Posted by Larry Hoover on July 5, 2003, at 8:23:11
In reply to Re: ADs and placebo response: article series., posted by stjames on July 5, 2003, at 0:03:36
> Very cool. I have always thought placebo response
> proves a strong mind/body connection. However,
> many times the effects noted by those receiving
> a placebo in a study are general ones, like headache, so it is hard to prove one causes the other. Here is a very specific placebo response
> noted in the study:
>
> Asthmatic patients have been shown to exhibit bronchoconstriction after inhaling a placebo described as a bronchoconstrictor and brochodilation after inhaling a placebo described as a bronchodilator
>
> To me this suuports the benifit of psychological
> thearpy, meditation, ect in treating conditions
> that are medical in orgin.Absolutely, the mind set and supportive elements of the subject are of supreme importance. In a clinical trial, subjects in the placebo arm aren't just mailed a sugar pill. They have all sorts of positive and supportive experiences.
From another similar report:
From http://www.psychiatrictimes.com/p000429.html, written by Dr. Khan.
"The less-than-impressive results in these and other studies also calls to
mind the fact that patients assigned to placebo treatment in clinical trials
are not "getting nothing." The capsule they receive is pharmacologically
inert but hardly inert with respect to its symbolic value and its power as a
conditioned stimulus. In addition, placebo-treated patients receive all of
the commonly employed treatment techniques: a thorough evaluation; an
explanation for their distress; an expert healer; a plausible treatment;
expectation of improvement; a healer's commitment, enthusiasm and positive
regard; and an opportunity to verbalize their distress. "He goes on to include a very important warning about the interpretation of
his findings. Note particularly the concluding statement."A cautionary note is indicated about the generalization of these data to
the clinical management of depressed patients. The less-than-impressive
difference between drug and placebo in this and other studies of clinical
trials does not speak directly to the effectiveness of antidepressants in
clinical practice. Participants in antidepressant clinical trials are a
highly select group and are not representative of the general population of
depressed patients. They are not actively suicidal, they are almost always
outpatients who are moderately rather than severely or mildly depressed, and
they are free of comorbid physical or psychiatric illness. They are likely
to have a higher placebo response rate than more severely ill depressed
patients. ""Furthermore, the primary aim of these studies is not to assess the optimal
effect of antidepressants, but rather to rapidly assess efficacy of new
drugs so they can be brought to the market. Therefore, dose, duration and
diagnosis in clinical trials are not necessarily ideally suited to identify
the optimal effects of antidepressants. Accordingly, clinical trials may
identify the lower bound of the effect size compared to placebo. "
poster:Larry Hoover
thread:239351
URL: http://www.dr-bob.org/babble/20030701/msgs/239455.html