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> The picture that emerges is that a placebo pill has almost no effect when administered by researchers who do not care about the placebo effect, but the exact

> The picture that emerges is that a placebo pill has almost no effect when administered by researchers who do not care about the placebo effect, but the exact same pill has an enormous effect larger than all existing treatments when administered by a researcher who really wants the placebo effect to be real. Stopped reading right here because it is nonsense. Antidepressant researchers would love nothing more than the 30-50% placebo response rate to go away and yet there it is, competing with whatever tiny effect their pill does.

Filligree 2y ago
Although there is an obvious reason why the placebo effect would be stronger for psychological issues.
- Xelynega 2y ago
  Also the entire point the post makes is that these studies are flawed. Where is this person getting the idea that antidepressant companies are competing with placebos?
  - griffzhowl 2y ago
    To bring a drug to market it has to be demonstrated as being more effective than a placebo
    - ta988 2y ago
      not necessarily. It can be against another existing drug.
      - PeterStuer 2y ago
        That were already proven to be stronger than placebo?
        NeuroCoder 2y ago
        Usually we test against best current treatment and not just always against placebo. If something clearly improves outcomes for a patient, it's unethical to not give them a treatment so that you can test your new intervention against a placebo.
        PeterStuer 2y ago
        I meant if A>B and B>placebo, would that not imply A>placebo?
    - Filligree 2y ago
      Most doctors don't prescribe placebos, and may not even be allowed to. Even though a placebo might very well work. Placebos are ideal drugs in some cases. Effective, no side-effects...
V__ 2y ago
Isn't most research also double-blind? Meaning that the "treatments when administered by a researcher who really wants the placebo effect" are also probably badly designed which might be the reason for this effect?
- NemoNobody 2y ago
  The patient needs to have no doubts that have received medicine and the placebo effect will work 30-50% according to the previous comment, which is really close to what I thought. If the patient doubts the effect won't take at all. So that matters but not all for the reasons OP thinks. It matters bc you can heal yourself, ppl literally do it everyday and it is measured by science as the placebo effect but if you don't think you can, you can't.
  - Jabbles 2y ago
    It has been widely reported that placebos can work even if you know it's a placebo: https://www.health.harvard.edu/blog/placebo-can-work-even-know-placebo-201607079926 https://www.health.harvard.edu/blog/placebo-can-work-even-kn...
NemoNobody 2y ago
Right, like this person clearly doesn't understand the placebo effect and wrote a whole article about it
deleted 2y ago
[deleted]
fnordpiglet 2y ago
They summarize their positions clearly in the introduction which is basically on objective observation the placebo effect doesn’t emerge in the physiology but in the self reported effects. While they seem to hold psychology as not relevant because it’s not objectively observable, the less hard ass way to read this is the placebo effect doesn’t produce objectively measurable effects on physiology but it does appear to have a psychological effect. They are positing the psychological effects are confirmation bias and conforming to expectations, but what they don’t address is whether the psychological outcome is real. Depression is greatly impacted by our psychology and whether the effect is due to some social conformity, beliefs, or other non physiological basis, is irrelevant to the efficacy. Ultimately the authors argument is based on the notion that psychology is not real science, because science deals with things you can directly observe, and anything that isn’t real science is false. This is obviously fallacious. Even assuming psychology isn’t a real science, and psychology researchers have done themselves no favors here, the second statement is where the fallacy lies. Well done science is generally not false. But not everything that is true has been explained by science. Something can be true without us knowing the facts of how it works. Psychology requires self reporting by its very nature and as such is subject to all sorts of bias and difficult to control aspects - some impossible to control - and it’s likely some aspects of psychology are cultural and contextual and change with time. This doesn’t make it not real and not true. It just makes it difficult.
photochemsyn 2y ago
I think there's a placebo effect that is related strictly to the human interaction effect - you go to see a doctor, the doctor pays attention to you, you feel like people care about what happens to you, and so your mood improves. I have no idea how to quantify this effect (send pills in the mail with no human interaction?) but it appears to be significant in some cases of depression.
- idunnoman1222 2y ago
  Just randomly pump antidepressants into peoples water supplies and check the suicide rate

Filligree 2y ago

Although there is an obvious reason why the placebo effect would be stronger for psychological issues.

Xelynega 2y ago
Also the entire point the post makes is that these studies are flawed. Where is this person getting the idea that antidepressant companies are competing with placebos?
- griffzhowl 2y ago
  To bring a drug to market it has to be demonstrated as being more effective than a placebo
  - ta988 2y ago
    not necessarily. It can be against another existing drug.
    - PeterStuer 2y ago
      That were already proven to be stronger than placebo?
      - NeuroCoder 2y ago
        Usually we test against best current treatment and not just always against placebo. If something clearly improves outcomes for a patient, it's unethical to not give them a treatment so that you can test your new intervention against a placebo.
        PeterStuer 2y ago
        I meant if A>B and B>placebo, would that not imply A>placebo?
  - Filligree 2y ago
    Most doctors don't prescribe placebos, and may not even be allowed to. Even though a placebo might very well work. Placebos are ideal drugs in some cases. Effective, no side-effects...

V__ 2y ago

Isn't most research also double-blind? Meaning that the "treatments when administered by a researcher who really wants the placebo effect" are also probably badly designed which might be the reason for this effect?

NemoNobody 2y ago
The patient needs to have no doubts that have received medicine and the placebo effect will work 30-50% according to the previous comment, which is really close to what I thought. If the patient doubts the effect won't take at all. So that matters but not all for the reasons OP thinks. It matters bc you can heal yourself, ppl literally do it everyday and it is measured by science as the placebo effect but if you don't think you can, you can't.
- Jabbles 2y ago
  It has been widely reported that placebos can work even if you know it's a placebo: https://www.health.harvard.edu/blog/placebo-can-work-even-know-placebo-201607079926 https://www.health.harvard.edu/blog/placebo-can-work-even-kn...

NemoNobody 2y ago

Right, like this person clearly doesn't understand the placebo effect and wrote a whole article about it

deleted 2y ago

[deleted]

fnordpiglet 2y ago

They summarize their positions clearly in the introduction which is basically on objective observation the placebo effect doesn’t emerge in the physiology but in the self reported effects. While they seem to hold psychology as not relevant because it’s not objectively observable, the less hard ass way to read this is the placebo effect doesn’t produce objectively measurable effects on physiology but it does appear to have a psychological effect. They are positing the psychological effects are confirmation bias and conforming to expectations, but what they don’t address is whether the psychological outcome is real. Depression is greatly impacted by our psychology and whether the effect is due to some social conformity, beliefs, or other non physiological basis, is irrelevant to the efficacy. Ultimately the authors argument is based on the notion that psychology is not real science, because science deals with things you can directly observe, and anything that isn’t real science is false. This is obviously fallacious. Even assuming psychology isn’t a real science, and psychology researchers have done themselves no favors here, the second statement is where the fallacy lies. Well done science is generally not false. But not everything that is true has been explained by science. Something can be true without us knowing the facts of how it works. Psychology requires self reporting by its very nature and as such is subject to all sorts of bias and difficult to control aspects - some impossible to control - and it’s likely some aspects of psychology are cultural and contextual and change with time. This doesn’t make it not real and not true. It just makes it difficult.

photochemsyn 2y ago

I think there's a placebo effect that is related strictly to the human interaction effect - you go to see a doctor, the doctor pays attention to you, you feel like people care about what happens to you, and so your mood improves. I have no idea how to quantify this effect (send pills in the mail with no human interaction?) but it appears to be significant in some cases of depression.

idunnoman1222 2y ago
Just randomly pump antidepressants into peoples water supplies and check the suicide rate