To gain FDA approval for a new drug, pharmaceutical companies must show that it outperforms placebos in two independent studies. This is not easy. For example, more than 90 percent of pain medications fail in the final stage of drug trials. In other words, most drugs did not perform better than placebos. Every clinical trial is actually a study of the placebo effect.
The placebo effect is powerful. It can evoke a real
neurobiological healing response, using the pathways that affect bodily
sensations, symptoms and emotions. As one scientist remarks, “It seems that if
the mind can be persuaded, the body can sometimes act accordingly.” The healing
response is also affected by healing rituals and acts of caring. The brain translates
the act of caring into physical healing, turning on the biological processes
that relieve pain, reduce inflammation, and promote health.
Scientists have recently discovered that the response to
placebos varies among people depending on their genetic makeup. A particular snippet
of our genome governs the production of an enzyme, called COMT, that affects
people’s response to pain and painkillers. Some people have weak placebo
responses and some have strong responses.
For years scientists thought that the placebo effect was the
work of the imagination. Now, with the use of imaging machines, they can see
the brain lighting up when a test subject is given a sugar pill. Those people
who are strong placebo responders show consistent patterns of brain activation.
If drug companies can weed out the strong placebo responders
from their trials, they’ll have better luck!
For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.
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