Is placebo effect genetic?

[paula_w]

Received from planton, a pipeliner.

Genes Determine Whether Sugar Pills Work

Main Category: Clinical Trials / Drug Trials (http://www.medicalnewstoday.com/sections/clinical_trials/)
Also Included In: Genetics (http://www.medicalnewstoday.com/sections/genetics/); Psychology / Psychiatry (http://www.medicalnewstoday.com/sections/psychology-psychiatry/)
Article Date: 04 Dec 2008 - 6:00 PST

It is a well-known fact in drug trials that individuals can respond just as well to placebos, sugar pills, as to the active drug. On the other hand, it is difficult to explain why only certain people get better from placebos. A team of researchers from Uppsala University and Gothenburg University have now found gene variants that can impact the placebo effect and a mechanism in the brain that characterizes those who respond to placebos.
The study, published in Journal of Neuroscience, examined 108 individuals suffering from social phobia using a brain camera (PET, positron emission tomography). The individuals were participating in a treatment study looking into how anxiety-moderating drugs affect brain activity. Just under one fourth of the subjects were given a placebo instead of a drug. This was a double-blind study, meaning that neither the subjects nor the research team know who was taking the drug or the sugar pill.

article: http://www.medicalnewstoday.com/articles/131827.php

[jeanb]

When I was in the CEP-1347 clinical trial, I was in an email group of about 12 others in the trial. We shared our experiences, our side effects, visits to study centers, doctors, and overall how well we were doing etc etc.

Several of my correspondents were doing VERY well - their symptoms hadn't worsened - and they hadn't had to start on pd meds. I admit that I envied them - and I hoped when the trial ended I would get the GOOD dose - the dose they were on.

you can see where this is heading...

When the trial was unblinded, it turned out THEY had been getting the placebo. And I had gotten the lowest dose - the group that did the worst (go figure).

[ZucchiniFlower]

From another article:

Finding genetic markers for the placebo effect could raise ethical questions about how companies design their clinical trials, Furmark says. For example, "it could be tempting to screen all individuals and ... select only those with [the] nonresponsive phenotype [for the trial]."

Why is that an ethical question? It would be wonderful if one could exclude those that might exhibit a strong placebo effect from the trial. How is that possibly unethical?

http://sciencenow.sciencemag.org/cgi/content/full/2008/1202/1

[paula_w]

From another article:

Finding genetic markers for the placebo effect could raise ethical questions about how companies design their clinical trials, Furmark says. For example, "it could be tempting to screen all individuals and ... select only those with [the] nonresponsive phenotype [for the trial]."

Why is that an ethical question? It would be wonderful if one could exclude those that might exhibit a strong placebo effect from the trial. How is that possibly unethical?

http://sciencenow.sciencemag.org/cgi/content/full/2008/1202/1

ZF,

I'm still somewhat in a fog today so if the logic is off here I'm sorry. But would it be better to just factor in the placebo genes [somehow] and still let those prone to placebo effect have a shot at the treatment? I'm not sure if that even makes sense, but wouldn't it be unethical to eliminate those with the genes from getting a potentially life saving treatment in time? Is that what they are saying?

paula

[ZucchiniFlower]

Hi Paula,

I would expect them to get the drug when and if it is approved, of course. I'm only talking about the trial.

I suppose that one could include them in the trial to see if those genetic differences have the same effect re: placebo effect. But, I would not want their results to count when the effectiveness of the drug is analyzed.

In other words, let them join the trial, but don't let their genes screw up the results of the trial.