Sep 7 2009

Drug companies have real problem: human body can heal itself

Somehow I frequently get involved in conversations about drugs.

I’m generally a ‘mind-over-matter, you can control your body if only you know how’ type, which I think people find insulting because they think that I’m saying that they’re responsible for their condition (which I’m not).

I have always had an acute interest in the placebo effect; it’s amazing to me that this well documented phenomena is not more widely used in treatment and that there aren’t people working on how to make the effect stronger. My interest was peaked earlier this week when Ian mentioned off-handedly that the placebo effect has been getting stronger over the last few years and that many drugs are having difficulty getting to market because their effects can not be meaningfully differentiated from the effects of the placebo.

Tonight I saw this article on Wired, which gives a pretty high-level summary of the situation. I was pleased to find out that there are indeed researchers working on strengthening the placebo effect and that in fact many physicians claim to use it (although not really in the way I was talking about above).

I also read a more medical-focused dialog about the Wired article here (the comments have a pretty good back-and-forth as well, although it gets technical at times).

Lastly, I found this on Wikipedia and thought it interesting:

Depression
A meta-analysis in 1998 found that 75% of the effectiveness of anti-depressant medication is due to the placebo-effect rather than the treatment itself. A meta-analysis in 2008 found that 79% of depressed patients receiving placebo remained well compared to 93% of those receiving antidepressants for the effect of placebos (for 12 weeks after an initial 6–8 weeks of successful therapy). Another meta-analysis in 2002 found a 30% reduction in suicide and attempted suicide in the placebo groups compared to a 40% reduction in the treated groups.

A 2002 article in The Washington Post titled “Against Depression, a Sugar Pill Is Hard to Beat” summarized research as follows, “in the majority of trials conducted by drug companies in recent decades, sugar pills have done as well as — or better than — antidepressants. Companies have had to conduct numerous trials to get two that show a positive result, which is the Food and Drug Administration’s minimum for approval. the makers of Prozac had to run five trials to obtain two that were positive, and the makers of Paxil and Zoloft had to run even more”.

A few places talked about the geographical significance of the drug-effectiveness studies as well as simply our susceptibility to effective drug marketing. It’s a funny thought that little capsules will make us subjectively “feel better” in part because we live in a culture that tells us that “taking little capsules will make us feel better.”