Do Placebos Really Exist?

Photo: Ragesoss (CC)

Photo: Ragesoss (CC)

From ScienceDaily:

The thinking behind relying on placebo-controlled trials is this: to be sure a treatment itself is effective, one needs to compare people whose only difference is whether or not they are taking the drug. Both groups should equally think they are on the drug — to protect against effects of factors like expectation. So study participants are allocated “randomly” to the drug or a “placebo” — a pill that might be mistaken for the active drug but is inert.

But, according to the paper’s author, Beatrice Golomb, MD, PhD, associate professor of medicine at the University of California, San Diego School of Medicine, this standard has a fundamental problem, “there isn’t anything actually known to be physiologically inert. On top of that, there are no regulations about what goes into placebos, and what is in them is often determined by the makers of the drug being studied, who have a vested interest in the outcome. And there has been no expectation that placebos’ composition be disclosed. At least then readers of the study might make up their own mind about whether the ingredients in the placebo might affect the interpretation of the study.”

Golomb pointed out these limitations to the placebo in a pair of letters to the journal Nature 15 years ago.

“A positive or negative effect of the placebo can lead to the misleading appearance of a negative or positive effect of the drug,” she said. “And an effect in the same direction as the drug can lead a true effect of the drug to be lost. These concerns aren’t just theoretical. Where the composition has been disclosed, the ingredients of the placebo have in some instances had a likely impact on the result of the study — in either direction (obscuring a real effect, or creating a spurious one). In the cases we know about, this is not because of any willful manipulation, but because it can in fact be difficult to come up with a placebo that does not have some kind of problem.”

Read more here.

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  • http://voxmagi-necessarywords.blogspot.com/ VoxMagi

    Now thats a worrisome thought…but it would go a long way toward explaining the lousy performance of certain drugs that seemed to work so much better in trials. I’m sure in most cases the placebo is completely appropriate and largely as inert as possible…but given the long track record of rushing to market under serious pressure from shareholders…you can be sure that someone may have abused the system on more than a few occasions. The worst part is that its almost impossible to untangle whats been done in the past…especially with regard to placebos that weren’t carefully monitored at the time of study. Ugh.

  • http://voxmagi-necessarywords.blogspot.com/ VoxMagi

    Now thats a worrisome thought…but it would go a long way toward explaining the lousy performance of certain drugs that seemed to work so much better in trials. I’m sure in most cases the placebo is completely appropriate and largely as inert as possible…but given the long track record of rushing to market under serious pressure from shareholders…you can be sure that someone may have abused the system on more than a few occasions. The worst part is that its almost impossible to untangle whats been done in the past…especially with regard to placebos that weren’t carefully monitored at the time of study. Ugh.

  • Ken Vallario

    i wrote an essay on this topic called “The Question of Sanity and the Anti-Placebo”, it’s part of a novel i’m working on but this essay stands alone, check it out:

    http://www.kenvallario.com/Site/FreemanPaper.html

  • Ken Vallario

    i wrote an essay on this topic called “The Question of Sanity and the Anti-Placebo”, it’s part of a novel i’m working on but this essay stands alone, check it out:

    http://www.kenvallario.com/Site/FreemanPaper.html

  • Anonymous

    A case of ‘good science’ being highjacked by ‘corporate science’. I have always been flabergasted at how the pharmaceutical cartels can self regulate their testing procedures.
    I can remember placebos being referred to as sugar pills. Not inert, but surely completely different than the test drug.

  • oman28

    A case of ‘good science’ being highjacked by ‘corporate science’. I have always been flabergasted at how the pharmaceutical cartels can self regulate their testing procedures.
    I can remember placebos being referred to as sugar pills. Not inert, but surely completely different than the test drug.

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