Take two placebos and call me in the morning.

By mw | Related entries in Drugs, Health Care, Science

Choose the red pill, the blue pill, or the placebo.

This story has me wondering if I’ve fallen through a portal into a parallel bizarro world.

Most people are familiar with the “placebo effect” – people who believe they are being treated for an ailment can show improvement or be cured, even if the treatment consists of sugar pills. This is the hurdle pharmaceutical companies must clear when testing a new drug. To be proven effective, a drug must be shown to be more effective than a placebo. Apparently the bar is getting higher.

Steve Silberman reports in Wired that placebos are statistically getting stronger and more effective:

“Last November, a new type of gene therapy for Parkinson’s disease, championed by the Michael J. Fox Foundation, was abruptly withdrawn from Phase II trials after unexpectedly tanking against placebo. A stem-cell startup called Osiris Therapeutics got a drubbing on Wall Street in March, when it suspended trials of its pill for Crohn’s disease, an intestinal ailment, citing an “unusually high” response to placebo. Two days later, Eli Lilly broke off testing of a much-touted new drug for schizophrenia when volunteers showed double the expected level of placebo response.

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.”

This is a problem for Big Pharma, who are spending millions designing drugs that are not as effective as the astonishing curative power of belief in a sugar pill. Silberman described the effect in a CNBC interview on Monday:

With billions at stake, drug companies are apparently tinkering with a pill’s color, shape, name and labeling in the hope of building a better, more effective um… placebo. Again from the article:

“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.”


“Reality is that which, when you stop believing in it, doesn’t go away.” – Philip K. Dick

This entry was posted on Monday, August 31st, 2009 and is filed under Drugs, Health Care, Science. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

6 Responses to “Take two placebos and call me in the morning.”

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  2. gerryf Says:

    Doesn’t surprise me–we are a much more gullible and empassioned people, in many respects. Given the fervor with which people will believe anything these days (Obama is not a US citizen, Iran was behind 9-11, Iran had WMD, FOX News is fair and balaced, Sarah Palin was opposed to taking largesse from Washington, etc), and given how people cling to these notions despite obvious facts to the contrary, all one needs to do is accept that the mind is a powerful curative.

  3. Eimajine Says:

    What about the possibility that more people believe they’re sick than really are? If an illness is “in your head,” then the cure can be, too. I know far too many people who are defined by their illness(es). I don’t think they’d have anything to talk about if they were well. It wouldn’t surprise me if some of these people’s conditions improved after taking a placebo. As long as they still have something to talk about – their doctor, their treatment, etc.

    I know that may not be the complete answer to the increase in the effectiveness of placebos. There’s likely to be something else going on, too. It will be interesting to see what future studies find.

  4. mw Says:

    Certainly a possibility. But these are scientific studies of screened subjects that Silberman references, not anecdotes, and he is reporting a real and large statistical shift. Don’t you have to assume that the people who are screened for these studies actually have a diagnosed affliction? And what to make of follow-up studies that show drugs that were once shown to be more effective than placebo, now are not?

    I am leaning the other way, that some drugs being developed and promoted are actually far less than meets the eye, that much of their clinical benefit actually derives from a “placebo effect”. They are in effect – super placebos, benefiting from the same mechanism, but designed to enhance the effect through packaging and marketing. One could make the case that the kind of saturation drug advertising we’ve seen in recent years,increases and reinforces a pervasive belief system – a belief that the solution to all of life’s ills, can be found in a pill.

  5. kranky kritter Says:

    Don’t you have to assume that the people who are screened for these studies actually have a diagnosed affliction?

    Good point, I think you do. But what sorts of diagnosed afflictions? Don’t you have to wonder what the effectiveness of placebos is against depression and anxiety and insomnia and other mental afflictions as opposed to a drug that treats your cholesterol level?

  6. christmas present Says:

    A bit harsh some of the comments, we’re not taking into account the human body’s ability to repair itself. Terms like “healthy mind a healthy body” “a laugh a day keeps the doctor away” have all proved good medicine in the past. Then you also have to take into account alternative and complementary medicine, which is not really my cup of tea but some people rave about Reiki, also how easy is it to stop a child crying after a fall, depending on what the parent does or says can sometimes depend on the child’s reaction even when there is a genuine “minor” injury, would that the placebo?

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