The American Journal of Psychiatry explores the implications for science and ethics of the rising placebo response rate in trials of antipsychotic drugs, in an editorial prompted by this an article in November’s issue, the “largest and most comprehensive meta-analysis to date of the phenomenon of increasing placebo response.”
Agid, O., Siu, C., Potkin, S., Kapur, S.; Meta-Regression Analysis of Placebo Response in Antipsychotic Trials, 1970–2010. American Journal of Psychiatry. November 1, 2013; 170(11) 1335-1344. doi:10.1176/appi.ajp.2013.12030315
Leucht, S., Heres, S., Davis, J.; Increasing Placebo Response in Antipsychotic Drug Trials: Let’s Stop the Vicious Circle. American Journal of Psychiatry. November 1, 2013; 170(11) 1232-1234 doi:10.1176/appi.ajp.2013.13081129
What is interesting about the article and editorial is that in all of the hypothesizing about why the placebo response rate is so hihg. the fail to mention the possiblity that these drugs are not that effective.
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That is because the people who believe the biological model of mental illness, see the problem differently. They believe that the problem is how to design the trial to mend the problem of high placebo response rate. They already believe in a particular outcome. Now they want to find evidence to support the outcome that they believe exists. This is the problem with the profession of psychiatry. They never ask the right questions. Psychiatry is more dogma than science. There was one interesting comparison of the US in this study to other countries.
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I think the term anti-psychotic itself is misleading cause they often just add on the zombie like state of anhedonia to the psychosis.
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My psychiatric uses the term “anti-manic” when trying to sell drug treatment to me. Perhaps a child psychiatrist would call them “anti-ADHD”? Perhaps they’re just “anti-dysfunction” pills that really don’t work very well? They certainly appear to be prescribed for most psychological disorders.
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The sad thing here is that they’re more interested in making the drugs look good than they are in understanding and augmenting the placebo response without dangerous drugs.
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