Sacred Disorder | Cliff Bostock's blog – 'Finally, I came to regard as sacred the disorder of my mind' (Rimbaud)

Obecalp, that’s ‘placebo’ spelled backwards

ObecalpSeveral studies, including a recent one based on drug companies’ own research, have concluded that antidepressants don’t work any better than placebos in the treatment of mild depression. (They do have measurable effects on cases of severe depression.)

The problem of course is how to make use of the placebo effect in real life, since a belief in the placebo’s efficacy is usually considered central to its success. Arguably, a lot of alternative therapies rely on the placebo effect, as does faith healing.

When I was a kid, my mother would occasionally give us homeopathic remedies, especially arnica for injuries. Some people argue that homeopathy depends on the placebo effect, while others dispute that. I’m not sure.

Now, a woman in Maryland has developed a placebo for use with children. It’s called Obecalp — that’s “placebo” spelled backward — and it’s creating lots of controversy. One argument is that in most double-blind tests that involve a placebo, neither the patient nor the researcher knows who is getting what. In the use of Obecalp, the parent knows, of course.

This raises not only questions about methodology but ethical matters for some. Is it right to lie to the child? Does use of a placebo tend to make kids dependent on drugs for every ailment?

Meanwhile, some interesting research has developed to suggest that placebos may work even when the subject does know she is taking one. Says The New York Times:

At least one study has shown that placebos can be effective even when the patients know that they are inert. In a study in 2007, 70 children with attention deficit hyperactivity disorder were asked to reduce their medications gradually by replacing some of their drugs with placebo pills. The children and their parents were explicitly told that these “dose extender” pills contained no drug.

After three months, 80 percent of the children reported that the placebo had helped them. Although that study used a placebo in a different context from Obecalp, it did suggest that deception might not be necessary for a placebo to work, said the senior author, Gail Geller, a bioethicist at the Berman Institute of Bioethics at Johns Hopkins.

Read the entire article here. One of the interesting, if unintended, aspects of the story is the moralism that comes through with some of the consulted medical people. Who would have imagined medical people being moralistic? (Yes, that’s sarcasm.)

More: Apparently, the Veterans Administration has discovered Obecalp. Read one veteran’s story about it here.

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