ArticlesI just had, not one but, two odd thoughts in the shower this morning.
I was pondering the biochemistry of the placebo effect. When you think about it, it is kind of weird that your mental state – how confident you are that you will be getting better – can affect your actual healing process.
I wondered if one day, some team of biochemists would announce to the world that they had discovered exactly how the process worked – that being hopeful pumped hormone X into your blood, that feeling confident inhibited neurotransmitter Y, and that this affected the healing process.
Perhaps they could produce a pill! One which genuinely invoked the same biochemistry of the placebo effect, without the patient needing to believe that they would get better quickly! That would be revolutionary!
But wait… (The first odd thought hit me.)
…how could you ever clinically test whether it worked? What would the control be?
I pondered the issue a bit more.
Could you tell the patients that the drug had no effect? Why would they agree to take it?
Is it ethical to lie to the patients in the trial? Can you tell them it would help their blood pressure, when it is really to help their Parkinson’s?
Perhaps it would be useful on unconscious patients?
Then the second odd thought occurred to me. I was taking getting a too scientific approach!
I was getting confused trying to reverse the normal demand of a drug trial – proving that it is better than placebo. Rather than admitting I can’t prove my drug is good, I should take the opposite approach: You can’t prove my drug isn’t good. Watch how that works…
- Fire the team of biochemists working on the mechanism of the placebo effect.
- Produce a sugar pill. (There have been studies that show some sizes and colours of placebo work better than others. Use those to design the most effective pill.)
- Package it up as “Pseudo-Placebo”. Explain that it mimics the biochemistry of the placebo effect, and thus enhances your regular treatment regime.
- Put in big letters on the front of the box that it must be used in conjunction with your medical doctor’s recommended treatment. (I am nothing, if not an ethical scammer.)
- Make sure the pharmacist gets a good cut of the margin, so that it gets pushed harder than the other junk they sell.
- Profit!
I’ll be selling the first ever honest snake-oil cure. It actually does what it says it will – invoke the placebo effect to aid healing.
I’ll be rich!
Comment by Alastair on February 4, 2008
Not quite the same as your idea, but nevertheless I must to point you to FairDeal Homeopathy, who describe the workings of their product thus:
Comment by Jonathon Duerig on February 6, 2008
I like you’re first idea better. But you test it simply. First split the patients into two groups, the control, and the test group. Of course it has to be double blind. Now, you give sugar pills to half and the hormone/whatever-inducers to the other half. And everybody is told that they are taking sugar pills which won’t have an effect. This should allow a definitive answer.
-D
Comment by Julian on February 6, 2008
Jonathon,
Would you get compliance issues? Suppose you were sick and I handed you some pills would have no effect.
If you really believed me, wouldn’t you stop taking the pills? And if you didn’t believe me, wouldn’t that ruin the experiment?
Hmmm… if I *paid* you to take them anyway, and could observe you taking them, maybe that *would* work….
Comment by Julian on March 2, 2008
Via Bad Science comes this 1965 exploratory study, in which they persuaded 14 of 15 neurotic adults to take placebos which were clearly explained to be just sugar pills.
I am largely ignoring the results of the study (The lack of a control group made it is unclear how well the placebo did compared to absolutely no action and against secret placebos) but the fact that they got such a large compliance rate indicates Jonathon’s suggestion could work despite my protestations.
Comment by Julian on September 1, 2010
For once, I wasn’t the last person to riff on an idea.