Creative Destruction

The actual mechanism of the placebo effect is a field of great interest and potentially great importance. See here, here, here, and here. News like this makes a person wonder, though: if large parts of the public become convinced that antidepressant drugs don’t work, will they? And the question remains: do the SSRI drugs do anything at all through their supposed chemical mechanisms? It’s not like we know. One way to find out would be to run a placebo versus placebo trial. You could blind things at the start, even though everyone was getting the same sugar pills, and you’d presumably see the same response in each group. Then you unblind and cross everyone over, telling people that they’d been in one group and were now headed to the other. Careful work would give you four study arms: 1 people who responded to placebo, and who were then told they’d been taking sugar but were now getting the real drug, 2 people who responded and were told that they were taking a real drug but were now being switched off of it, 3 people who didn’t respond, but were told that this was because they’d been taking sugar, but help was now on the way, and 4 people who didn’t respond, and were told that they’d been getting apparently ineffective drug, but were now coming off even that. Fascinating stuff, but we’re going to have to wait for the North Koreans to set it up for us, because no other regulatory agency would let it through.

http://pipeline.corante.com/archives/2008/02/27/antidepressants_depressing_news_or_not.php

The final sentence seems odd to me. I would think that since this proposed study involves no actual drugs, no regulatory agency would be involved. You’re just giving people sugar pills!