Placebo May Augment Effects of ADHD Meds
Small Study Suggests Low-Dose Medications Helpful When Paired With Placebo
"There is a large body of evidence on the placebo effect, and it's possible that pairing a placebo drug with their active [ADHD] medication has the potential to elicit a similar physiological benefit," Bodfish tells WebMD. "If you repeatedly present two things together, the body conditions itself to respond a certain way. If someone rings a dinner bell every time they feed you dinner, after time, your body would respond to the bell sound alone as if you're seeing, smelling, and even tasting the food."
Psych 101 grads may remember this "conditioning" response from Pavlov's famous dog, who was conditioned to salivate upon hearing a bell.
While Bodfish's study was small and lasted only three months -- too short to study long-term effects -- he is currently testing this theory in a larger trial involving 150 ADHD children for longer period, courtesy of a National Institutes of Health grant.
The pill initially used with a half-dose of regular active medication was made to look visually distinctive, and the patients and their parents were fully told of the study's intention. "We explained that previous studies have shown that you can condition medication effects with a placebo, and there is a possibly they could get similar effects with less side effects using this placebo pill with a lower dose of their regular drug," Bodfish says.
This conditioning response may be behind the so-called "placebo effect," the reason why many participants in medical studies respond favorably when given the "dummy" pills, which primarily consist of sugar.
However, the study was too small and short-term to draw convincing conclusions, say two experts not involved in the research.
"This is certainly an interesting finding, and they present a great theory that is consistent with other studies," says neurologist Thomas Megerian, MD, PhD, ADHD specialist at Children's Hospital of Boston. "We see around a 30% response rate to placebo in depression and many other psychiatric conditions. But at this point, these researchers are hinting at an effect but the results aren't there."
Megerian says that while the study results suggest improvement with placebo, the results were not statistically significant. "This is what we call 'a trend toward significance,' but we're not there yet," he tells WebMD. "This is probably why the NIH said, 'do this on a larger number of people.'"