The Placebo Effect–Myth vs. Science

Background

There has been a large uptick in interest about the so-called placebo effect, mostly from the complementary and alternative junk medicine (CAM) crowd. Evidently, they feel that being equivalent to doing nothing is good enough to be real. A recent article in the Wall Street JournalWhy Placebos Work Wonders, is indicative of this recent pro-placebo point-of-view.  

What exactly is the placebo effect? The definition is often misused, implying some beneficial effect from a sugar pill or sham treatment. But in medicine, a placebo is actually a failure. If a new pharmaceutical, procedure or medical device shows no difference in efficacy compared to a placebo, then it is rejected.  But the CAM-pushing herd thinks that proves its a success when one of its potions and lotions is equivalent to a placebo. What? A failure of a modality in evidence-based medicine is somehow converted into a successful product in the CAM world?

Continue reading “The Placebo Effect–Myth vs. Science”

Placebos cannot replace antipsychotics

As I’ve discussed previously, placebo effects are mostly a myth, and if a new drug has an effect barely above that of a mythical placebo effect, it’s considered a failure. In a recent article in Reuters Health, Rising placebo response seen in schizophrenia trials, Amy Norton states that clinical trials of anti-schizophrenia drugs, in a class of drugs called antipsychotics, are finding lesser effects because patients are responding positively to placebos (that presumably does not contain anything but sugar).

Treating schizophrenia or any psychosis is difficult because different patients respond in different ways to each drug. For some individuals, these drugs can treat many of the symptoms of schizophrenia, including hallucinations and delusions, which allows them to live relatively normal lives. But for some individuals these same drugs have significant side effects, including sedation, weight gain, and hyperglycemia (which can be serious for a diabetic). Eventually, individuals stop using the drugs because of the side effects and their psychotic symptoms return. Continue reading “Placebos cannot replace antipsychotics”

A homeopath discusses evidence based homeopathy–except no evidence

I ran across a blog that is titled Homeopathy: Science Modern Evidencebased (sic). Since any reasonable person would understand that homeopathy violates some of the basic principles of physics, chemistry and biology. And because there is no viable mechanism that would make you think homeopathy actually could work, clinical trials show that it doesn’t work, or, at best, it is a mythical placebo. So, if it doesn’t work in clinical trials, and there is no possible mechanism underlying it, employing Occam’s Razor, we would have to say the simplest explanation is the best: Homeopathy does not work. It’s a lie. It’s a scam. Period. End of story.

But you want more. You want real explanations.   Continue reading “A homeopath discusses evidence based homeopathy–except no evidence”

The Placebo Myth from Science Based Medicine

While doing some research on the placebo non-effect, I found this article, The Placebo Myth, by Mark Crislip (an infectious disease specialist), in the Science Based Medicine blog.  He makes a simple and effective question which debunks the “placebo effect”:  “why would actively doing nothing have any measurable physiologic effect? It shouldn’t and it doesn’t. Mind over matter? Bah, humbug.”  He continues, “I think that the placebo effect with pain is a mild example of cognitive behavioral therapy; the pain stays the same, it is the emotional response that is altered.”  So, it’s talking therapy (albeit not very focused), not a sugar pill that works. Continue reading “The Placebo Myth from Science Based Medicine”

How the placebo effect proves nothing and means nothing

Recently, there has been a large uptick in interest about the so-called placebo effect, mostly from the complementary and alternative junk medicine (CAM) crowd.  Evidently, they feel that being equivalent to doing nothing is good enough to be real.  A recent article in the Wall Street Journal, Why Placebos Work Wonders, is indicative of this recent pro-placebo point-of-view.  I’ve got other bones to pick with WSJ on global warming, but I’ll save that for another day.

What exactly is the placebo effect?  The definition is often misused, implying some beneficial effect from a sugar pill or sham treatment.  But in medicine, a placebo is actually a failure.  If a new pharmaceutical, procedure or medical device shows no difference in efficacy compared to a placebo, then it is rejected.  But the CAM-pushing herd thinks that proves its a success when one of its potions and lotions is equivalent to a placebo.  What?  A failure of a modality in evidence-based medicine is somehow converted into a successful product in the CAM world? Continue reading “How the placebo effect proves nothing and means nothing”

Study: Vaccine against bacterial meningitis shows promise

Study: Vaccine against bacterial meningitis shows promise – USATODAY.com.

The study is published in the Lancet (how ironic), and the conclusions (from the original study) state that 91-100% of participants (who received the vaccine) had high titers of antibodies for each strain of meningococcal B.  By the way, the placebo group were in the 29-50% range for the placebo group.

Just in case you might wonder if there’s a placebo effect that causes an immune response to the bacteria, it’s probably not.  There is usually a background seropositive individuals in a population, since individuals may be exposed to the bacteria on a usual basis.  Even at 50%, the risk is so high that the vaccine (which is nearly 100% effective) is still necessary.

One more conclusion from the authors of the Lancet article:

No vaccine-related serious adverse events were reported and no significant safety signals were identified.

Just in case anyone was wondering.