It’s a placebo placebo!

I find that the study muddies the waters a bit. My understanding of the placebo effect is that it’s dependent on the fact that there is an intervention, a ritual, like the doctor handing out pills. So by handing out a placebo, the ritual is performed, and the placebo effect can take place.

In my opinion, a better study would dispense medication by vending machine (no human interaction), and randomly either provide pills labelled “placebo” with an explanation of the word, or pills labelled “medicine”, or blank pills. If there’s a difference between the groups, it’d be dependent on their understanding of what they’re taking, not so much the ritual involved in administering the pill.

Would increasing the dosage help?

http://en.wikipedia.org/wiki/Hawthorne_effect

“The workers’ productivity seemed to improve when changes were made and slumped when the study was concluded. It was suggested that the productivity gain was due to the motivational effect of the interest being shown in them.”

I.e. in a normal study, the control group would be experiencing the effects of the placebo alone because everyone in the study has the same expectation of efficacy. In this case, the control group had zero expectation of efficacy because they knew they weren’t receiving treatment. So the way I see it, all this study did was test the effectiveness of a degree of belief, not the effectiveness of an actual placebo pill.

It is surprising that people can be aware of the placebo and still feel the effects. However, that has a lot to do with the people. I´m sure we all know people that do things that are seemingly irrational and yet it works for them, despite them admitting outright that they know it doesn´t make sense. Yet me, for example, as much as I believe in the power of belief, because I’m “aware of the strings” so to speak, it never works. I´m too much of a skeptic… yet the things that I do genuinely believe, even when I have no way to prove them, are 100% dependable.

In short, the power of the mind is something way greater than we really understand, and I wonder if, in this case, ignorance is bliss. Perhaps, the more we know, the less it will work…?

The Placebo effect is that the patient believes they are getting a real drug. So if the patient thinks the Doctor is lying to them about getting a placebo, and instead believe they are actually getting a real drug, then the Placebo Effect still holds true.

After all, the whole study is about the effectiveness of lying.

Patients may not feel better, but may unconsciously report improvements or downplay problems to please the researchers interviewing them. Researchers may let their biases shine though and see an improvement somewhere it isn’t (thus making a placebo effect possible even in animal studies). I don’t know anything about the tools being used to collect data, but if they rely upon subjective or subject-reported information that immediately casts a lot of doubt on the idea that these people are seeing meaningful improvement.

I’m currently a research assistant for a randomised double-blind placebo-controlled trial for high dose multi-vitamin and mineral supplements for the treatment of adult ADHD. It has been a very interesting experience, and if the results turn out the way the principle investigator expects, your may hear about it in about a year’s time.

Just want to point out that the trial was actually not placebo vs. drug, it was “we’re giving you a sugar pill that will have no pharmacological effect but may actually help you anyway” vs. “we’re not giving you anything other than the same doctor visits the people in the other arm get.”

That’s what makes this study novel and kind of fascinating. All previous comparisons have been placebo vs. actual drug (in which case, the drug is shown to not be beneficial) or blinded placebo studies where people didn’t know they weren’t getting a potentially bioactive drug. Here, nobody’s getting anything, and everybody knows it. And STILL the placebo worked. That’s the awesome part.

I also wonder if the placebo effect is most dominantly effective on maladies that are induced by the nocebo effect; the mind causing damage to the body.