This thought has long troubled me -- especially so, in the context of psych medications -- what to make of the so-called "placebo effect"? How much of the patients' response (in psych-med cases, at least) might be due to the fact that someone, somewhere, is finally showing enough of an interest -- to try and help them?
Moreover, what to make of study-measures (like those in psych-med trials) that are inherently expressed in shades of gray, and vary (even perhaps only minimally), from clinical assistant (reporter to reporter -- or even, among self-reporters -- patients)? How much of the placebo effect is the varying attentiveness of the observer/reporter? Are new generations of psych drugs growing less potent, or are study participants becoming more suseptible to a latent alternate potency -- inside the their own bodies? [Alternatively, are drug companies less easily-able to allegedly game the outcomes, these days?]
In a wonderful article-as-short-story format, Wired's Steve Silberman takes this on (do go read it all -- but here is a teaser):
. . . .Edward Scolnick, Merck's research director, laid out his battle plan to restore the firm to preeminence. Key to his strategy was expanding the company's reach into the antidepressant market, where Merck had lagged while competitors. . . . "To remain dominant in the future," he told Forbes, "we need to dominate the central nervous system."
His plan hinged on the success of an experimental antidepressant codenamed MK-869. Still in clinical trials, it looked like every pharma executive's dream: a new kind of medication that exploited brain chemistry in innovative ways to promote feelings of well-being. The drug tested brilliantly early on, with minimal side effects. . . .
Behind the scenes, however, MK-869 was starting to unravel. . . .
If, as early as 2002, Merck felt it needed to "own" the central nervous system-influencing drugs marketplace, per its science executives, generally, and Merck's Scolnick, specifically, it would be extremely interesting to learn where Whitehouse Station presently stands on William Potter's now-apparently quite-substantial body of work -- on the placebo effect -- in behavioral drugs, seven years into his efforting.
Will it continue, in the "New Merck" regime?
What will it mean, for the advancement of basic science, if it does not?
I know at least one regular commenter will have some cogent insights, and likely weigh in, here. [Blogging will be intermitent through Sunday evening, here -- on the West Coast, and more-than-occasionally off the grid.]