boundary. By the late '90s, for example, the classic antianxiety drug diazepam (also known as Valium) was still beating placebo in France and Belgium. But when the drug was tested in the US, it was likely to fail. Conversely, Prozac performed better in America than it did in western Europe and South Africa. It was an unsettling prospect: FDA approval could hinge on where the company chose to conduct a trial.

Mistaken assumption number two was that the standard tests used to gauge volunteers' improvement in trials yielded consistent results. Potter and his colleagues discovered that ratings by trial observers varied significantly from one testing site to another. It was like finding out that the judges in a tight race each had a different idea about the placement of the finish line.

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Rx for Success

What turns a dummy pill into a catalyst for relieving pain, anxiety, depression, sexual dysfunction, or the tremors of Parkinson's disease? The brain's own healing mechanisms, unleashed by the belief that a phony medication is the real thing. The most important ingredient in any placebo is the doctor's bedside manner, but according to research, the color of a tablet can boost the effectiveness even of genuine meds—or help convince a patient that a placebo is a potent remedy.—Steve Silberman

Yellow pills
make the most effective antidepressants, like little doses of pharmaceutical sunshine.

Red pills
can give you a more stimulating kick. Wake up, Neo.

The color green
reduces anxiety, adding more chill to the pill.

White tablets—
particularly those labeled "antacid"—are superior for soothing ulcers, even when they contain nothing but lactose.

More is better,
scientists say. Placebos taken four times a day deliver greater relief than those taken twice daily.

Branding matters.
Placebos stamped or packaged with widely recognized trademarks are more effective than "generic" placebos.

Clever names
can add a placebo boost to the physiological punch in real drugs. Viagra implies both vitality and an unstoppable Niagara of sexy.

SolaScriptura · #2 (**permalink**) 09-23-2009, 08:59 PM

Very very interesting.

**py3ak** · #3 (**permalink**) 09-23-2009, 09:00 PM

Quote:

Originally Posted by Semper Fidelis

Quote:

The roots of the placebo problem can be traced to a lie told by an Army nurse during World War II as Allied forces stormed the beaches of southern Italy. The nurse was assisting an anesthetist named Henry Beecher, who was tending to US troops under heavy German bombardment. When the morphine supply ran low, the nurse assured a wounded soldier that he was getting a shot of potent painkiller, though her syringe contained only salt water. Amazingly, the bogus injection relieved the soldier's agony and prevented the onset of shock.

Couldn't that also raise the possibility that salt is a painkiller?

***Semper Fidelis*** · #4 (**permalink**) 09-23-2009, 09:01 PM

**py3ak** · #5 (**permalink**) 09-23-2009, 09:07 PM

Salt is recommended for people with low blood pressure problems, so it could prevent shock by its own instrumentality, not merely by making someone think it helps.

So it seems that the despite of placebos was misplaced.

SRoper · #6 (**permalink**) 09-24-2009, 01:21 PM

Quote:

Originally Posted by Semper Fidelis

Placebos Are Getting More Effective. Drugmakers Are Desperate to Know Why.

I found this article fascinating. I think it demonstrates materialisms inability to deal with the soul/body that is man.

Thanks, I found the article very interesting. I'm not sure that holding to a two-substance view of man makes it any easier to answer the central question raised as to why the placebo effect appears to be greater now than in the past and why it varies from region to region. I think the expectations fostered by pharmaceutical advertising is part of the answer.

The article raises some interesting ethical questions. I had never heard of the "nocebo" effect before. I wonder whether this casts some doubt on the principle of informed consent. If by telling a patient of possible side effects you increase their chances of experiencing those side effects, would a doctor ever be justified in omiting mentioning those side effects?

tcalbrecht · #7 (**permalink**) 09-24-2009, 04:12 PM

Facinating.

OPC'n · #8 (**permalink**) 09-24-2009, 06:58 PM

I don't think salt would fool any of my patients!!!

JBaldwin · #9 (**permalink**) 09-24-2009, 10:56 PM

This is a fascinating article. I wonder how much genetic makeup has to do with how a drug works or does not work?

***Semper Fidelis*** · #10 (**permalink**) 09-25-2009, 12:42 PM

Quote:

Originally Posted by SRoper

Quote:

Originally Posted by Semper Fidelis

Placebos Are Getting More Effective. Drugmakers Are Desperate to Know Why.

I found this article fascinating. I think it demonstrates materialisms inability to deal with the soul/body that is man.

Thanks, I found the article very interesting. I'm not sure that holding to a two-substance view of man makes it any easier to answer the central question raised as to why the placebo effect appears to be greater now than in the past and why it varies from region to region.

I didn't state that having a Biblical view of the nature of man necessarily provides easy answers to all phenomena but my point is that methodological naturalism demonstrates its impotence in the article.

ColdSilverMoon · #11 (**permalink**) 09-25-2009, 01:06 PM

Quote:

Originally Posted by Semper Fidelis

Quote:

Originally Posted by SRoper

Quote:

Originally Posted by Semper Fidelis

Placebos Are Getting More Effective. Drugmakers Are Desperate to Know Why.

I found this article fascinating. I think it demonstrates materialisms inability to deal with the soul/body that is man.

Thanks, I found the article very interesting. I'm not sure that holding to a two-substance view of man makes it any easier to answer the central question raised as to why the placebo effect appears to be greater now than in the past and why it varies from region to region.

I didn't state that having a Biblical view of the nature of man necessarily provides easy answers to all phenomena but my point is that methodological naturalism demonstrates its impotence in the article.

Interesting article, and I think you're right, Rich. Matthew 4:24 says this about sickness:

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...and they brought Him all the sick, those afflicted with various diseases and pains, those oppressed by demons, epileptics, and paralytics, and He healed them.

Notice disease is classified as natural (diseases and pains, epilepsy, paralysis), and supernatural (those oppressed by demons). We cannot understand disease unless we analyze it in the comprehensive way that Scripture does. The science of medicine today is very strong, but we take a much more simplistic view than the Bible takes when we reduce it to purely natural phenomena.

The placebo effect is well-recognized, though it is interesting that it seems to be rising....