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Placebo Nation

Thursday, February 28, 2008 - 05:27 PM

Jonah Lehrer, a frequent Radio Lab contributor, had some interesting things to say on his blog about a topic we've explored, the placebo effect.

Lots of attention has been paid to the latest review/meta-analysis demonstrating that popular antidepressant medications don't seem to be that much more effective than placebos. While this certainly isn't the first time someone has demonstrated that Prozac is only mildly more useful than a sugar pill (unless, that is, you fall into the 'severely depressed' category), this review was noteworthy because it consisted mainly of previously unpublished studies done by the drug makers before the drugs were put on sale.

He goes on to make a very interesting point about this study: that it is a meta-study which analyzes the results of multiple trials to glean some insight on prozac vs. placebo in a very short timeframe: 6-8 weeks. Essentially, there has been a well observed placebo effect in treating depression, but that affect diminishes over time and the drug then performs better. It's notable to me that the placebo is so effective in treating depression in the first place, and the thing Jonah points out is downright fascinating:

And then there's the meta problem of meta-analyses like this. If a large percentage of the SSRI benefit comes from the placebo effect - people expect the drug to work, and so it works - then learning that Prozac isn't actually that effective might actually make it less effective. It's long been recognized that both placebo response and drug response for antidepressants have steadily increased over time. Much of this increase is most likely due to marketing. People have been trained by Eli Lilly's ads to believe that a little blue pill will make them less depressed, and so they end up significantly less depressed. A little self-delusion might not be such a bad thing after all.

Which brings us right back to Soren's post from yesterday. How is it that we keep stumbling into information about how delusion is positive? Who knew?

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Comments [2]

Max

To convince people to still take SSRIs I think that doctor's are taking the tactic of pointing out a placebo's effectiveness does indeed die out, well the SSRI's don't. Well, my doctor is doing that anyway.

I'm just starting on antidepressants for the second time, and my doctor made a major point that this study doesn't completely disprove them.

Don't know what my point is, just that I find it interesting that me and everyone else in the public seems to have heard about this study.

Mar. 20 2008 03:05 PM
REkzkaRZ

I don't appreciate your arguments calling belief delusion.

I'm not a religious person, but humans are creatures of belief. We frame our realities in cages constructed of beliefs.

Before atoms were other concepts of matter, and surely there will be concepts later disproving our current beliefs.

The placebo-effect is not proof that delusion / deception are effective, it is the proof of the power of the human mind and belief.

Radiolab's mis-direction on this area is deeply upsetting.

rekzkarz.com

Mar. 05 2008 02:08 AM

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