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> it always automatically happens This is exactly the framing the author is criticizing. It assumes that the placebo effect is a constant that cannot be improved upon, and thus deserves no consideration, when designing the treatment. However, the placebo effect is malleable, and can be improved [1], In scientific studies, this is typically done through suggestions and conditioning [2]. However, this is not standard clinical practice (AFAIK). Where the author is wrong, is that people that are designing drugs, aren't thinking about using the placebo effect more optimally. It is fairly well known, that the efficacy of drugs correlates with the severity of off-target side effects: say that you are taking an analgesic that acts by binding receptor A, but which also induces nausea by also binding an unrelated receptor B. During drug development, the structure of the drug is often tweaked to reduce or abolish binding to such off-target receptors, thus limiting side effects. However, these structural changes also often reduce efficacy, even if the affinity of the drug to the intended target isn't altered at all. My colleagues and I (working in pharmacology but in academia) have often wondered to what degree drug companies try to actively keep non-severe side effects as part of the response profile, given that they may be beneficial for the treatment outcome. [1] https://www.nature.com/articles/npp201081 [2] https://www.sciencedirect.com/science/article/pii/S030439590... |