ANTH106-Placebos-2010

ANTH106-Placebos-2010 - Pharmaceutical Drug Trials, Ethics,...

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Pharmaceutical Drug Trials, Ethics, and Placebos Dr Lisa Wynn ANTH106, Drugs Across Cultures 10 May 2010
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First, a review: causation vs correlation An alien comes to Earth and observes: On days when it rains, people wear raincoats. Do raincoats cause rain? Cannabis and the gateway theory Sex and stress during public speaking
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Back to cannabis and the gateway theory Why is there no study that can distinguish between correlation and causation when it comes to studying cannabis and the gateway theory? + + ??
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When can you perform random experiments on people? What ethical considerations have to be taken into account before you can experiment on people? Harm from receiving drug being tested Harm from not receiving drug being tested
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How drug trials work 1. Open trial : both the researcher and the patient know full details of treatment. Problems: bias and placebo effect. 2. Blind, placebo-controlled trials a. Single-blind trial Researcher knows details of treatment but patient does not. b. Double-blind trial Both patient and researcher are “blinded.” Most accurate research results: no bias, controls for placebo effect. When can’t trials be blinded?
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Placebo effect as meaning effect Moerman and Jonas, “Deconstructing the Placebo Effect and Finding the Meaning Response.” Annals of Internal Medicine 2002;136:471-476. http://www-personal.umd.umich.edu/~dmoerman/aim_plac.pdf Their argument: placebos do not cause placebo effects. Placebos are inert and don’t cause anything. Placebo effect is not about placebos – placebo effect is about meaning Copyright 2004 Holly Kuchera
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Placebo response as meaning response Moerman and Jonas argue that we should think of the placebo response as a ‘meaning response.’ Placebos clearly cannot do anything themselves, but their meaning can. Definition of meaning response : ‘the physiologic or psychological effects of meaning in the origins or treatment of illness; meaning responses elicited after the use of inert or sham treatment may be called the “placebo effect” when they are desirable and the “nocebo effect” when they are undesirable.’
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Steven Levitt on wine and sensory perception “Do More Expensive Wines Taste Better?” Journal of Wine Economics , Vol. 3, No. 1. Conclusion : fancy people with lots of training can tell cheap wine from expensive wine, but regular people cannot. Champagne: Domaine Ste. Michelle Cuvee Brut ($12, from Washington state) vs Dom Perignon ($150 ) (Robin Goldstein, The Wine Trials ) Vinegar in your beer (Dan Ariely, Predictably Irrational )
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The placebo effect (or meaning response): what’s happening in the brain? Hilke Plassmann, John O'Doherty, Baba Shiv, and Antonio Rangel, “Marketing actions can modulate neural representations of experienced pleasantness.” Proceedings of the National Academy of Sciences . http://www.pnas.org/content/105/3/1050.abstract Subjects told: cheap wine vs expensive wine (actually, both wines the same)
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This note was uploaded on 07/06/2010 for the course ANTHRO ANTH106 taught by Professor Lisawynn during the Three '10 term at Macquarie.

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ANTH106-Placebos-2010 - Pharmaceutical Drug Trials, Ethics,...

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