Podcasts about placebo studies

If there was ever any evidence for the depth of complexity within our own brains, look no further than the placebos and their effects. Both a help and hinderance to the medical community, rheumatology clinicians and researchers can agree that when testing new treatments, the placebo effect is as powerful as it is disruptive. But what is it exactly? How does it work and for which symptoms? Are there symptoms to which this effect is ineffective? How can you diminish the effect? What is the “Nocebo Effect” and what ethics are involved when dealing with placebos? To answer these questions, we've invited Professor Ted Kaptchuk, director of the Harvard-wide Program in Placebo Studies and the Therapeutic Encounter (PiPS) at Beth Israel Deaconess Medical Center in Boston, Massachusetts to be our guest today and tell us all about placebos, their effects and why they work. 

Why does your horoscope seem so accurate? Is it possible to believe and not believe in something at the same time? And is Mike a classic Gemini? SOURCES:P. T. Barnum, 19th-century American showman and businessman.David Brooks, New York Times Opinion columnist.Bertram Forer, 20th-century American psychologist.Daniel Kahneman, professor emeritus of psychology and public affairs at Princeton University.Irving Kirsch, associate director of the Program in Placebo Studies and lecturer in medicine at Harvard Medical School.Sten Odenwald, Director of STEM Resource Development at NASA.Sydney Page, staff reporter for The Washington Post. Jane L. Risen, professor of behavioral science at the University of Chicago Booth School of Business. RESOURCES:"Young People Are Flocking to Astrology. But It Comes With Risks," by Sydney Page (The Washington Post, 2023)."The Age of Aquarius, All Over Again!" by David Brooks (The New York Times, 2019)."Response Expectancy and the Placebo Effect," by Irving Kirsch (International Review of Neurobiology, 2018)."Believing What We Do Not Believe: Acquiescence to Superstitious Beliefs and Other Powerful Intuitions," by Jane L. Risen (Psychological Review, 2016).Thinking, Fast and Slow, by Daniel Kahneman (2011)."Effects of Stress and Tolerance of Ambiguity on Magical Thinking," by Giora Keinan (Journal of Personality and Social Psychology, 1994).Changing Expectations: A Key to Effective Psychotherapy, by Irving Kirsch (1990)."The Fallacy of Personal Validation: A Classroom Demonstration of Gullibility," by Bertram Forer (The Journal of Abnormal and Social Psychology, 1949).Myers-Briggs Type Indicator. EXTRAS:"What Do Broken-Hearted Knitters, Urinating Goalkeepers, and the C.I.A. Have in Common?" by Freakonomics Radio (2022)."Sam Harris: 'Spirituality Is a Loaded Term,'" by People I (Mostly) Admire (2021).

Welcome to Angela's Symposium, your trusted source for scholarly discussions on magic, esotericism, Paganism, and the occult. In today's episode, we are honoured to host Peter J. Carroll, a pioneering figure in Chaos Magick. From the evolution of Chaos Magick to its relationship with technology and empirical science, this interview covers it all. Peter J. Carroll is a key figure in the development of Chaos Magick, and he has authored several books that have become foundational texts in the field. Here is a list of some of his notable works: 1. "Liber Null & Psychonaut" (1987) - https://amzn.to/3LYrvb9 2. "Liber Kaos" (1992) - https://amzn.to/3PVXyK2 3. "PsyberMagick: Advanced Ideas in Chaos Magick" (1995) - https://amzn.to/3S0QBKe 4. "The Apophenion: A Chaos Magick Paradigm" (2008) - https://amzn.to/3QiJR9g 5. "The Octavo: A Sorcerer-Scientist's Grimoire" (2010) - https://amzn.to/45xpwRV 6. "EPOCH: The Esotericon & Portals of Chaos" (2014) - https://amzn.to/3S5ZouB Peter J. Carroll's official website is Specularium (https://www.specularium.org/), where you can find more information about his works, theories, and other contributions to the field of Chaos Magick and esoteric studies. Please note that the years mentioned are for the original publications. CONNECT & SUPPORT

The Science Behind The Placebo EffectEarlier this month, a Food and Drug Administration panel concluded that a common decongestant ingredient used in drugs like Sudafed and NyQuil doesn't work. The panel agreed that while the ingredient, called phenylephrine, isn't dangerous, it doesn't work any better than a placebo.That made us wonder: How well do placebos work? And why do they work even when people know they're getting a placebo?Ted J. Kaptchuk, professor of medicine at Harvard Medical School and director of the Program in Placebo Studies and Therapeutic Encounter at Beth Israel Deaconess Medical Center, joins guest host and musician Dessa to talk about what's new in placebo research. They discuss the benefits placebos can offer for chronic illness management, and when doctors might start using them in treatments. Where Technology Meets AbleismWith all the bad news on our feeds, a feel-good story can be a welcome reprieve. But what happens when that story comes in the form of coverage of disability technology?You might've seen the videos online of a person with a physical disability being fitted with an exoskeleton, essentially “wearing” a robot, to help them walk. Onlookers cheer in the background, dramatic music swells, and we get the sense we're watching something inspirational and empowering—a victory of the human spirit.This might seem like a triumph of scientific innovation, but our guest asks us to look again at what's actually going on in narratives like this one.Dr. Ashley Shew, associate professor at Virginia Tech, studies the intersection of disability and technology and how our collective fixation on these fancy, supposedly transformative gadgets could be doing more harm than good. In her new book, she coins the term “technoableism” to get to the heart of the matter.Guest host and musician Dessa talks with Dr. Shew about her book Against Technoableism: Rethinking Who Needs Improvement, about what disability technology is, what the future should look like, and even how disability intersects with space travel and climate change. Sour Times For Florida's CitrusFlorida is known for citrus, particularly its fresh-squeezed orange juice. But citrus trees in the state are struggling. For the last two decades, crops have been struck with a devastating disease called “citrus greening.” And Florida orange production has dropped some 94% over that period.                                              Citrus greening is caused by an invasive insect, the Asian citrus psyllid, which is threatening to wipe out the citrus industry in the state. One of the effects of the disease is a bitter, acidic fruit. Scientists are hard at work devising possible solutions to save Florida's crop.Guest host and musician Dessa talks with Dr. Yu Wang, associate professor of food science at the University of Florida's Citrus Education and Research Center, about her recent advances in making infected orange plants sweeter. Making Neuroscience Into MusicWhen composer Sarah Hennies learned about a neurological theory called “motor tapes” from Oliver Sacks' book Musicophilia, the concept stuck with her for years. The theory comes from neuroscientist Rodolfo Llinás, who posited that many of our thoughts, memories, and physical movements operate via a series of “looping tapes,” with the goal of reducing the amount of energy the brain uses while doing common, repetitive tasks.The concept resonated with Hennies, who is also a visiting assistant professor of music at Bard College. Most of her compositions use heavy amounts of repetition, and Llinás' theory fit with how she experienced her own memories and the evolution of her identity. Her piece “Motor Tapes” premiered in early August, performed by Ensemble Dedalus.Hennies joins guest host and musician Dessa to talk about repetition in music, how to translate neuroscience into art, and what that pairing can reveal about our bodies and the world around us. To stay updated on all-things-science, sign up for Science Friday's newsletters.Transcripts for each segment will be available the week after the show airs on sciencefriday.com.

Sloppy by modern standards — and maybe even those back then — a 1955 article on the placebo effect by Harvard anesthesiologist Henry K. Beecher was nonetheless remarkable and influential. It paved the way for sounder drug trials and pushed scientists to better understand how we process pain. To explore its significance, Host Charlotte Stoddart enlisted the help of Ted Kaptchuk, director of the Program in Placebo Studies at the Beth Israel Deaconess Medical Center in Boston, who knows the paper well.

What's the Antidepressant Myth? Have We Been Scammed?     Today, Rhonda and I interview one of our heroes, Dr. Irving Kirsch, who is a giant in depression research and a fun, down-to-earth human being at the same time! Dr. Kirsch is Associate Director of the Program in Placebo Studies and the Therapeutic Relationship, and a lecturer on medicine at the Harvard Medical School (Beth Israel Deaconess Medical Center). He is also Emeritus Professor of Psychology at the University of Hull (UK) and the University of Connecticut (USA). Dr. Kirsch has published 10 books, more than 250 scientific journal articles and 40 book chapters on placebo effects, antidepressant medication, hypnosis, and suggestion. He originated the concept of response expectancy. This is the expectation that people have that a given treatment or intervention will be helpful. Kirsch's 2002 meta-analysis on the efficacy of antidepressants influenced official guidelines for the treatment of depression in the United Kingdom. His 2008 meta-analysis was covered extensively in the international media and listed by the British Psychological Society as one of the “10 most controversial psychology studies ever published.” His book, The Emperor's New Drugs: Exploding the Antidepressant Myth, has been published in English, French, Italian, Japanese, Turkish, and Polish, and was shortlisted for the prestigious “Mind Book of the Year” award. It was also the topic of a 60 Minutes segment on CBS and a 5-page cover story in Newsweek. In 2015, the University of Basel (Switzerland) awarded Irving Kirsch an Honorary Doctorate in Psychology. In 2019, the Society for Clinical and Experimental Hypnosis honored him with their “Living Human Treasure Award.” In today's podcast, we cover a wide range of topics, including a patient-level reanalysis of all of the data on the effects of antidepressant medications versus placebos submitted to the FDA. This analysis included more than 70,000 depressed individuals and indicated something troubling and surprising. The difference in improvement between individuals treated with antidepressants and individuals receiving antidepressant medications was only 1.8 points on the Hamilton Rating Scale for Depression. This test can range from 0 to 50, and a difference of 1.8 points is not clinically significant. In addition, the beneficial antidepressant effects observed in both the placebo and “antidepressant” groups are large, with reductions of around 10 points or so on the Hamilton Scale. These were the shocking discoveries that led to his popular book, The Emperor's New Drugs (LINK), and to his appearance on the Sunday evening 60 Minutes TV show. In addition, Dr. Kirsch agreed that tiny difference between the “effects” of antidepressants vs placebos could be the result of problems in the experimental design used by drug companies. Because they give patients in the placebo groups pills with inactive ingredients, there are no side effects in the placebo groups. This makes it fairly easy for individuals to guess what group they were assigned to—the “real” antidepressant group or the placebo group. This might account for the differences in the groups, since many individuals in the medication groups may think, “Hey, I'm getting some side effects. I must be in the antidepressant group. That's terrific!” This thought would be expected to trigger some mood elevation, but it's the thought, and not the pill, that causes this. In contrast, some individual in the placebo groups may have the thought, “Hey, I'm not getting any of the side effects they described. I must be in the placebo group!” And this thought may trigger disappointment, and a worsening of depression. This would contribute to differences between the drug and placebo groups in drug company outcome studies with new chemicals that they hope to get approved as “antidepressants.” This problem could easily be corrected by the use of active placebos, like atropine, which produces dry mouth, a side effect of many antidepressants and has been used as an active placebo in a small number of trials. Most of the studies using active placebos have failed to show any significant effect of the antidepressant over the active placebo. Drug companies have been reluctant to implement this change in their research designs, perhaps due to the fear that it will “erase” the tiny differences that they have been reporting. This would be of potential concern since billions of dollars are at stake if the FDA gives you permission to call your new chemical an “antidepressant.” We also discussed Dr. Kirsch's unlikely journey to Harvard. When he was in England, planning to return to the United States, he asked a colleague at Harvard if it would be possible for him to get a library card so he'd have access to articles in research journals. His colleague told him that it was difficult to obtain a library card for people not affiliated with Harvard. However, they were willing to offer him a position as Instructor on Medicine, given that he was the Associate Director of the  Program in Placebo Studies and the Therapeutic Relationship, which was hosted at one of the Harvard teaching hospitals. That's a wow! But certainly deserved, and a most fortunate affiliation with unanticipated and highly positive consequences that have led to many important discoveries on how the placebo effect actually works. The placebo effect is not a bad thing, and has been one of the doctor's best “medicines” for hundreds if not thousands of years. On the podcast, we also discussed the confusion—for patients, doctors, and researchers alike—caused by the placebo effect. For example, many people who receive antidepressants do improve, and some recover completely. They will SWEAR by antidepressants, and may feel hurt or disappointed by the results of Dr. Kirsch's research. But in fact, there is no discernable difference between the effects of placebos and so-called “real” effects. And one of the downsides of the confusion about placebos is that people who take antidepressants and improve have improved because of changes in their thinking, and not from the antidepressant. But they wrongly give credit to the pills they took, whereas they deserve the real credit for overcoming their feelings of depression. We discussed many other topics, including pushback he has received from the psychiatric community and some in the general public as well who have not taken kindly to his findings. I, too, have experienced that when I have summarized the data in the Food and Drug Administration, and have had to be very careful in how I present this information, because none of us want to discourage anyone who is depressed. We have also invited Dr. Kirsch to consult with us on the research design we use in our beta testing of the Feeling Good App, and have developed tests of “expectations” (the so-called placebo effect) that we will use in our latest beta test as well. We want to “walk the walk” and not just “talk the talk” and find out how much the improvement we see in beta testers might be due to a placebo, or “mega-placebo” effect. Rhonda and I were honored and thrilled to have this chance to interview Dr. Irving Kirsch, a friend and research giant for sure! Thanks so much for listening to today's podcast! Irving, Rhonda, and David

Tro, hopp och förväntningar kan ge effekter på beslut och uppfattningar av vår omvärld och de kan också påverka våra kroppsliga funktioner. Det gör att preparat som i medicinsk mening borde vara overksamma ändå kan ha en effekt. Frågan är bara hur?Karin Jensen är är en av världens främsta placeboforskare. Hon är verksam vid på Karolinska Institutet i Stockholm och har intresserat sig för smärta och placebo. Hon är nära knuten till Program in Placebo Studies vid Harvard Medical School i Boston (USA) och är sedan 2016 invald i styrelsen för internationell placeboforskning, tillsammans med ledamöter från många andra länder. Förra året gav hon ut boken “Hoppets anatomi” som är en fascinerande resa i detta låtsasland med mycket verkliga effekter.Vi bjöd in henne till studion för ett samtal som kom att handla om likheterna mellan trolleri och placebo, åt varför självbedrägeri kan fungera och om placebokirurgi - alltså när man skär i andra men inte utför något. Bland mycket annat.Jensens rekommendationer:Besök Hagströmerbiblioteket i StockholmGå och se en riktigt bra trollerikonstnär eller kolla in roliga illusionstrick på Youtube.Programledare: Per Grankvist. Producent: Jens Back. Mixning av Stray Dog Studios. #perspektivpodden"Perspektiv "är en podd från Vad Vi Vet - tjänsten som hjälper dig bli allmänbildad med minimal ansträngning. Hosted on Acast. See acast.com/privacy for more information.

Placebo treatments have been making people feel better for a long time. They've been working since long before Franz Mesmer was run out of 18th-century Vienna for "mesmerizing" a young pianist into regaining her eyesight, after all hope for a medical cure had been lost. Doctors have long dismissed the placebo effect as inferior to conventional medical treatments that sometimes fail where placebo works well, including in surgical procedures like arthroscopy, a popular procedure that relieves the pain of arthritic knees. The placebo effect is triggered not by a magic pill, but through a combination of expectation, hope, and the strength of the doctor-patient relationship. Placebo is real; it's on the rise in America, and technology is allowing researchers to link placebo with physiological and psychological changes and genetic predisposition that could change the way we treat illness. GUESTS: Gary Greenberg - Psychotherapist and the author of The Book of Woe: The DSM and the Unmasking of Psychiatry Ted Kaptchuk - Professor of medicine, Harvard Medical School, and Director, Program of Placebo Studies and Therapeutic Encounter at Beth Israel Deaconess Hospital Bruce Moseley - Orthopedic surgeon and sports medicine specialist, former team physician to the Houston Rockets, first to perform placebo surgery Join the conversation on Facebook and Twitter.Support the show: http://www.wnpr.org/donateSee omnystudio.com/listener for privacy information.

In this episode of The Healers Café with Dr. Manon, she chats with Dr. Elizabeth Hughes, the Stress Antidote doctor. Highlights from today's episode include: At 5:43-6:07 - Healed an incurable condition with just a change in belief At 10:08 - Detecting illness versus celebrating and amplifying health At 11:40 - How to change your subconscious beliefs that then changes your genetic makeup At 14:11 - What healthy and stress-free feel like At 16:48 - Dis-empowerment and 'Victim Blaming' At 17:41 - The impact of stress on the body At 23:02 - The energy medicine technique At 30:45 - From victim to agency Dr. Hughes recommends the following resources: The Biology of Belief by Bruce Lipton, PhD -- on the subject of epigenetics The Molecules of Emotion by Candace Pert, PhD -- on psychoneuroimmunology When the Body Says No by Gabor Mate, MD Ted Kaptchuk is the director of the Program in Placebo Studies and the Therapeutic Encounter at Harvard. He has not written books specifically on this subject, but has published hundreds of medical articles, has numerous interviews, and has given a TED talk which people can find easily. www.elizabethhughesmd.com About Dr. Manon Bolliger, ND: Dr. Manon is a Naturopathic Doctor, the Founder of Bowen College, an International Speaker with a TEDx talk in September 2020, and the author of the Amazon best-selling book "What Patient's Don't Say if Doctors Don't Ask." Watch for her next book, due out in 2020. About The Healers Café: Dr. Manon's show is the #1 show for medical practitioners and holistic healers to have heart to heart conversations about their day to day lives. Visit Dr. Manon's website at https://www.drmanonbolliger.com/ Follow Dr. Manon on social media! FB: https://www.facebook.com/DrManonBolli... IG: https://www.instagram.com/drmanonboll... Follow the podcast on social media! FB: https://www.facebook.com/thehealerscafe Watch & listen to her podcast, The Healers Café with Dr. Manon, at https://www.drmanonbolliger.com/thehealerscafe

Between the latest online fads and the crazy media headlines, it’s easier than ever to get confused about your health. If you want to make better decisions about your health today so you can feel better and live longer, you’ve come to the right place. Are antidepressants harmful? Do their side effects outweigh their benefits? Should you avoid using them except in the most critical cases? The answers to these questions only matter if the medications you’re taking actually work. And, particularly in the case of psychotherapy drugs, the answer is not always a clear one. I’m joined today by Dr. Irving Kirsch, associate director of the Program of Placebo Studies at Harvard Medical School. Dr. Kirsch has spent years researching the true effect of placebos on health and healing, and I know you’re going to find his findings just as shocking as I did. We discuss the duration of effectiveness of placebos, the potential danger of nocebos, and the potential future of medicine and healing. Whether you are looking for alternatives to medications with potentially negative side effects or just want to further your understanding of the power of placebos, this is one medical myth-busting episode you won’t want to miss.   Key Takeaways: [1:10] Today’s topic is the effect of antidepressant medications relative to the placebo effect. [2:31] Dr. C introduces Dr. Irving Kirsch, who explains the origins of his findings on placebo effects in the treatment of depression and the studies he ran to reach these conclusions. [8:12] Companies are required to show that medications are more effective than placebos, but they are allowed to run any number of studies to obtain the findings they are looking for. [10:40] The numerical relevance of the numbers from Dr. Kirsch’s findings and the effects that both patients and doctors experienced with the placebos and the actual drugs. [18:44] The duration of the placebo effect can last for years in patients suffering from depression, asthma, Parkinson's disease, allergies, digestive issues, and more. [21:51] The physiological and subjective changes that take place with the placebo effect are all very real, as are the side effects of the nocebo effect. [25:32] Dr. Kirsch offers an overview of the research that went into his new book and the policies that should be changed as a result of his findings. [31:47] A look at effective non-drug treatments for depression include physical exercise, psychotherapy, acupuncture, Omega-3 supplements, yoga, and homeopathy. [34:31] The effectiveness of open placebo trials in which patients know that they are being given a placebo and the necessary explanation that must be given in order for it to work. [40:35] What you need to do if your antidepressant medication is not working and it is posing negative side effects. [43:43] Dr. Kirsch shares the experiences he has had as a result of sharing his findings in The Emperor's New Drugs, including placebo surgery, injections, and pills. [49:41] The color, size, quantity and price tag of placebo pills all influence their effectiveness. [51:11] The most surprising findings that Dr. Kirsch has discovered relative to the placebo effect, his hopes for the future of placebos in clinical practice, and his recommendations for patients. [58:54] Do you have a topic you’d like me to cover? Contact me on Facebook or Instagram using #medicalmyths.   To learn more: www.drchristianson.com Dr. Christianson on Instagram Dr. Christianson on Facebook Comprehensive Thyroid Care Telemedicine The Emperor's New Drugs: Exploding the Antidepressant Myth by Dr. Irving Kirsch  

Dr Phil Parker interviews Prof Luana Colloca MD. Luana is a medical doctor, holds a PhD in neuroscience and has an MSc in bioethics. Her cutting edge research into Parkinson's with Prof Benedetti changed the map on how we value and understand placebos. She has a special research interest in placebos, pain, the opioid crisis and music. She is an Associate Professor in Pain and Translational Symptom Science and Adjunct Professor Department of Anesthesiology (School of Medicine) at the University of Maryland in the  USA.

Dr Phil Parker interviews Prof Irving Kirsch. Very few researchers know more about placebo studies than the self-effacing and incredibly knowledgable Prof Irving Kirsch. Discover how his pioneering work in the 70s has shaped the scientific interest in how the mind and body interact. Author of pivotal studies on depression, pain, non-deceptive placebos and much more. Also, true fact- he was Grammy nominee for a best selling comedy album in the 1970s...should be fun Associate Director of the Program in Placebo Studies and a lecturer in medicine at the Harvard Medical School and Beth Israel Deaconess Medical Center. He is also professor emeritus of psychology at the Universities of Hull and Plymouth in the UK, and the University of Connecticut in the  USA.

Episode 72!Some highlights include:How to make incredible bone brothPhoExtended fasting and why it is so excellentMore placebo and nocebo studies to blow your mindDr. Christopher Spevak-- Wounded Warrior InitiativeAnti-Trauma5 steps of forgiveness-forgiving the other party-give them permission to forgive you-forgive yourself for any hurt that you might have caused yourself in the process-what's the lesson?-be thankful/gratefulIf you like the podcast, let us know by leaving a review!https://www.instagram.com/thecultivatedbeing/Dr. Nick Hyde's websitehttps://www.getinsideouthealth.com/and Dr. Jake Hyde's website.https://www.drjakehyde.com/Email us at thecultivatedbeing@gmail.comThe Cultivated Being Podcast is meant for educational purposes only. It is not meant to treat or diagnose any issue. If you have an issue please consult your doctor.

In this episode we are talking about negativity and how to deal with negative people, negative energy and how to break this cycle when it is really tough to break out of. There is a lot of science around this so we explore the placebo effect and the nocebo effect, why it matters and how we can change it. I'm am also going to be sharing a little bit about what has worked for me. Key Points: · Placebo effect vs. Nocebo effects · Why to not cut people out · Why to Protect your emotions · The value in practicing positivity and negativity · Remembering to take a deep breath Quote from: John Kelley, Ph.D., deputy director of Harvard Medical School's Program in Placebo Studies & Therapeutic Encounter. "Whenever you look at any randomized control trials, it’s surprising how similarly the side-effect profile for the placebo often mirrors the side-effect profile for the active [treatment]... It’s the power of the imagination. …. Just imagining something is happening is enough to activate those portions of the brain associated with that thought, or worry, or pain.” --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

Placebos are commonly dismissed as "fake" treatments that have no real power on you or your body. But scientists are realizing more and more that placebos are more powerful than we realized. New research shows that while placebos may not cure diseases, they can reduce symptoms of our ailments like irritable bowel syndrome and even Parkinson's disease, and in the process actually make us feel better. Even traditional medicine takes advantage of the placebo effect, which could mean the placebo effect could play a significant role in treating diseases. On this episode we talk to Dr. Kathryn Hall, who appeared on Adam Ruins Spa Day, about how placebos can have such powerful effects on our brains and how placebos are changing the way we conduct science and treat patients. Kathryn is a molecular biologist and Director of Placebo Genetics at Harvard Medical School's Program in Placebo Studies. Adam is on Twitter @AdamConover and you can find past episodes and bonus content from the TruTV show at AdamRuinsEverything.com. Produced by Shara Morris for MaximumFun.org.

This week I have had the honour of interviewing Dr Irving Kirsch. Dr Kirsch is Associate Director of the Program in Placebo Studies and lecturer in medicine at the Harvard Medical School and Beth Israel Deaconess Medical Center. He is also Professor Emeritus of Psychology at the University of Plymouth and the University of Hull in the UK and University of Connecticut in the US. He has published 10 books and more than 250 scientific journal articles and book chapters on placebo effects, antidepressant medication, hypnosis, and suggestion. He originated the concept of response expectancy. His meta-analyses on the efficacy of antidepressants were covered extensively in the international media and influenced official guidelines for the treatment of depression in the United Kingdom. His 2009 book, The Emperor’s New Drugs: Exploding the Antidepressant Myth, was shortlisted for the prestigious Mind Book of the Year award and was the topic of 60 Minutes segment on CBS and a 5-page cover story in Newsweek. In this interview, we discuss Dr Kirsch’s research into the placebo effect and the efficacy of drugs used for depression. In this episode we discuss: How, as an undergraduate student, Dr Kirsch became interested in behavioural therapy but that he doubted the rationale behind these approaches That this led to an interest in beliefs that people had and research into the placebo effect How, while working at the University of Connecticut, his research into the placebo led to an interest in the efficacy of antidepressant drugs when compared to placebo How his work led to the surprising conclusion that, were antidepressant drugs were concerned, the placebo effect was so large that there was very little room for a meaningful drug effect How this changed Dr Kirsch’s views on antidepressant drugs entirely, causing him to ask whether the risks were worth the small benefit for depressed patients That a belief that a person has can affect their response to a drug either in a positive way (placebo) or in a negative way (nocebo) Dr Kirsch found that there are many conditions that can show a profound placebo effect including depression, anxiety, irritable bowel syndrome, pain, Parkinson’s disease and asthma  That the placebo tends to have a greater effect in conditions that have a large psychological component when compared to functional disorders such as diabetes That placebo can have an effect even if the patient knows that they are taking an inactive tablet and that part of this response is down to classical conditioning That Dr Kirsch is working on ‘open-label placebo’ which is being able to prescribe placebo to patients without deception That Dr Kirsch used to refer depressed patients for antidepressant treatments, but that his research made him a disbeliever when looking at the evidence of efficacy when compared to placebo How, when you give someone a new treatment, that often will counter feelings of hopelessness that characterise depressive experiences That in looking at this size of this effect, it made clear that the difference between placebo response and antidepressant response was so small that it was not clinically significant That even drugs with very different modes of action resulted in virtually identical responses in patients, for example, Tianeptine, which is an SSRE (selective serotonin reuptake enhancer) and decreases serotonin levels between neurons, this drug should make depressed people worse but instead, it showed the same efficacy as SSRI antidepressants How, when looking at the clinical trials used to demonstrate antidepressant efficacy, it became clear that the obvious nature of antidepressant adverse effects meant that trial participants would often “break blind” and they would know if they were in the active drug group or the placebo group, this would naturally influence the results of the trial That, in a small number of studies, an active placebo was used, which was a substance that mimicked the side effects of the active drug while having no clinical effect itself That in these active placebo studies, you were much less likely to get a significant difference between drug and placebo when compared to trials that used an intern placebo That the trials conducted by pharmaceutical manufacturers are designed to show their drug in the best possible light and so they do not use active placebo in their studies That Dr Kirsch feels that when conducting trials for drugs used for depression, patients should be asked early on in the trial whether they think they are in the active group or the placebo group and that this question would help ensure the trials were reliable How, when using the data from unpublished trials, the difference between placebo effect and drug effect was even smaller How Dr Kirsch was pleased that other researchers found his conclusions controversial because it meant that they were paying attention to the study and that others who have replicated the approach have found similar results That influencing clinicians to better balance risk vs benefit will take time and that we need to share the data and discuss the conclusions as much as we can to allow change to happen  That people do need help with depression and that there are many different interventions that are at least as effective as antidepressants but without the associated risk How we can’t infer that ‘off-label’ prescribing is effective until the studies have been undertaken for a particular disorder Relevant Links: Dr Irving Kirsch The Emperor’s New Drugs: Exploding the Antidepressant Myth The Emperor’s New Drugs: Exploding the Antidepressant Myth (video) 60 Minutes: Treating Depression: Is there a placebo effect? (video) Antidepressants and the Placebo Effect Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration To get in touch with us email: podcasts@madinamerica.com © Mad in America 2017  

Dr. David Kallmes’s medical degree is real. But one of his treatments for spinal fractures might not be. Kallmes performs vertebroplasty, a surgery he has helped to develop and standardize, that involves injecting medical cement into the fractured bone to stabilize the fractured area and relieve pain. He says he gets great results from his patients, and teaches the method to other doctors at conferences. But here’s the thing: he has no idea why vertebroplasty works. So a few years ago, he decided to test it against a placebo.  Kallmes found that pretending to perform vertebroplasty – making it seem like he was injecting a needle into the spine but without the cement – had similar effects. About 40 percent of both groups experienced immediate relief from pain after the surgery. He published his results in the New England Journal of Medicine. So even though Kallmes’s research put the procedure into question, the practice continues: more than 14,000 patients received vertebroplasties last year. Most of us would like to think the medicines and treatments we take – and pay for – are grounded in solid science, that our doctors know exactly what they’re doing when they prescribe them. But there’s consistent proof that placebos work just as well as some medical treatments, and it isn’t just because of a positive attitude. Until recently, the “placebo effect” wasn’t taken seriously by the medical establishment. But one researcher, Ted Kaptchuk, has decided to make it the focus of his work.  “I kept seeing things that were not explainable by my training,” said Kaptchuk, who directs the Center for Placebo Studies at Harvard Medical School. Kaptchuk had an unusual trajectory to the medical research field. He was the founder of the Students for Democratic Society at Columbia University, and then quit when he thought it became too radical. He studied and practiced Chinese medicine and acupuncture and lived in Asia for years. He noticed that patients throughout his practice would get better from their interactions with the medical system, and the belief that they were being helped, even if the medicine’s impact was difficult to track. He started to study this mechanism – the placebo effect – and the endorphins, the body’s natural painkillers, that the body releases when it happens. He had a theory there was more to it than blind faith: a neurological reason, and maybe a genetic reason. In one of the most revealing studies on this phenomenon, published back in 1978, researchers divided patients into three groups after a dental surgery and gave them each a different treatment: morphine (a painkiller), salt water (a placebo), and naloxone (a chemical that blocks endorphins). That third group didn’t get the placebo effect. “It was the first time that we [could see] a biology, a neurobiology of placebo effects,” Kaptchuk said. “Patients were not making this up in their heads.” And while the findings were now backed by evidence, the pain-killing endorphins and response to placebos actually come from a less measured place. Kaptchuk said it’s the ritual of medicine – seeing a doctor, planning a treatment – that triggers the brain into healing itself. “I’ll be quite simple and say what I think I’m doing is quantifying and making the art of medicine a science,” he said.   EDITOR’S NOTE 4/13/16 The text has been edited to clarify Dr. Kallmes’s role in developing the vertebroplasty procedure. He did not single-handedly develop the procedure, as the original text may have implied, nor did he inject the cement himself. The article also said that that vertebroplasty and placebo patients experienced immediate relief after their surgeries, when, in fact, it was about a 40 percent success rate for patients in both groups. The text has been updated and clarified.

Ted Kaptchuk is a professor of medicine at Harvard Medical School and director of the Program in Placebo Studies and the Therapeutic Encounter at Beth Israel Deaconess Medical Center. Stephen Morrissey, the interviewer, is the Managing Editor of the Journal. T.J. Kaptchuk and F.G. Miller. Placebo Effects in Medicine. N Engl J Med 2015;373:8-9.

Learn about groundbreaking research on the power of the placebo and how a platform called PatientsLikeMe puts health outcomes in patients’ hands. Also: weighing the pros and cons of making foundation proposals public to help ideas spread.

This episode is primarily relevant to professionals. In this episode, R. Trent Codd, III, Ed.S. interviews Irving Kirsch, PhD about his research on antidepressant effectiveness.  In this episode they discuss: An overview of the current controversy pertaining to the effectiveness of antidepressants  How antidepressants perform relative to placebo A summation of Dr. Kirsch’s research in the area  Criticisms leveled at Dr. Kirsch’s conclusions as well as Dr. Kirsch’s responses to those criticisms Effective treatments for depression  IRVING KIRSCH, PHD BIOGRAPHY Irving Kirsch is Associate Director of the Program in Placebo Studies at the Harvard Medical School, lecturer in medicine at Beth Israel Deaconess Medical Center, Professor of Psychology at the University of Plymouth (UK), and Professor Emeritus at the University of Hull and the University of Connecticut.  He has published 10 books and more than 200 scientific journal articles and book chapters on placebo effects, antidepressant medication, hypnosis, and suggestion.  He originated the concept of response expectancy and his meta-analyses on the efficacy of antidepressants were covered extensively in the international media and influenced official guidelines for the treatment of depression in the United Kingdom.  His book, The Emperor’s New Drugs: Exploding the Antidepressant Myth was shortlisted for the prestigious Mind Book of the Year award. It has been published in English, French, Japanese, and Polish and is currently being translated into Italian and Turkish.