From: Andrew Johnson
Date: 2009-09-22 07:57:37
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“sans-serif”;COLOR:#1f497d;} #ygrps-yiv-1476028340 .ygrps-yiv-1476028340MsoChpDefault { FONT-SIZE:10pt;} #ygrps-yiv-1476028340 DIV.ygrps-yiv-1476028340Section1 { } #ygrps-yiv-1476028340 OL { MARGIN-BOTTOM:0in;} #ygrps-yiv-1476028340 UL { MARGIN-BOTTOM:0in;} From: Ernest Hotmail [mailto:ernestvm@hotmail.com] Sent: 22 September 2009 03:47To: Ernest HotmailSubject: The placebo problem Big Pharma’s desperate to solve The fact that an increasing number of medications are unable to beat sugar pills has thrown the industry into crisis. The stakes could hardly be higher. In today’s economy, the fate of a long-established company can hang on the outcome of a handful of tests. Why are inert pills suddenly overwhelming promising new drugs and established medicines alike? The reasons are only just beginning to be understood. A network of independent researchers is doggedly uncovering the inner workings – and potential therapeutic applications – of the placebo effect. In interviews with the press, Edward Scolnick, Merck’s research director, laid out his battle plan to restore the firm to pre-eminence. Key to his strategy was expanding the company’s reach into the antidepressant market, where Merck had lagged while competitors like Pfizer and GlaxoSmithKline created some of the best-selling drugs in the world. “To remain dominant in the future,” he told Forbes, “we need to dominate the central nervous system.” Ironically, Big Pharma’s attempt to dominate the central nervous system has ended up revealing how powerful the brain really is. The placebo response doesn’t care if the catalyst for healing is a triumph of pharmacology, a compassionate therapist, or a syringe of salt water. All it requires is a reasonable expectation of getting better. That’s potent medicine. Nearly half of the doctors polled in a 2007 survey in Chicago admitted to prescribing medications they knew were ineffective for a patient’s condition – or prescribing effective drugs in doses too low to produce actual benefit – in order to provoke a placebo response. It’s not only trials of new drugs that are crossing the futility boundary. Some products that have been on the market for decades, like Prozac, are faltering in more recent follow-up tests. In many cases, these are the compounds that, in the late 90s, made Big Pharma more profitable than Big Oil. But if these same drugs were vetted now, regulators might not approve some of them. Two comprehensive analyses of antidepressant trials have uncovered a dramatic increase in placebo response since the 80s. One estimated that the so-called effect size (a measure of statistical significance) in placebo groups had nearly doubled over that time. It’s not that the old meds are getting weaker, drug developers say. It’s as if the placebo effect is somehow getting stronger. Further research by Benedetti and others showed that the promise of treatment activates areas of the brain involved in weighing the significance of events and the seriousness of threats. “If a fire alarm goes off and you see smoke, you know something bad is going to happen and you get ready to escape,” explains Tor Wager, a neuroscientist at Columbia University. “Expectations about pain and pain relief work in a similar way. Placebo treatments tap into this system and orchestrate the responses in your brain and body accordingly.” In other words, one way that placebo aids recovery is by hacking the mind’s ability to predict the future. One of the most powerful placebogenic triggers is watching someone else experience the benefits of an alleged drug. Researchers call these social aspects of medicine the therapeutic ritual. www.wired.co.uk/wire… No virus found in this incoming message.Checked by AVG – www.avg.comVersion: 8.5.409 / Virus Database: 270.13.111/2386 – Release Date: 09/21/09 17:55:00
