Big Pharma’s Placebo Problem

Let’s now return to our original question. We know that Sarah was unaware that the drug she was taking was Prozac. She thought that Sarafem was a specific pill developed for her specific “problem.” Sarah was wrong. What Sarah also did not know was that Prozac was rebranded as Sarafem more for financial than scientific reasons.

But the question still remains about whether Prozac was rebranded for other reasons too. Was it rebranded because the company knew that Prozac would provoke only a small placebo effect in women suffering from so-called PMDD? Did Lilly turn Prozac into a distinctly female pill to achieve a higher placebo effect in this new patient group?

The importance that the drug companies place on the effectiveness-boosting psychological tricks they use in marketing their drugs makes me think that the drugs themselves may not have much in the way of real effects. In fact, meta-studies of SSRIs (a class of antidepressants) have found that this entire class of drugs does not produce clinically significant results vs placebos in treating depression.

As Ben Goldacre pointed out in Bad Science (which I have read) and his recent book Bad Pharma (which I haven't) many, many studies funded by drug companies that show negative effects, or that show weaker results than competing drugs — or even a placebo — are buried. There is no requirement to publish research, and there is no requirement to report negative results, and so companies quite often just ignore contrary findings.

It's kind of frightening that such a large part of the effectiveness of many drugs is due to nothing more than belief. We might as well be treating some things with chants and rattle shaking instead of drugs with numerous documented physical side effects which often have no better outcome than a Tic Tac would have, as long as it was handed out by anyone believed to be a health care professional.