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But No Analgesic Placebo Effect in Alzheimer’s

https://medium.com/the-mission/the-worlds-most-essential-drug-f8f5eba8407b

Good article, telling the difficulties with the placebo effect. Placebo effect allows drug recipients, taking a sham placebo, to often have strong, detectable reductions in disease symptoms. A phenomenon well known today.

But, can the placebo effect work with all “drugs” and all human disease conditions? For Alzheimer’s, according to the article, no. “Painkillers don’t work as well for Alzheimer’s patients, as they are unable to formulate ideas about the future and don’t get the benefits of anticipating treatment.”

In these cases, the administered drugs are not placebos at all. They are approved drug analgesics. The Alzheimer’s patients’ reduced cognition keeps them from even understanding that the painkiller pill they just took is supposed to work. Because they don’t know about or understand the painkilling drug, it has reduced efficacy. A reverse placebo effect. Real drug, for a real medical condition, but reduced efficacy because of reduced cognitive abilities.

If a real drug, an FDA approved analgesic, can’t induce pain reduction in cognitively-deficient Alzheimer’s patient, how could that same patient turn around and start thinking normally in anticipation that the new pill that was taken was a new, highly-effective Alzheimer’s treatment?

Fact is, the placebo effect requires strong consideration in the design, conduct, and interpretation of new drug clinical trials. But to presume every sort of patient, of even markedly reduced cognition will be affected is not supported by experience. We all await the posting of data revealing a placebo effect for a new, in-trial Alzheimer’s drug. Many companies have conducted new Alzheimer’s drug trials for several decades. Any record of a placebo effect? If not, why would the placebo effect all of a sudden be in effect for the testing of a sigma-1receptor drug? Cognitively, the mid-stage Alzheimer’s patients wouldn’t be able read or pronounce acetylcholinesterase inhibitor or sigma-1 receptor agonist, let alone have any idea what good symptomatic outcomes they are supposed to evoke.

Clearly, the placebo effect is not universally applicable. If you think it is, next time you have a sore tooth from dental caries, take a spoonful of sugar and see how that works out in a few months. Sugar, from Saccharum officinarum, is a common placebo material, with “proven” effects.