Firstly, a warning: my commentary is on an issue VERY tangential to our actual readings; i.e. it has little to do with the actual arguments from this week. Still, I wanted to highlight one of the most impressive facts I have yet come across this class, from the McGoey reading: On a test with Prozac, those administered with placebos demonstrated a 7.80 point improvement on the 51-point Hamilton test that is designed to measure efficacy for antidepressant treatment. Prozac patients, on the other hand, only had a 1.8-point, or 23%, improvement on their Hamilton scores over the placebo group (67).
My reaction to these stats: Placebos are awesome! A 7.8 improvement on a 51 point scale is pretty impressive, especially when “actual” medicine is only slightly better in efficacy. In fact, let me ask you this: putting aside concerns of deception, if you were a psychiatrist and had to give a moderately depressed patient Prozac or a placebo, what would you pick? The side-effects of Prozac include a lighter wallet, possible addiction, sleeping problems, physiological discomfort, impotency and the ever-so-slight chance of death. The risk of a placebo, cleverly disguised as some fancy medicine with an “-ide” at the end, is limited to the possibility that your patient will be quite annoyed to later find they’ve been “duped” into feeling better. Myself, I would give the patient the placebo. Wouldn’t you?
Some problems: there is deception involved, placebos are not endorsed by the medical community, and it is likely patients will figure out the (well-intentioned) placebo scam eventually. At the same time, psychiatric medications are so dangerous and the beneficial effects of actual medications over placebos are so marginal, that I think doctors owe it to their patients to try placebos at initial stages of treatment.