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So it looks like I'm on a prescription for the long term but I'm not convinced the pills are making much difference (they aren't for a serious health issue, more of a comfort issue so I can wake up to a Pure Morning). However if I don't take them, I know I haven't taken them so that plays on my mind. I've asked my GP about doing some sort of controlled test but they aren't interested - they're happy to keep prescribing and aren't that bothered about my concerns over efficacy. So I was wondering about trying to find a placebo that looks almost the same as the pills I'm taking so I can experiment on myself. However a search for placebos brings up all sorts of dodgy links and while I don't want to be a Nancy Boy about it I really don't want to potentially buy harmful stuff from some dodgy website. I know there's some folk involved in medical testing on here so where do you get yours from?
Have you tried CD or vinyl rather than mp3?
so to defend your GP, it's not their role to do a 'controlled test'..so don't blame them for that.
They should talk to you about your response to the meds, and stop/change them if you feel they aren't working.
Re the placebo thing...it's interesting as EVEN IF you tell someone it's a placebo, it'll probably help them a degree (whether it'll help as much as a true active medication is unclear).. but we can't prescribe placebos (gee I wish we could). Ultimately though, you can't really experiment on yourself if you know which pill you're taking (hence true tests are double blinded.. the pill giver, and the pill taker are unaware of what the pill is)
Just buy some tictacs I guess..the act of taking a pill may help?
DrP
Talk to a Homeopath, they'll happily give you (well, sell you) sugar pills.
Buy some skittles? Chewy vitamins?
It's unlikely you could get 'fake' tablets that look similar enough to the real thing to fool yourself, isn't it? At which point it's hard to get a reliable result. Plus someone needs to be overseeing what tablet gets put in your hand each day, and GPs really don't have time for that kind of work.
Blinding and randomisation is a big thing and taken very seriously. In trials they are normally not just "off the shelf", they go through the same manufacturing process, just without the API (active product ingredient). Then are packaged into identical packs. One exception might be infusions, where the placebo is normally just saline. In some diseases placebo can be a very good drug. HALF of all depression clinical trials have a placebo response large enough to mask any therapeutic response for a potential new therapy.
When testing comparators drugs, sometimes a tablet will be over-encapsulated, so both test and control look the same. In doing so the criticism used to be that if you stick a shell over the comparator it might not be absorbed as well so you are biasing the competition. We've done exposure comparisons to show this was not an effect before big studies too!
Ultimately though, you can’t really experiment on yourself if you know which pill you’re taking
If you would really like to try and modulate exposure and consider any effect on your own response, you 1) need a reproducible measuring scale for your sleep - say a smart watch measure, and 2) need to modulate exposure. One method is to randomise the number of times per week and days you take the medication. Repeat this and monitor average weekly sleep scale. Of course this is still "open label" so there will be inherent bias, but over the course of weeks you will tend to forget how many times you took the medication and on what specific days, and achieve some average exposure response. And the measurement really needs to be objective rather than a subjective (sleep scale 1,2,3,4). But applying some degree of average forgetfulness is possible - an analogy might be how many days did you wear blue last week?
Pet homeopathy is a thing. Owners report excellent outcomes.
Stop trying to Fix Yourself, your 36 Degrees, you've no Special Needs, if you keep on with the Meds you end up on Special K.
For TINAS 😆 🤣
What about looking at supplements?
https://www.bulk.com/uk/accessories-clothing/empty-capsules.html
You could just take a multivit or something similar?
Apparently capsules are better than tablets, and the blue/red ones the best of those. Placebo effect is weird so even if you know it can still work. But then so can regression to the mean.
It's your life - what about these
Hopefully you’ll be sorted out and be Running Up That Hill in no time.
TiRed is absolutely right with his post.
Some drugs also need to build up in your system and to be taken regularly.
Maybe talk to your pharmacist. They really understand this stuff and will hopefully persuade you to try the meds and keep taking them on a regular basis.
talk to the pharmacist? Best not ask for a pack of party-poppers that pop in the night
There was a really good documentary on this a few years ago, worth seeking out.
Yes, for some people it worked, even when they knew it was a placebo. One lady with debilitating IBS had no symptons for the 3 weeks she was on them but it came back as soon as they stopped supplying them.
She went off trying to buy them afterwards but had no luck.
The most amazing case was the chap with parkinsons who had a remarkable recovery from an attack after being given a placebo (he didn't know it was a placebo).
And to keep it STW, there were pro cyclists that thought they were in a test for a new suppliment who mostly got PB's after dropping cornflower. The brain sure is a powerful thing.
As was said, want a placebo? See a homeopath.
If you want to deal with your problem see your GP or pharmacist. That’s what they are there for.
Using the regular interpretation of the ‘placebo effect’ requires that you believe it is an active treatment. This is unlikely if you know you are taking an inert product.
The interesting thing about placebos is that they have NO EFFECT. Hence their use in RCTs. Effects on outcome in a group in an RCT of placebo must be attributed to other things. For example, sometimes people just get better, or the measure used is ‘noisy’.
One of the early, and perhaps most influential, papers on the ‘placebo effect’ turned up in a critique recently. I can’t find that reference, but it suggested, again, that Beecher may have exaggerated his estimate of the ‘placebo effect’ to make a point: to properly test a new intervention you must have a control.
https://jamanetwork.com/journals/jama/article-abstract/303530
This one goes into estimating the ‘placebo effect’: https://academic.oup.com/aje/article/190/1/2/5876955
This one has a concise critique of Beecher’s paper: https://pubmed.ncbi.nlm.nih.gov/9449934/#:~:text=Beecher%20was%20the%20first%20scientist,most%20frequently%20cited%20placebo%20reference.
Thanks for the variety of opinions and song titles. I've been on these things for years already, and that was after a lot of to-ing and fro-ing with a consultant where we ended up with this option. When I started taking them I did (as requested by my consultant) keep a symptom diary to check their effectiveness and we agreed that there seemed to be a benefit, but now I'm not sure if that was a placebo effect in itself. There is no long term accumulation of these in the system - they are cleared out in about 8-12 hours. The GP is happy for me to make a decision about them, but that's limited to a stop/continue decision - any bigger change would need a referral back to a specialist and frankly it ain't worth bothering the NHS about and certainly isn't worth going private for.
Wear a sleep monitor - smart watch? - while you sleep and record everything you can for 2 weeks plus a symptom diary while you continue to take the normal medication.
Buy some empty capsules that you can put your active medication in. FilL 50% of the active capsules with your medication and 50% with a simple sugar pill. The capsule should prevent you seeing exactly which one you are taking. For 2 weeks just take the capsules from a bottle with a mixture of real meds and sugar pills. You won't know whether it is medicine or placebo.
Compare the recordings and symptom diaries of the 2 weeks on real medicine to 2 weeks on 50/50 medicine and see if there is a difference.
You could try a reducing amount of real meds to track when their effectiveness declines. first 2 weeks at 100%, next 2 at 75% mix, 50% mix, 25% mix, all placebo. That way, if there is a level at which they help, say 50% of the time, you will know how many placebo pills to mix into your nightly pill bottle.
Thanks for the memories. Been so many years since ive seen that photo. Looks totally different to how i remember it, which is weird considering it how formative they were in my teens.
Got my playlist for the morning.
If you don't think they do anything then stop. A placebo won't work as you'll know it's a placebo (though appearently that's not true).