RE: Placebo in indirect PD models

From: Mark Sale - Next Level Solutions mark@nextlevelsolns.com Subject: RE: [NMusers] Placebo in indirect PD models Date: Mon, 01 May 2006 06:37:33 -0700 Jeff, If the placebo model is inextricably linked to the biology/pharmacology, then it is easy. I'm not sure the citation is about a physiologic link. As you point out, pain may be a very poor example of seperation of placebo and drug effect - but I'm searching for another example where they might actually be a physiologic link between placebo effect and drug effect (I'm imagining endorphins, but I'm way out of my depth here). But, I'm not sure that the placebo response being proportional to the drug response demonstrates that the same mechanism/pathway is involved. Does the placebo effect result in greater receptor occupany? The discussion uses words like "correlate" and "metaanalysis" and "confounding", not pharmacologic terms. I assume that "closely linked" means statistically. Not sure what data they might have that could demonstrate a physiologic link. And I can think of a number of mechanisms resulting in a statistical link - including but not limited to being mediated by the same biochemical pathways. Mark Mark Sale MD Next Level Solutions, LLC www.NextLevelSolns.com _______________________________________________________