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A question about placebo

K

kuba

TRIBE Member
I read this weekend that there are more and more health studies using MDMA especially with respect to treating PTSD.

Half the group is given a placebo the other half is given actual MDMA.

Having tried MDMA once* in my life I can say the effects were quite amazing, fantastic, superb and mind-opening.

My question to those who study or know about placebo:

How can someone be given MDMA and "think" they are on it?

I know that with pain killers the mind is a wonderful thing, and placebo painkillers have been shown to actually decrease pain, but with something like MDMA I can't quite grasp it.

Anyone?
 
Wiseman

Wiseman

TRIBE Member
Isn't it just a control group? They don't have to think they're on it. They are just the comparison for the people that did get the real drug.
 
O

octo

TRIBE Member
no. the control group doesn't take anything or think they're taking anything

the placebo group thinks they're taking a real drug

the treatment group gets the drug

the placebo group will never have taken mdma before. so they don't know what to expect. my mom does pain research and the stories i hear... it's crazy what the mind can do to a body.
 
O

octo

TRIBE Member
btw you can have a control group that is given a placebo. but the point is that if you think you're taking something the mind can, at least in the short term, have incredible effects.
 
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K

kuba

TRIBE Member
So what I'm saying is that there are say 10 people: 5 take mdma and 5 do not. A drug as powerful as pure mdma can have pretty incredible effects on the mind. Yet I wonder how the heck can a placebo produce something similar - not in effect but in treatment effect.
 
praktik

praktik

TRIBE Member
Bear in mind the question of the study is going to be something like:

After using this pill in conjunction with some therapy for X months, how many patients were reporting reduced symptoms of PTSD after 6 months, 12 months, etc

The question is not:

Did you get anything off of those pills guy?

hehe ;)
 
P

Persephone

TRIBE Member
kuba said:
So what I'm saying is that there are say 10 people: 5 take mdma and 5 do not. A drug as powerful as pure mdma can have pretty incredible effects on the mind. Yet I wonder how the heck can a placebo produce something similar - not in effect but in treatment effect.
Click to expand...
Firstly, the dose of MDMA that is given for therapeutic purposes is far lower than anything you would've been exposed to recreationally. So the effect of taking it is going to be much more subtle.

Secondly, patients who take the drug and who don't actually have no idea whether they're getting one or the other. The mind is pretty incredible, and many people will have spontaneous and transient improvements in their health when given a placebo. There is little understanding about how this actually happens in the mind, but it does. And it happens more frequently than you would expect - 20-30% of the time.

Some other thoughts about clinical trials...

If these are properly conducted controlled trials, then the patients who are enrolled have never been exposed to the drug and therefore wouldn't even know what to expect when taking it. The effects will be described to them, but they should never have had the experience. So they think there's some chance of this tiny pill containing a medicine, and there's some chance that the medicine will improve their condition. Remember, these are people who are enrolled in a trial - they're obviously willing to take risks and are also likely to be keen to see some kind of improvement.

If the trial is properly blinded, the assessors (physicians administering treatment or working through therapy with the patients) are unaware of who received real drug vs. placebo too. So the hope is that the assessors are making an unbiased assessment of the patient's condition/improvement.

If the patient had taken MDMA previously that would bias the study against the drug. Someone who had taken it recreationally would expect a strong, intense high lasting several hours. If they didn't feel that, they would THINK that the drug is not working, or that they received placebo, even if they rec'd the medicine. In that case, the mind could work against the effect of the medicine, biasing against it (or, reducing its effect).
 
P

Persephone

TRIBE Member
Persephone said:
Firstly, the dose of MDMA that is given for therapeutic purposes is far lower than anything you would've been exposed to recreationally. So the effect of taking it is going to be much more subtle.

Secondly, patients who take the drug and who don't actually have no idea whether they're getting one or the other. The mind is pretty incredible, and many people will have spontaneous and transient improvements in their health when given a placebo. There is little understanding about how this actually happens in the mind, but it does. And it happens more frequently than you would expect - 20-30% of the time.

Some other thoughts about clinical trials...

If these are properly conducted controlled trials, then the patients who are enrolled have never been exposed to the drug and therefore wouldn't even know what to expect when taking it. The effects will be described to them, but they should never have had the experience. So they think there's some chance of this tiny pill containing a medicine, and there's some chance that the medicine will improve their condition. Remember, these are people who are enrolled in a trial - they're obviously willing to take risks and are also likely to be keen to see some kind of improvement.

If the trial is properly blinded, the assessors (physicians administering treatment or working through therapy with the patients) are unaware of who received real drug vs. placebo too. So the hope is that the assessors are making an unbiased assessment of the patient's condition/improvement.

If the patient had taken MDMA previously that would bias the study against the drug. Someone who had taken it recreationally would expect a strong, intense high lasting several hours. If they didn't feel that, they would THINK that the drug is not working, or that they received placebo, even if they rec'd the medicine. In that case, the mind could work against the effect of the medicine, biasing against it (or, reducing its effect).
Click to expand...
You know what? I stand corrected on my bolded statement. Some information on MDMA dosing:

Typical recreational dose: up to 120 mg per pill
Dose in a recent pilot study: 125 mg, plus 62.5 mg supplemental dose

So it looks like they're giving the recreational dose but in pure form.

If you're still questioning the placebo effect, the wiki page is a decent summary of our understanding of it: http://en.wikipedia.org/wiki/Placebo#Placebo_effect_and_the_brain
 
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B

Bumbaclat

TRIBE Member
kuba said:
Having tried MDMA once* in my life I can say the effects were quite amazing, fantastic, superb and mind-opening.

My question to those who study or know about placebo:

How can someone be given MDMA and "think" they are on it?
Click to expand...

maybe you were given a placebo? :p
 
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alexd

alexd

Administrator
Staff member
Placebo's are often 50% as effective at the drugs being tested in clinical trials, with none of the side effects, and a fraction of the cost.
 
R

Re: Shoe

TRIBE Member
FDA Approves Sale Of Prescription Placebo

GlaxoSmithKline expects to have two versions of placebo on the shelves in late December. One, a 40-milligram pill called Appeasor, will be marketed to patients 55 and over, while the other, Inertra, designed for middle-aged women, is a liquid that comes in a 355-milliliter can, and is cola-flavored. Eli Lilly plans a $3 million marketing campaign for its 400-milligram tablet, Pacifex.

"All placebos are not the same," Eli Lilly spokesman Giles French said. "Pacifex is the only placebo that's green and shaped like a triangle. Pacifex: A doctor gave it to you."
Click to expand...
 
praktik

praktik

TRIBE Member
alexd said:
Placebo's are often 50% as effective at the drugs being tested in clinical trials, with none of the side effects, and a fraction of the cost.
Click to expand...
Which, coincidentally or not, mirrors the impact of most "natural" remedies...

Actually I bet that isn't a coincidence...
 
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B

Blysspluss

TRIBE Member
Well..I hope it helps the ladies and gents coming back from war and other situations where PTSD is the result.

Our veterans get fucked. So if there's any small bit of something we can give them to improve their QoL..I say EXCELLENT. Really hope this helps move treatment forward.
 
B

Blysspluss

TRIBE Member
I've thought about trying it once recreationally.

Then again...good old-fashioned reefer is so awesome...I can't really honestly say I'm interested in anything else as a mind-altering party favour. (of course, booze goes without saying.)
 
praktik

praktik

TRIBE Member
Blysspluss said:
I've thought about trying it once recreationally.

Then again...good old-fashioned reefer is so awesome...I can't really honestly say I'm interested in anything else as a mind-altering party favour. (of course, booze goes without saying.)
Click to expand...
I'm in same boat. Actually preference is baked THC if possible.. smuggle in a few cookies, get a few beers, and I'm good til close!

Thing is I am a bit of an enthusiastic dancer so people always assume I am on E and ask me for pills...

"Sorry friend - THIS <points at self> is all-natural yo!"

Dancing on E can be great but it isn't always a lock - sometimes gets my mind racing and I end up thinking too much, which is the death of good dancing..;)
 
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