Friday, January 04, 2008

Treating explosive aggression in special needs adults - a huge placebo effect

A study on Risperdal in special needs adults is being described as showing that Risperdal has no  benefit.

That's interesting, though the drug is approved for use in children with autism, not for the group that was studied. The most interesting result, however, is the incredible placebo effect seen in the study group...

Treating impulsive aggression: HUGE placebo effect is better than Risperdal

... Impulsive and irritable aggression is a big issue in low IQ adults and children. Risperdal, in particular, has been heavily prescribed for this problem over the past ten years...

Drugs Offer No Benefit in Curbing Aggression, Study Finds - New York Times

... The new study tracked 86 adults with low I.Q.’s in community housing in England, Wales and Australia over more than a month of treatment. It found a 79 percent reduction in aggressive behavior among those taking dummy pills, compared with a reduction of 65 percent or less in those taking antipsychotic drugs.

...After a month, people in all three groups had settled down, losing their temper less often and causing less damage when they did. Yet unexpectedly, those in the placebo group improved the most, significantly more so than those on medication....

Holy cow. That's one hell of a placebo effect.

A typical placebo effect should have been around 30% improvement. In that case Risperdal would be looking great today.

In this group the placebo effect is MUCH larger than expected.

If this is born out in f/u studies, we need to figure out how to leverage that. Why was the placebo effect so large? Was it due to a change how peers and caregivers treated the study participants? A synergistic effect between the study participants expectations and behaviors and those of his (most are male) caregivers...

It's hard to get funding to study a placebo effect. Drug companies, obviously, aren't interested. It will take some serious work to get funding to find out why the placebo effect was so successful in this study. If the effect is real, and we can harness it, we can make a huge difference to the lives of many people.

We really need to find out how large this effect is in children.

1 comment:

alanbooker said...

Right on with your comment “A synergistic effect between the study participant’s expectations...” that is in my mind how most genuine therapeutic processes work, acknowledged or not! Alan