The current view of the psychopharmacology research community is generally “they mostly don’t (apart from a strong placebo effect), and BTW they’re also potentially really fucking dangerous”.
The current alternatives aren’t any better, however. We simply don’t have an effective treatment for (or understanding of) depression at the moment.
To be fair to successive Indian governments, they were not totally motivated by cultural chauvinism and a desire to show that traditional local superstitions were as good as anything from overseas, for they also adopted the German-American homeopathy scam into the national health system.
[quote=“bobtato, post:26, topic:97957”]
If military medics routinely dispensed sugar pills labelled as “winklol-69”, then sooner or later their patients would figure it out and feel patronised.[/quote]
Hey - placebos still work even when you know it’s a placebo, right?
So why does a trial have to be blind? Surely it’s easier to just tell the placebo group they’re the placebo group, right? You just need a little spiel about placebos still being effective when the cat’s out of the bag.
Hmm… seems like alternative medicine of whatever variety could provide placebo therapy to folks who know it’s bunk.
I went through three months of chemo with acupuncture, and had exactly one day or actually one afternoon of nausea. My acupuncturist was also able to get rid of the pain from a surgical adhesion that had been bothering me for about 10 days.
I started as a skeptic, figuring I’d just give it a try. My acupuncture appointments were actually the only hour I look forward to each week for about six months
"How SSRIs work
SSRIs ease depression by increasing levels of serotonin in the brain. Serotonin is one of the chemical messengers (neurotransmitters) that carry signals between brain cells. SSRIs block the reabsorption (reuptake) of serotonin in the brain, making more serotonin available. SSRIs are called selective because they seem to primarily affect serotonin, not other neurotransmitters."
Sure, but you know better than to trust your intuition when it comes to reasoning about facts, don’t you?
Check out the vid @Wanderfound posted:
The issue is that “pain management” is so subjective. In evaluating “alternative” forms of pain management, people who used acupuncture consistently reported positive results. I think they did their best with the information at hand, but people do seem to like acupuncture.
Most commentators here seem to think acupuncture is quackery.
I do not.
When I receive acupuncture, I experience sensations that are specific to acupuncture and different from the calming experience of meditation, massage, or yoga (all different). Of course, N=1, and confirmation bias, etc.
My biggest issue with the way research on acupuncture is conducted in the West is that, in my opinion, the causal model used is complete nonsense. Sham acupuncture is not an appropriate research strategy. The unit of treatment is “practitioner skilled in modality plus patient”; you can compare clinical outcomes vs. clinical outcomes with other protocols but you cannot compare sham to actual.
The reason people go for this nonsense is because people think of acupuncture as being like a drug or surgery. It is not. Acupuncture is much more like talk therapy. It is a conversation between practitioner and patient, mediated by needles. You would never be foolish enough to try double-blind trials of talk therapy, because the communication model is obvious, but because many people believe in linear causality in the medical world, they think this approach to researching the efficacy of acupuncture is appropriate.
As @wanderfound points out, there is a wide range of efficacy in “placebo” treatments. I think the word placebo is not the most useful one, because it is often read as “invalid” or “fake”, rather than “rhetorically effective”.
The concept of rhetorical efficacy is the best option when we are trying to understand the experiential phenomena that some people describe as “chi” or “ki”. For example, any person who has taken an introductory class in Ki Aikido will have had their instructor demonstrate the difference between lifting a person who is holding ki in their belly and lifting a person who is focusing ki downward. Two incoming students can always take the arms of the first person and lift them off the ground. Those same incoming students can never (almost never?) lift that same person when the intended liftee is focusing their ki downward. Why? I’ve spoken with curious Aikido instructors who have focused their ki downward while standing on bathroom scales. Their weight does not observably change. The only way they could be consistently generating such an experientially overwhelming effect is through a reliable form of nonverbal communication – communicating “I am heavy” without needing words to do so, in a way that other participants reliably find convincing.
This is rhetorical efficacy. The mechanism of communication is not the important part; the important question is, “are patients reliably experiencing changes in their bodies as a result of the interaction with this practitioner or class of practitioners?”
Acupuncture is rhetorically effective, particularly when practiced skilfully. Not all patients find it so, and often you need a good match between patient and practitioner, but the various clinical studies of pain treatment that have found acupuncture to be effective have at least shown us that people’s bodies are often convinced not to feel pain.
For these reasons, I strongly disagree with the prevailing mood on this thread!
It’s the fact that they would cite a survey at all that is disappointing - it’s not even close to scientific.
@CoffeeAlchemist: I want to be clear, I don’t think acupuncture is quackery, I just think Consumer Reports using a customer survey to support the practice puts them in a tenuous position.
Fair enough!
See my response to Wanderfound. Replace “placebo” with “treatment that derives its efficacy primarily from communication between practitioner and patient, rather than through mechanical / chemical forcing of changes in the patient’s body”, and your statement is clearly true! Unfortunately, the word “placebo” carries the meaning-aura of “trick” or “false”, so calling a treatment an “effective placebo” is likely to reduce its efficacy.
That’s fair. I found it a little odd that they would weigh in on this. But they now have a little health bulletin that they mail me every month, and I guess they have a few pages to fill.
Yeah, to be absolutely clear, I do not in any way think acupuncture is quackery. I’ve seen enough examples of it being extremely effective that I’m very open minded about it as a treatment; I’ve seen it clearly alleviate serious pain in dogs, and I somehow think dogs are not getting a placebo effect from it.
But this style of acupuncture, which as others have pointed out uses the outer ear as a sort of voodoo doll model of the entire human body, has very little support or effectiveness.
Fair enough!
I thought “battlefield acupuncture” meant “bayonets.”
I can think of several explanations, the most convincing being that you cannot lift someone by the arms without their cooperation (unless their arms are straight above their head, which doesn’t sound like what you’re describing). If I hold my arms out, perpendicular to the floor, they will not support my weight unless I tense my shoulders sufficiently.
A better experiment would be to see if the “focusing ki downwards” has any effect on lifts which do not require the subject’s cooperation: lifting a chair with someone sitting in it, or a backboard with someone lying on it, or perhaps a fireman’s carry. And, while it’s completely impossible to blind the person being lifted, the lifters should be blinded as to which scenario is which, and, if possible, to the nature of the experiment entirely. That is, they should go in, be asked to lift a 100-pound dummy, and then to lift ten actual people in the same manner, and then to provide a guess as to each person’s weight. Five of those people should be told to focus their ki inward, and five to focus it downward, and the people observing and instructing should not know which are which.
After the results are correlated and people’s guessed weights are compared to their actual weights, then, and only then, the envelops telling the researchers how each was focusing their ki (for that iteration of the experiment) should be unsealed.
Similarly, if you don’t like the experiments that are being used to determine the efficacy of acupuncture: design and conduct a better experiment.
All promising possibilities. None of them are proven effective treatments, and all of them carry obvious risks.
I’m familiar with the mechanism of the pharmacology; I’ve published some papers on it.
There’s a difference between understanding “what neurotransmitters are released when this drug is administered, and what is the mechanism driving that release?” and understanding “why does this drug alleviate the symptoms of depression?”.
We’ve got a decent partial understanding of the first question, but very little clue on the second.
