Before the study began, researchers explained to the parents and the kids, aged 6 to 12, that the dose extender contained no active ingredient. After eight weeks, the symptoms of ADHD had grown more severe in kids who took only a half dose, but they remained stable in the groups that received either the full dose or the half dose plus placebo.

It’s very interesting to see this done with ADHD and stimulants, I guess partly because “stimulants” retain their association with recreational and addictive drug use, and “dose extenders” recall some of the ritual replacement people can use when they are trying to break a dependency. Obviously it’s only suitable with drugs with certain kinds of modes of action—it would spur the development of antibiotic resistance to use this method to “stretch” antibiotic supplies in a stressed environment, for example.

Kids in the ADHD study were told that, “the mind and body work together in interesting ways and placebos are known to work sometimes but no one knows why,” while researchers told patients in [another trial, in irritable bowel syndrome] that placebos “have been shown in clinical studies to produce significant improvement in IBS symptoms through mind-body self-healing processes.”

I like this approach, because it explicitly brings a broader inclusion of factors in the patient’s well-being into the doctor’s office. I think it has the potential to improve medical care in a number of ways, from reducing harm (potential side effects) to helping patients feel less buffeted about by what’s brought them into the doctor’s office in the first place. It would be interesting to see some of this work combined with what we’re learning about the better outcomes in people who simply comply diligently with medication instructions—no matter what they’re taking.

Read the whole article, It May Be Fake, but Trust Me—It’ll Work, which also talks about the variety of placebo effects and some of the limitations to consider before putting them to use.