3 ms·

The placebo effect is a helluva drug

Broken_Hippo 4y ago
No, it really isn't. Its help rate can be as low as 15%. Using anything that is only 15% effective as a drug is not only not effective, but can easily be mistreatment. Most of the time, you have to lie to the patient so they can get an effect (IF they get it at all) and then you often have a drug that is consistently more effective than the placebo. It isn't a helluva drug. It is a bad drug that often simply won't work for you.
- Pyramus 4y ago
  It can be. And it's not all positive. The nocebo effect can be so strong, that people actually die because they think they are cursed (other examples: Covid vaccines, statins, ...). Any generalised statement about the effect of placebo/nocebo is difficult, because some portion of the effect is regression to the mean, and relatively little is known about the mechanism of action (e.g. there is some indication about a genetic factor). Not disagreeing with you that it may not work for you, but it may work quite well for some people. Acupuncture being a prime example.
  - deleted 4y ago
    [deleted]
- donthellbanme 4y ago
  We need to throw out Allopatic medicine that does not work, along with Acupuncture, Chiropractic, Naturopathic, Osteopathic bad healing techniques that work slightly better than Placebo in an Indian village in studies with less than 100 poor souls, and a questionable Control group, and rumors of payola floating around. Meaning enough with the bullshit remedies that don't work. Most Psychiatry drugs are on my hit list. I can't believe these $450 a visit fancy boys are allowed to prescribe 90% of their bread and butter drugs. I'm not just picking on shrinks either, but they are an easy target. I am beyond disillusioned that our FDA has approved drugs that are harmfully and actually don't work. (Former Chiropractic student who walked out after hearing, "We have over 15 upper cervical techniques--and they all work Equally well.") Enough is enough.
  - ncmncm 4y ago
    Then it is a good thing you have no say in our access to psychiatric pharmaceuticals. The only way known to distinguish one variety of depression from at least a half-dozen others is to see which medication relieves it. So, any RCT of a depression treatment necessarily throws together people with a half-dozen or more independent conditions, some of which might be relieved by the treatment, others worsened. Repeat after me: RCT results depend absolutely on precise and correct diagnosis. If you cannot diagnose, you cannot design a valid RCT. Invalid RCTs are easy, though; people run those all the time. The RCTs that seem to prove psychiatric drugs are ineffectual are exactly those. We are in the condition of people getting arm and leg fractures, but we can't tell where. Splinting is seen to help; doctors who put splints on various places usually hit on a place where it manifestly helps. But our RCTs of splints placed on left shinbones seem to help only a precious few of our patients. Some people swear up and down, loudly and repeatedly, that they are dead certain this means splints are useless and a big scam.

No, it really isn't. Its help rate can be as low as 15%. Using anything that is only 15% effective as a drug is not only not effective, but can easily be mistreatment. Most of the time, you have to lie to the patient so they can get an effect (IF they get it at all) and then you often have a drug that is consistently more effective than the placebo. It isn't a helluva drug. It is a bad drug that often simply won't work for you.

Pyramus 4y ago
It can be. And it's not all positive. The nocebo effect can be so strong, that people actually die because they think they are cursed (other examples: Covid vaccines, statins, ...). Any generalised statement about the effect of placebo/nocebo is difficult, because some portion of the effect is regression to the mean, and relatively little is known about the mechanism of action (e.g. there is some indication about a genetic factor). Not disagreeing with you that it may not work for you, but it may work quite well for some people. Acupuncture being a prime example.
- deleted 4y ago
  [deleted]
donthellbanme 4y ago
We need to throw out Allopatic medicine that does not work, along with Acupuncture, Chiropractic, Naturopathic, Osteopathic bad healing techniques that work slightly better than Placebo in an Indian village in studies with less than 100 poor souls, and a questionable Control group, and rumors of payola floating around. Meaning enough with the bullshit remedies that don't work. Most Psychiatry drugs are on my hit list. I can't believe these $450 a visit fancy boys are allowed to prescribe 90% of their bread and butter drugs. I'm not just picking on shrinks either, but they are an easy target. I am beyond disillusioned that our FDA has approved drugs that are harmfully and actually don't work. (Former Chiropractic student who walked out after hearing, "We have over 15 upper cervical techniques--and they all work Equally well.") Enough is enough.
- ncmncm 4y ago
  Then it is a good thing you have no say in our access to psychiatric pharmaceuticals. The only way known to distinguish one variety of depression from at least a half-dozen others is to see which medication relieves it. So, any RCT of a depression treatment necessarily throws together people with a half-dozen or more independent conditions, some of which might be relieved by the treatment, others worsened. Repeat after me: RCT results depend absolutely on precise and correct diagnosis. If you cannot diagnose, you cannot design a valid RCT. Invalid RCTs are easy, though; people run those all the time. The RCTs that seem to prove psychiatric drugs are ineffectual are exactly those. We are in the condition of people getting arm and leg fractures, but we can't tell where. Splinting is seen to help; doctors who put splints on various places usually hit on a place where it manifestly helps. But our RCTs of splints placed on left shinbones seem to help only a precious few of our patients. Some people swear up and down, loudly and repeatedly, that they are dead certain this means splints are useless and a big scam.