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The anti-placebo: OCD


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OCD sufferers are far less likely to respond to placebo than those with depression alone. NAMI cites this fact in support of OCD's physical basis.1 Two doctors tell me, "You OCD folks tend to fail medications more than other groups." They reason: "People with OCD are hyper-vigilant about side-effects and so find it difficult to give drugs long enough trials."

However, I feel the lack of placebo response explains the dissatisfaction with new medications at least as well as hyper-vigilance (an admitted factor). I should point out that the placebo effect applies to drugs which haven't begun "to work" chemically or drugs which never will work very well (again, chemically) as well as those "drugs" that have no pharmacological value. Obsessiveness reduces to doubt--about the safety of the world, the harmlessness of one's actions, etc. This doubt must extend to belief in a drug's efficacy, upon which the placebo effect depends. The honeymoon period, where belief (that a drug will help) actually lessens pain and improves mood, is denied people with OCD. Lacking this, they might stop taking a drug before it would "kick in," or are more likely to refuse to put up with something in the long run that's not working. This is my analysis. What do you think?

You'll notice in my signature a laundry list of meds. Some were prescribed to treat depression; others, anxiety; still others, OCD. 1. I have strong, sometimes paradoxical reactions to medications. 2. It's hard treat my dark triad of symptoms together. 3. I am hyper-aware of uncomfortable changes drugs have on me. 4. I'm building a pill bottle go-cart. 5. I do not have the boost the placebo effect provides in any of my conditions.

That's what I'm thinking.

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