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

[The Straight Story]

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

Merck was in trouble. In 2002, the pharmaceutical giant was falling behind its rivals in sales. Even worse, patents on five blockbuster drugs were about to expire, which would allow cheaper generics to flood the market. The company hadn't introduced a truly new product in three years, and its stock price was plummeting.

In interviews with the press, Edward Scolnick, Merck's research director, laid out his battle plan to restore the firm to preeminence. Key to his strategy was expanding the company's reach into the antidepressant market, where Merck had lagged while competitors like Pfizer and GlaxoSmithKline created some of the best-selling drugs in the world. "To remain dominant in the future," he told Forbes, "we need to dominate the central nervous system."

His plan hinged on the success of an experimental antidepressant codenamed MK-869. Still in clinical trials, it looked like every pharma executive's dream: a new kind of medication that exploited brain chemistry in innovative ways to promote feelings of well-being. The drug tested brilliantly early on, with minimal side effects, and Merck touted its game-changing potential at a meeting of 300 securities analysts.

Behind the scenes, however, MK-869 was starting to unravel. True, many test subjects treated with the medication felt their hopelessness and anxiety lift. But so did nearly the same number who took a placebo, a look-alike pill made of milk sugar or another inert substance given to groups of volunteers in clinical trials to gauge how much more effective the real drug is by comparison. The fact that taking a faux drug can powerfully improve some people's health—the so-called placebo effect—has long been considered an embarrassment to the serious practice of pharmacology.

http://www.wired.com/medtech/drugs/magazine/17-09/ff_placebo_effect

[ecstatic]

1. Maybe the human mind is evolving into

something more powerful. Or maybe we're beginning to use a larger percentage of our brain now?

[hunter]

21. Or maybe the drug companies were cheating.

Look, the drugs were effective: They made money.

What's our health or the scientific method got to do with anything? It's all about the money.

[FarCenter]

2. Direct-to-consumer advertising of prescription drugs is the likely explanation

The pharmaceutical companies have spent untold billions of dollars on advertising to convince the public of the magical curative powers of their latest pills.

It's no wonder that when some doctor gives a patient a sugar pill, it works. Particularly for psychotropic drugs like antidepressants. It is activating the belief system built by the advertising.

On the other hand, doctors have been handing out sugar pills and giving saline shots to their hypochondriacs for a long time.

[Johonny]

7. I don't like that either

It really fuels the hypochondriac part of the population. Why are drugs that can only be prescribed by a doctor allowed to be advertised like a breakfast cereal?

[DireStrike]

10. This is a good explanation.

Why do more people believe pills have more power now? They are being told so.

If only we could use this...

[KittyWampus]

39. Some of us DO use "this". It's' called Consciousness. The Scientific Establishment unfortunately

has largely decided to go with the Reductionist model and refuse to investigate and those who do are demonized or discounted.

[Odin2005]

46. *GROAN*

"Reductionism" is the boogyman of woo-woos. :eyes:

[Uncle Joe]

20. Along that same vein, in the push to market legal drugs

during the prime-time "news" hour; perhaps the definition or view of depression itself has broadened in scope while shallowing in requirement?

[sandnsea]

25. Exactly. Everybody who sheds a tear

thinks they're "depressed".

An anti-depressant can help during the loss of a child, for example. But so might a placebo.

Not remotely true with bipolar disorder and other true depressions.

[nadinbrzezinski]

37. Shh... you are telling the world the secret

true story, we had a guy who came to the ER like clockwork with all kinds of maladies...

Well got to the point that he came through the door we had a shot of NS ready within ten minutes...

Hey it WORKED for another week or so.

By the way, we still did a checkup just to make sure. After all once he did come in with pneumonia

[abumbyanyothername]

3. Not to play doctor or pharmacologist here

but, having personally experienced depression, I can attest to the power of cognitive therapy.

In my case, there was something to be said for taking responsibility for my own thinking, learning some defense mechanisms against my toxic thoughts, and learning some behaviors that could be applied.

As a friend of mine says, "The reason you're afraid is because you're thinking scary thoughts."

[kjackson227]

17. I agree, and not to mention the fact that vitamins/minerals/herbal supplements/...

can make a BIG difference in one's physical being. Supplements may not be able to cure big-time diseases at the moment, but it can help alleviate/prevent a lot of illnesses such as depression, diabetes, hormonal imbalances, etc. People are taking more control of their health.

[sandnsea]

24. As someone who has experienced chemical depression

Controlling your thoughts has zip to do with it. A placebo might help periodic depression. It won't do anything for chemical depression. The doctors haven't figured out how to diagnose the difference. Or at least, there aren't enough of those that do know how.

[abumbyanyothername]

33. And just to be clear

I was never claiming that cognitive therapy could work for all forms of depression.

My case was pretty clearly situational (lots of life changes all at once very difficult to digest).

[sandnsea]

38. There ya' go

I have a family member who is currently hospitalized because he keeps trying therapy when he is bipolar and no amount of therapy is going to fix it. Twenty years we've been going through crises. I get a teense bit annoyed when people aren't perfectly CLEAR about the kind of depression they were dealing with. It's so important to differentiate.

Hope things are better for you. :hug:

[abumbyanyothername]

41. 20-25 years ago.

So life is much better now.

Cognitive therapy does not work on bipolar. Patients tend to wish that it did, however. They hope that they can maintain the highs, and manage the lows.

[hunter]

4. We're onto those pharmaceutical companies now.

It's simply becoming more difficult for them to fudge the numbers.

This is like some excuse a kid would make.

"No really, we couldn't possibly have sold drugs based on biased or falsified research! Placebos are getting more effective!

[Dreamer Tatum]

5. Anyone want to invest in my new pharma: Placebotics? nt

[Robb]

6. Can I use fake money? nt

[Dreamer Tatum]

8. rimshot nt

[SidDithers]

35. Well played, sir. Well played...nt

Sid

[DireStrike]

9. Should placebos be administered to sick patients?

In the case of ailments where the placebo effect is strong, isn't the healing inspired simply by being given the complete illusion of treatment a valuable success story?

Is there any way we can allow doctors to do this, or even test whether it could/should be done, humanely?

[abumbyanyothername]

12. In the 1820s

there was a doctor in Mass. who regularly gave his patients placebos and advised them to avoid eating in order to avoid diluting the strength of the "drug."

The doctor actually believed that the human body, left to its own devices, and freed from a non-stop assault by toxins in the name of food, could heal itself better than anything a doctor could do.

He had a pretty good track record.

[FarCenter]

13. Doctors prescribe placebos all the time

A placebo doesn't have to be a sugar pill -- just a medication that the doctor knows will have no pharmaceutical effect on the illness.

For example, antibiotics are prescribed for children with viral illnesses. It makes the mother happier until the child recovers on its own.

[DireStrike]

19. I think the patients are usually aware of placebos nowadays

For example, antibiotics for viral illnesses are often "just in case" there is some bacterial infection as well.

I can see how it might be done with children and the consent of the parent, but aren't there legal reasons a doctor can't prescribe things unnecessarily?

[FarCenter]

23. I think it is the AMA ethics position that patients be informed that placebos may be used

But not that some specific prescription is a placebo.

And according to news stories, the ethics position didn't receive too warm a welcome from practitioners.

Covers like telling the patient that the antibitics are being given to ward of possible bacterial complications would be the typical patter by the physician. Whether the patient realizes that the doctor is saying that the antibiotic will have no effect on the current illnes is unlikely.

For the antibiotic to have effect would require that:
1) the child is exposed to some bacteria (of course, this might happen at any tims, but we don't take antibiotics continously as a preventive measure), and
2) the current illness has somehow weakened the child's immunity against the bacteria (and it isn't really clear that having a viral illness increases or decreases immunity against bacterial illnesses).

[SidDithers]

36. No. A patient should always be a fully informed partner in their health care...

trickery has no place in medicine.

Sid

[EOTE]

11. Ask your doctor if Placebo is right for you.

Warning: Extended use of Placebo may cause nausea and or vomiting, jitters, restless leg syndrome, high blood pressure and explosive diarrhea.

[Gman2]

14. We are becoming more gullible. As we watch megahours of boobtoob

and must more and more trust experts for much of our lives, so too would the placebo effect strengthen.

[Barack_America]

15. Placebos more effective? Or study participants healthier?

Today we have the ability to diagnose many diseases very early, often before serious symptoms develop. One could ask what effect a diagnosis has on the perception of symptoms, particularly in a world with disease information so largely available on the internet. If the symptoms are largely psychologic, should we be surprised that the cure is psychologic as well?

[lildreamer316]

30. But how does that assesment jive with the lack of healthcare (millions) and rising obesity?

Either we are healthier as a population or we aren't. Can't have it both ways.
Since there are so many uninsured ppl and under-insured ppl; wouldn't it stand to reason that early diagnosis of many diseases is not happening at a large increasing rate? Tests cost money.

[Barack_America]

42. Sure we can. We don't all have depression or Parkinson's, etc.

These diseases, which were among those listed in the article, have different symptoms than those found with obesity.

Parkinson's for example is usually diagnosed based on the presence of tremors. But how much does knowledge of a Parkinson's diagnosis affect those tremors? There is a psychological component to most diseases and this might be what is interfering with pharmaceutical research when it comes to the "placebo effect".

[Froward69]

16. The Brain is an

amazing thing. it does control everything. If a patient BELIEVES in the placebo, it will have the desired effect.

[pink-o]

18. Maybe the lactose sugar is stimulating the seratonin production in their brains n/t

[Wounded Bear]

22. Actually, I think the real drugs are just getting weaker...

:scared:

;)

[FarCenter]

27. The '80s and '90s saw a big increase in understanding of biochemistry

Lots of the easy drug targets for high-volume (hence profitable) therapies have been picked off.

New blockbuster drugs are harder to come by. There are rare illnesses that haven't been addressed since too few people have them. There are common illnesses for which good therapies aren't available, but all the obvious things have been tried already.

[Orsino]

26. Perhaps the institutional neglect manadated by overloaded doctors...

...and malign insurance companies has increased the relative efficacy of any TLC.

I'm remeinded of the South Park episode in which Mr. Garrison invented a new form of personal intercity transportation, a wheel-shaped thing that "required" the insertion of a rectal probe of some sort into the opereator. It was wildly popular because, as people repeatedly said, "at least it's better than the airlines."

Placebos may not have become more effective, but doctoring has become less so.

[unblock]

28. i think it's partly what they're testing for

if you're testing how well a sugar pill battles tuberculosis or polio, it not only won't fare too well but nothing else the subject does will interfere with the study.

if you're testing how well a sugar pill battles depression, not only might the "placebo effect" actually work but so many other things interfere, inclulding simple passage of time, that might affect the results.

i think we're simply applying test to a wider range of ailments. if the ailment is not black and white and the definition of a successful treatment is not black and white then placebos will have more of an impact.

[Rex]

29. It is because we can change reality a lot easier then most people

think.

[lildreamer316]

31. ..

:)

[Rex]

44. .

:hi:

[hunter]

32. Yeah, we can sell people very expensive drugs that are not effective.

Is that what you mean by "change reality?"

[FarCenter]

34. It has worked for laundry detergents for generations

All sorts of marginally effective additional ingredients and snappy packaging changes, along with a gripping ad campaign, will sell the products.

[Rex]

43. No.

But we do need to 'change reality' in that sense. Start thinking about how.

[Odin2005]

47. Um, no.

:eyes:

[Rex]

50. Um, yes.

:dunce:

[Odin2005]

51. If you jump off a building and try to wish yourself to fly you will still die hitting the ground.

Reality has a why of biting people in the ass. :P

[Rex]

52. I didn't say be stupid about it.

:P

[HarveyDarkey]

40. And I was expecting a link to an Onion article

N/T (except for this)

[Wilms]

45. k&r n/t

[Odin2005]

48. Warning, Woo avalanche...

:banghead:

[madmusic]

49. Maybe they don't watch the news while in the study nt

[Motown_Johnny]

53. more people watching FOX so they are more open to believing things that are not real

[Maru Kitteh]

54. "we need to dominate the central nervous system."

Keeee - ryst these people FREAK ME OUT.

I'm thankful for the many advances of the modern pharmaceutical industry here and around the world but it's whackadoodles like that person that absolutely NEED to be watched very, VERY closely.

[Vidar]

55. The placebo effect is extremely well documented. Belief in a

medication's efficacy, regardless of of its real curative powers, lessons symptoms 42% of the time.

[Hannah Bell]

56. if the drug is no more effective than placebo for illness x, the standard conclusion is that

the drug is ineffective v. illness x, not that placebos are getting more effective or humans are evolving.

occam's razor: their drug doesn't work.