Placebos Are Getting More Effective

The inconvenient science shaking big pharma & how it should change humanity

When I drop the bombshell that antidepressants barely outperform placebos (if at all), people lose their minds. "But it worked for me!" they cry. "I felt different right away!"

Hold up. I'm not saying these pills don't do anything. They absolutely can make you feel different - but so can a sugar pill wrapped in scientific-looking packaging.

In clinical trials, they give half the people the real deal and half a dummy pill. Neither group knows what they're getting. And guess what? The placebo group starts feeling better too. Their mood lifts. Their "depression symptoms" magically improve.

This isn't some new-age mumbo jumbo. It's cold, hard science.

So what's really going on here? Are we tapping into the mind's hidden superpowers? Is Big Pharma pulling a fast one? Or is the truth somewhere in between?

The placebo effect, once hailed as a wartime miracle, has now transformed into the pharmaceutical industry's most formidable adversary. This tale of medical irony begins on the blood-soaked battlefields of World War II, where desperation bred innovation and a simple act of compassion unknowingly set the stage for a scientific revolution.

It was 1944, and the Allied forces were pushing through Italy. Amidst the chaos of combat, an Army nurse found herself in a predicament that would change the course of medical history. The morphine supplies had run dangerously low, and wounded soldiers were crying out for relief. In a moment of quick thinking and deep empathy, the nurse filled a syringe with saline solution—mere salt water—and administered it to a grievously wounded soldier, assuring him it was a powerful painkiller.

To her astonishment, and that of the attending physician, Henry Beecher, the soldier's pain subsided. His body, believing it had received morphine, produced its own natural painkillers. This wasn't just pain relief—it was a profound demonstration of the mind's power over the body, triggered by nothing more than belief and expectation.

Beecher, a Harvard anesthetist, was deeply moved by this incident. Returning from the war, he couldn't shake the implications of what he'd witnessed. If a placebo could mimic the effects of morphine, what did this mean for medicine as a whole? How many treatments were effective not because of their inherent properties, but because of patients' belief in them?

Driven by these questions, Beecher embarked on a crusade to revolutionize medical research. His 1955 paper, "The Powerful Placebo," published in the Journal of the American Medical Association, sent shockwaves through the medical community. He demonstrated that, on average, about 35% of a drug's effectiveness could be attributed to the placebo effect. This wasn't just a minor statistical quirk—it was a fundamental challenge to the way medicine understood healing.

The placebo effect is now growing stronger, particularly in the United States, posing a significant challenge to the pharmaceutical industry. A 2015 study, extracting data from published randomized controlled trials (RCTs) of drugs for the treatment of chronic neuropathic pain over the years 1990 to 2013, revealed that Americans are experiencing greater improvements simply by participating in studies, regardless of whether they receive the actual drug or a placebo.

This trend is making it increasingly difficult for new drugs, especially those targeting depression and anxiety, to demonstrate effectiveness in clinical trials. Some well-known drugs might even struggle to pass if retested today. As a result, many promising treatments are failing at the final hurdle, after pharmaceutical companies have invested billions in research and development. While the exact reasons for this strengthening placebo effect remain unclear, its implications for drug development, approval processes, and our understanding of the mind-body connection in healing are profound and far-reaching.

A 2018 Review argued that the primary effect for antidepressants in the treatment of anxiety and depression was placebo.

“Antidepressants are supposed to work by fixing a chemical imbalance, specifically, a lack of serotonin or norepinephrine in the brain. However, analyses of the published and the unpublished clinical trial data are consistent in showing that most (if not all) of the benefits of antidepressants in the treatment of depression and anxiety are due to the placebo response, and the difference in improvement between drug and placebo is not clinically meaningful and may be due to breaking blind by both patients and clinicians.”

-Irving Kirsch

This rising placebo response has become a major headache for drug developers, with many promising compounds failing to beat sugar pills in clinical trials. The pharmaceutical industry now finds itself in an unexpected arms race, not against disease, but against the mind's own healing powers.

The irony is palpable. The very mechanism that Beecher sought to understand and control has become one of the biggest challenges in modern drug development. What began as a wartime miracle has evolved into a complex scientific puzzle, forcing us to question our fundamental understanding of healing, the power of belief, and the complex interplay between mind and body in health and disease.

Big Pharma's Playbook: Beating the Placebo at Any Cost

As this mind-body phenomenon grows stronger, drug makers have resorted to increasingly sophisticated—and sometimes ethically questionable—tactics to prove their medications' worth. Here's an inside look at Big Pharma's arsenal for outsmarting the humble sugar pill:

1. Cherry-picking data:

In this statistical shell game, companies run multiple trials but only publish the winners. A 2008 study in the New England Journal of Medicine revealed that out of 74 FDA-registered antidepressant studies, 94% of positive results were published, compared to a mere 8% of negative ones. This selective reporting paints a deceptively rosy picture of a drug's efficacy, potentially leading to the approval of medications that are barely better than placebos.

2. Moving the goalposts:

When a drug fails to hit its primary target, researchers often shift their aim. They might redefine "improvement" mid-trial or focus on secondary outcomes where the drug performed better. The notorious Study 329 on paroxetine (Paxil) for adolescent depression exemplifies this tactic, where researchers changed their success criteria after the original measures flopped, then declared victory.

3. The washout illusion:

Before trials begin, patients stop all medications during a "washout" period. This practice, while necessary, can exaggerate a new drug's perceived impact. As patients' conditions may worsen during the washout, any subsequent improvement—whether from the drug or placebo—appears more dramatic. This effect can inflate efficacy rates for both the drug and placebo, potentially masking small but real differences between them.

4. Selective recruitment:

By carefully crafting inclusion criteria, companies stack the deck with patients most likely to respond favorably. This cherry-picking of "ideal" patients can lead to efficacy rates that don't translate to real-world effectiveness.

5. Statistical sleight of hand:

In the complex world of trial statistics, there's ample room for manipulation. Companies might analyze dozens of secondary endpoints, increasing the odds of stumbling upon a "significant" result by chance. They may use the "last observation carried forward" method for handling dropouts, which can artificially inflate a drug's perceived efficacy. More advanced techniques include complex subgroup analyses or novel statistical methods that can detect tiny effects of questionable clinical relevance.

6. The placebo washout:

In this particularly cunning move, companies pre-screen participants with a "placebo lead-in" phase. Those who respond positively to placebos are shown the door, leaving behind a group of "placebo-resistant" subjects. While technically allowed, this practice creates an artificial study population, potentially inflating a drug's perceived efficacy compared to its real-world performance.

The rising placebo response in clinical trials isn't just a challenge for drug companies—it's a glaring spotlight on a systemic issue that's causing widespread harm. Many of the drugs being prescribed, particularly antidepressants, come with a litany of side effects ranging from mild discomfort to severe, life-threatening conditions.

Yet, these drugs are being approved and widely prescribed even when their effectiveness is only marginally better than placebos—if at all. This is where the general public's and many prescribing physicians' lack of literacy in research design and statistics has created a perfect storm of misinformation and potential harm. When a sugar pill can provide substantial improvement without these risks, the continued prescription of these potentially dangerous drugs becomes ethically questionable at best.

The placebo effect isn't just a fascinating psychological phenomenon—it's a safer alternative that's being overlooked due to our collective blind spot in scientific understanding. This situation calls for an urgent reevaluation of our drug approval processes, prescription practices, and most importantly, our approach to mental health treatment. It's an invitation to radically reimagine our approach to emotional well-being, one that prioritizes safety and efficacy over pharmaceutical profits.

The Power of Collective Consciousness

The power of the placebo effect lies not in the inert sugar pill, but in the mind of the person swallowing it. This phenomenon reveals a profound truth: our beliefs about healing can become self-fulfilling prophecies. When someone takes a placebo and experiences relief, it's not the pill that's doing the work—it's the person's belief in the possibility of change. And this belief is growing stronger.

The increasing effectiveness of placebos is a reflection of our evolving collective consciousness. In our current paradigm, we've collectively bought into the idea that emotional distress is a chemical imbalance, a broken brain that needs fixing. This belief system primes us to expect that a pill can solve our deepest emotional wounds. And sometimes, because of the placebo effect, it does—but not for the reasons we think.

When people believe they've solved their problem by taking a pill, they often do feel better. But what's really happening here? The belief in the solution has triggered innate healing mechanisms, shifting brain chemistry and altering perception. The pill didn't fix anything—it simply gave permission for the mind to heal itself. As our collective belief in the power of medical interventions grows, so too does the strength of this self-healing response.

What if we fostered a collective belief not in the power of pills, but in our innate capacity for emotional resilience and growth? If the placebo effect shows us anything, it's that belief itself can be a powerful medicine. And as our understanding of neuroplasticity grows, our belief in our capacity for self-healing strengthens, potentially amplifying placebo responses even further.

However, this sword cuts both ways. Just as belief in a solution can foster healing, belief in the intractactability of our emotional states can lock us into suffering. This is where our current mental health paradigm may be doing unintended harm. By framing emotional challenges as "disorders" that require external intervention, we may be undermining people's belief in their own capacity for change and growth.

Imagine instead if our collective consciousness held a different set of beliefs:

1. Emotional pain, while challenging, is a normal part of the human experience and often signals areas in our lives that need attention or change.

2. We have an innate capacity for healing and growth, even in the face of profound challenges.

3. Our emotions, even the painful ones, carry important information and energy for transformation.

4. Healing often comes through connection, meaning-making, and aligned action, not through numbing or suppressing our emotional realities.

In this framework, the "placebo effect" wouldn't be limited to those taking sugar pills. Instead, this powerful self-healing capacity would be activated by our collective belief in human resilience and our trust in the wisdom of our emotional experiences.

The rising placebo response in clinical trials isn't just a challenge for drug companies—it's an invitation to radically reimagine our approach to emotional well-being. It's a reminder of the immense power of belief and a call to foster beliefs that empower rather than diminish our innate capacities.

By shifting our collective consciousness away from the "disorder and cure" model towards one of "challenge and growth," we might unlock healing potentials far beyond what any pill could provide. In doing so, we reclaim our power from external solutions and recognize the profound healing capacity that resides within our own consciousness. As we do this, we may find that the placebo effect—our mind's innate healing power—grows even stronger, not just in clinical trials, but in our everyday lives.

Next time Doc Drugpusher reaches for that prescription pad, hit 'em with some mind-blowing concepts. Like "placebo effect" or "lifestyle changes." Watch their eyes glaze over as their Big Pharma programming short-circuits.

Remember, folks: Medicine is just science, and science is never wrong... except when it is. Which is a lot. But hey, who's counting?

True healing begins when we rebel against the comforting lies that keep us sick, sedated, and subservient.

RESIST