Monday, December 27, 2010

Placebo Rocks

Apparently, results of a recently published study* suggest that placebo works (sometimes) even when the patient knows he's getting (only) placebo.


How did they measure compliance? serum placebo levels?
Maybe patients just have to THINK you're a doctor. This could end the physician shortage.
Can we compare placebo to psychotherapy?
Does it work with kids? at what age? by proxy via parents?
Works for what? If you give a patient placebo for one illness will it cure a concurrent illness a well?
Placebo effect apparently varies, eg I recall ~60% for Germans ~30% for Brazilians. Will these distinctions hold?
Have we discovered a "psychological marker?" Response to placebo means it was "all in your head?"
Will Medco require prior authorization for placebo prescriptions?
Will we have to wait seven years for generic placebos?
Will manufacturers of placebo pay leading physicians to use their names on ghost-written publications that exaggerate benefits and play down risks?
Will physicians consider it ethical to accept pens and free meals from placebo reps?
Will placebo sold on the street be cut with other materials to increase profits for dealers?
Will Teva generic placebos work as well as or better than other generics?
Will over-the-counter placebos work as well as prescription placebos?
Will emergency rooms be flooded with placebo overdoses?
Will placebos effectively treat drug addiction? Internet addiction? Addiction addiction?
Will placebos effectively treat drug withdrawal?
Will people become addicted to placebos? (Placebo Anonymous?)
Will placebo work if you don't know you're taking it? if someone puts it in your food without your knowledge? Will placebo become the new date-rape drug?
Will there be a new spate of DUI (driving under the influence of placebo) offenses?
Will spies carry suicide placebos to use if they get caught?
Will insurgent groups use money from illicit sales of placebo to finance overthrow of regimes?
Will we need a PEA (Placebo Enforcement Administration)?
Will natural placebo be safer than synthetic placebo?
Will we be able to treat allergic reactions to placebo with another placebo?
Will placebo work better if you smoke it instead of eating it in brownies?

*Kaptchuk TJ, Friedlander E, Kelley JM, Sanchez MN, Kokkotou E, et al. (2010) Placebos without Deception: A Randomized Controlled Trial in Irritable Bowel Syndrome. PLoS ONE 5(12): e15591. doi:10.1371/journal.pone.0015591

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