Blue Pill Research Articles

Are the colors and shapes of current psychotropics designed to maximize the placebo response?

Patient expectations are an important aspect of the placebo response. Color and shape of a medication lead to perceptions that an agent is stimulating or calming, strong or weak. We assessed the degree to which central nervous system medications match the perceived drug action and thereby harness the placebo response. We consulted the 2009 Physicians' Desk Reference and recorded the formulation and color of each referenced dose of central nervous system therapeutics approved for sale in the USA. On the basis of the expectations they engender, orange, yellow, and red pills were categorized stimulating; green, blue, and purple pills calming. White and gray pills were considered neutral. The majority of the 176 unique doses that were included in the study were in tablet (55%) and capsule (33%) form. Stimulants (75%) were the only drug category primarily formulated as capsules. Of the 176 unique doses included, 43% were stimulating, 23% calming, 23% neutral, and 12% were a formulation other than pill or capsule. There were no instances in which over 50% of the pills of an indication were stimulating or calming in color. Our study did not confirm the hypothesis that pharmaceutical companies color and formulate the shape of drugs to enhance the treatment response. In several instances, each approved dose of a given medication was a different color, and the majority of doses were in tablet form. Further research into the effect of different colors and formulations of medications on perceptions and efficacy evaluations should be considered.

In search of little blue pills

In search of little blue pills

The red pill: social studies, media texts, and literacies

This article explores the use of media texts in contemporary high school social studies classrooms. Much of the current research regarding media education in social studies classes has focused on history classes and has centered on small idealized samples of both teachers and students. This study, based on the observations conducted in eight secondary social studies classrooms located in urban, suburban, and rural high schools in the Midwestern region of the USA, provides insight into type and frequency of media text interaction in a broad range of social studies courses and contexts. Results indicate that students had few opportunities to interact with media texts in the classrooms. In addition, there was only a small amount of class time devoted specifically to media literacies skill development. Implications of these findings are discussed and may provide a reality check for the status of media use in high school social studies classrooms.

How Did I Get This Way? How Bad Is the Damage? <i>and</i> How Do I Fix It?

here is an old saying, ―Ignorance is bliss.‖ I never really knew what the elders meant by this statement until the last few years of teaching mathematics to high-SES students at a private school. You see it has been 3 years since I decided to take the red pill (like Neo in The Matrix) and this decision has led to numerous days of frustration, confusion, and unfulfilling results. Before doing so, I was in a state of ―ignorant bliss.‖ I stood in front of my students, poked my chest out, and indoctrinated them with knowledge relevant or irrelevant to their lives. In return, they wrote down word-for-word everything I said, never questioned my mathematics, and passed the assessments. Dialogue 1 was not present, numeracy was not present, and mathemacy 2 was nowhere in sight. Then the decision—the red pill—and I became conflicted and began to reflect differently on my teaching practices. I started to see the discourses that surround my students (and yes the wealthy too have discourses), discourses created by their teachers and their teachers‘ practices, and the discourses created by lofty and unsatisfied expectations of their parents. These practices and discourses work

The Nesting-Egg Problem: Why Comparative Effectiveness Research Is Trickier Than It Looks

A sixty-five-year-old woman goes to her doctor with excruciating lower back pain. When she first felt it, she assumed that she had merely pulled a muscle and that the pain would go away, but a month has passed with no relief. The diagnosis is straightforward: an MRI shows a hairline fracture in her spine due to osteoporosis. But choosing the right treatment will be anything but straightforward. One option is to keep doing what she has been doing: using over-the-counter pain relievers as needed until, ideally, the fracture heals. Another option is vertebroplasty, an injection of acrylic medical cement into the fracture. Until recently, vertebroplasty was the obvious choice. A few small trials had found it superior to conservative treatment. A consensus statement signed by several medical groups endorsed the procedure, and Medicare and private health insurers paid for it. But last summer, that certainty evaporated. Two trials involving about two hundred patients, published in the August 6th issue of the New England Journal of Medicine, found that vertebroplasty--which costs $2,500 or more, plus $1,000 to $2,000 for an MRI scan--was no better than a sham injection for relieving back pain from spinal fractures. is the sort of strong evidence that the federal government was aiming for last February when it allotted $1.1 billion for comparative effectiveness research as part of the American Recovery and Reinvestment Act of 2009, better known as the stimulus bill. In the most systematic and best-funded effort of this kind in the United States, the bill supports research comparing drugs, surgery, and other means of preventing, diagnosing, and treating particular health conditions. A panel of federal employees will oversee the research and advise the president and Congress on how to spend the money. Health care reform legislation being debated in Congress at press time also calls for comparative effectiveness research. Fewer than half of the treatments and tests that doctors recommend are supported by scientific evidence, according to a recent report from the Institute of Medicine. This uncertainty contributes to great variability in managing clinical problems, with costs and outcomes differing markedly across the country, the report concludes. The great hope of comparative effectiveness research is that it will supply some of the missing science. It will put doctors' decisions on firmer ground, help patients get the best possible care by sparing them the inconvenience, potential harm, and expense of unnecessary procedures, and ultimately save the health care system money. President Obama put it this way: There's going to be some disagreement, but if there's broad agreement that in this situation the blue pill works better than the red pill, and it turns out the blue pills are half as expensive as the red pill, then we want to make sure that doctors and patients have that information available to them. If only it were that easy. While comparative effectiveness research has had some game-changing successes--the association between Vioxx and increased heart attack risk came out in a comparative effectiveness study of pain relievers--it often fails to show which treatment is best, and for whom. It suffers from what might be called the nesting-egg problem. Instead of giving definitive answers, it opens the door to new questions, like little eggs revealed within larger ones. The blue pill may be more effective for most patients, but maybe the red pill could benefit a particular group. And what is meant by effective--shrinking a tumor by 10 percent? Extending life by a year? What outcomes really matter? The New England Journal of Medicine studies provide a prime example of the nesting-egg problem. In both studies, the group of people who got the vertebroplasty and the group that got the sham injection improved, but the difference between the groups was negligible. Does that mean that the treatment is worthless? …

"The Cracks Are Where the Light Shines In": Grief in the Classroom

"The Cracks Are Where the Light Shines In":Grief in the Classroom Leeat Granek (bio) Our dream of life will end as dreams do end, abruptly and completely, when the sun rises, when the light comes. And we will think, all that fear and all that grief were about nothing. But that cannot be true. I can't believe we will forget our sorrows altogether, that would mean forgetting that we had lived, humanely speaking. Sorrow seems to me to be a great part of the substance of human life. —Marilynne Robinson (104). I am sitting with my mother in a restaurant. It is a day before she is to be admitted to the hospital. We are, in fact, discussing this possibility. She is wearing a pink corduroy hat that covers her balding head and a thin pink shirt with a stain on it. We argued about this shirt before we left the house that morning. My mother was an impeccable dresser, the kind of woman whose shoes matched her purse and whose shirt was always tucked in. On this day, for the first time, she didn't care that her shirt had a stain on it and this worried me. We sat in the dark restaurant. Her meal, ordered from the children's menu, sat mostly untouched. She rested her head in her hands, her elbows propping her up. The last few days had been difficult. She had awoken the day before speaking in riddles, and we were trying to make sense of the gibberish. We didn't know yet that the tumors were in her brain, we didn't know yet that it was affecting her speech, we didn't know yet that she would die in less than seven days. We didn't know. But she knew. She closed her eyes as had become her custom over the last week. I watched her, let her rest at the table. "Mom," I said, after a few minutes. I was taken aback by her own startled response when her eyes jerked open. She had fallen asleep with her chin cradled in her palms. "I think we should ask the doctor about these symptoms." She had explained away the odd behavior as side effects of the drugs she was taking. There were red pills and blue pills and yellow pills and green pills and orange pills, so many pills, she had said, perhaps she had mixed them up? Perhaps she had taken too many? "Still," I persisted, "it's good to ask, just in case." She looked up suddenly. Her head had become too heavy for her neck in the last week; she seemed to be continually hunched over. Her beautiful piercing blue eyes were dulled, laced with a grayness I had never seen before. "I'm scared, Leeatie," she confided. "What if I'm dying?" My mother's death was not a surprise. Despite eighteen years of relative psychological and physical health while she lived with metastatic breast cancer, the last year of her life was a violent struggle against the disease that aggressively invaded her body. My mother fought her death until the last moment. One day we were shopping, [End Page 42] eating lunch, we were united, arm in arm, solid and content in our togetherness, and the next day she was in the hospital, attached to tubes, wires, and pain pumps. Suddenly her face was swollen, suddenly she was confused, suddenly she was no longer my mother but a body withering in pain, uncomprehending in her terrible, terrible suffering. Within five days of being admitted, she died. My mother was a cancer patient for as long as I can remember. I was nine when she was first diagnosed and twenty-six when she died. I don't remember much before that. I remember the matching dresses we used to wear when I was a toddler, a visible sign of our unity. I remember the comfortable weight of being embraced, nestled contentedly in the concave shape of her curled body. I remember the weight of her scent that used to envelope me when I came back from school each day, familiar and intoxicating. I remember the feel...

THE MATRIX RECONSIDERED

This article employs the conceptual opposition of the red and blue pill that is presented in The Matrix trilogy as a mechanism for investigating the philosophical antagonisms and structural conflicts commonly associated with the ‘information society’. The text is divided into two main parts: The first reconsiders the logical structure of this pharmacological dialectic, arguing that the choice between these two alternatives originates in the history of western thought and demonstrating how this binary arrangement organizes not just science fiction narratives but our understanding of social reality. The second part reconsiders the choice of the red pill. It critiques the assumed value of ‘true reality’ that is expressed in the cinematic narrative and suggests alternative ways to think outside the box of this rather limited binary structure. The objective of such an undertaking is not simply to question the philosophical assumptions of what has been defined as the ‘right choice’ but to learn, through such questioning, to intervene in and undermine its very system. The article, therefore, suggests an alternative method by which to challenge and critique the established network of conceptual oppositions that goes beyond mere revolution and the other familiar strategies of social change.

Toward “Good Enough Methods” for Autoethnography in a Graduate Education Course: Trying to Resist the Matrix with Another Promising Red Pill

Educational research suggests that the response biases of educators can negatively influence student performance and aptitude (Blanchett 2006; Bloom 2001; Darity et al. 2001; Gordon 2005; and Skiba et al. 2000). This article introduces “good enough methods” for autoethnography as an alternative approach to this problem. Luttrell (2000, 13) conceptualizes “good enough methods” researchers as those seeking to understand and appreciate difference and accept errors often made because of their blind spots and intense involvement. Evidence of this approach via autoethnography is provided here from cases of graduate student-practitioners and their Intergroup/Intercultural Education professor. Moreover, the article highlights (a) a connection of autoethnography to research in Education, (b) five key decisions of a “good enough methods” approach to autoethnography, and (c) how this approach can be applied to expose and address educator biases relating to “the matrix” (Hill-Collins 1990) of race, class, and gender.

Outstripping Students Again

IN THE late 1990s, Safford Middle School, which is in a rural area of eastern Arizona, adopted a policy prohibiting the nonmedical use, possession, or sale of drugs on school property or at school events. The policy defines drugs as including not only controlled substances but also alcoholic beverages and prescription or over-the-counter drugs except with the permission of school authorities. A stimulus for adopting this policy was an incident in which a student brought a prescription drug to school and distributed it to classmates, one of whom became seriously ill and wound up being hospitalized. On 22 August 2003, the school held a dance to celebrate the beginning of the new academic year. During the dance, several staff members noticed unusually rowdy behavior and the smell of alcohol coming from a small group of students, including Savana, an honor-roll eighth-grader, and her friend Marissa. Later in the evening, staff members found a bottle of alcohol and a package of cigarettes in the girls' restroom. No official action was taken at that time. On 1 October 2003, another student at the school, whose name was Jordan, and his mother requested and participated in a meeting with the principal and vice principal. Jordan's mother explained that a few nights ago her son had become violent with her and was sick to his stomach, a result--according to Jordan--of his having taken some pills a classmate had given to him at school. Jordan reported that specific students had brought drugs and weapons to school. He identified Savana as having served alcohol to her classmates at a party she hosted at her home prior to the August dance. On 8 October 2003, Jordan asked to meet with the vice principal and handed him a white pill that he said Marissa had given to him. He also claimed that a group of students were planning to take pills at lunch. The vice principal took the pill to the school nurse, who identified it as ibuprofen 400 mg, a dosage available only by prescription. Based on this information, the vice principal went to Marissa's classroom to escort her to his office. As she stood up, he noticed a black planner lying on the empty desk next to her. He asked her whether the planner was hers, and she said no. He handed it to the teacher and promised to attempt to find the owner. Soon thereafter, the teacher discovered that the planner contained knives, lighters, a cigarette, and a permanent marker. He promptly conveyed this information to the vice principal. At the office, the vice principal, in the presence of Helen Romero, a female administrative assistant, asked Marissa to turn out her pockets and open her wallet. She complied, producing one blue pill, several white pills, and a razor blade. When asked about the blue pill, which the nurse subsequently identified as Naprosyn 200 mg, an over-the-counter drug used to treat pain and inflammation, Marissa said: I guess it slipped in when she gave me the IBU 400s. When the principal asked her, Who is she? Marissa identified Savana. Upon questioning about the planner, Marissa continued to deny ownership and similarly disclaimed knowledge of its contents. The vice principal then directed Romero to escort Marissa to the nurse's office and conduct a search of her clothing and person for more pills. At the nurse's office, Romero closed the door, which locked automatically, and asked the nurse to observe. Next, she instructed Marissa to 1) remove her shoes and socks, 2) lift up her shirt and pull out her bra band, and 3) take off her pants and pull out the elastic of her underwear. Marissa complied, and no further contraband was found. Meanwhile, the vice principal retrieved Savana from her classroom and escorted her to his office. After stressing the importance of telling the truth, he showed Savana the black planner, and she acknowledged that it was hers but claimed that she had loaned it to Marissa several days earlier to help her hide some things from her parents. …

Introduction: We Need to Take the “Red Pill” of Reality

The article discusses various reports published within the issue, including one by George E. Smith that analyzes a report that U.S. business schools are de-emphasizing the teaching of management history in their curricula and another by Anson Seers that focuses on the nature and evolution of management education. [summary provided by EBSCOhost]

Taking a Red Pill to Disempower Unethical Students: Creating Ethical Sentinels in Business Schools

The article focuses on the creation of ethical sentinels in business schools. Particular attention is given to the ethics of students, the choices confronting business educators, as well as the sig...

Pulsology Reloaded

The Losartan Intervention For Endpoint reduction in hypertension (LIFE) Study,1 the Second Australian National Blood Pressure Trial (ANBP2),2 and the Anglo-Scandinavian Cardiovascular Outcome Trials3 have shown that different antihypertensive treatments may have different impacts on the rate of events in hypertension while achieving comparable brachial blood pressure (BP) reduction. Thus, although brachial BP estimation by classic Riva–Rocci cuff sphygmomanometer and the Korotkoff auscultatory technique have provided almost all of our knowledge on epidemiology, prognosis, and treatment of hypertension,4,5 recent trials1–3 are revealing intrinsic limitations of the conventional approach, because the real goal of treatment in hypertension is the reduction in the number and the rate of untoward events. More recently, the Conduit Artery Function Evaluation (CAFE) Study6 described higher central BP as a key factor explaining the greater number and rate of events with atenolol than with amlodipine plus perindopril. Central pressure waveform and BP values can be estimated by applanation tonometry, a method supported by solid theoretical principles and modeling studies in experimental settings.7 Analysis of the systolic portion of the carotid pressure waveform allows for obtaining indices of the arterial viscous-elastic properties that correlate with end-organ damage and clinical outcomes in hypertension.8 Therefore, the indices of arterial waveform reflection and mechanics and central BP assessed by applanation tonometry have the potential to add significant information for risk stratification beyond and above brachial BP. In fact, the conclusions of the CAFE Study were well received.9 In addition, applanation tonometry has also been associated with 2D-guided M-mode vascular ultrasonography to assess simultaneously the viscous-elastic properties of the carotid artery, the intima–media thickness, and quantification of atherosclerosis.8 Assessment of cardiovascular target organ damage is curial for a global risk assessment …

Letter to the Editor: Lincoln's Gait

Letter to the Editor:Lincoln’s Gait Norbert Hirschhorn and Ian A. Greaves Lincoln's Gait Our article in your journal, "Abraham Lincoln's Blue Pills" (co-authored with the late Robert G. Feldman) proposed that Lincoln suffered mercury poisoning from elemental mercury in the 19th-century medication called the blue pill, or blue mass (Hirschhorn, Feldman, and Greaves 2001). His symptoms included bizarre behavior and outbursts of rage (known as erethism when caused by mercury), insomnia, forgetfulness, and hand tremor under stress. We also noted Lincoln's odd gait, as described by his long-time law partner William Herndon: "When [Lincoln] moved and walked along . . . he put his whole foot down flat at once, not rising from the toe, and hence he had no spring to his walk." We took this as a possible indication of sensory nerve damage related to mercury. Now for this latter sign comes a more intriguing explanation. Laura Ranum and colleagues have found mutations in b-III spectrin associated with spinocerebellar ataxia type 5 (SCA5) in a family descended from Abraham Lincoln's paternal grandparents (Ikeda et al. 2006). Descriptions of Lincoln's gait are similar to gait abnormalities found in the early stages of SCA5 (Ranum, personal communication), such as this eyewitness account from the London Times journalist William Russell in March 1861: "Soon afterwards [Lincoln] entered, with a shambling, loose, irregular, almost unsteady gait. . . ." (Views of President Lincoln, 1861). Other eyewitnesses reported similarly: "His left shoulder was higher than his right and his walk was undulating and slightly off balance, making him resemble, someone said, 'a mariner who had found his sea legs but had to admit there was a rough sea running.' [End Page 631] The Reverend Dr. Phineas D. Gurley, his pastor, said when Lincoln walked, he looked as if 'he was about to plunge forward, from his right shoulder, for he always walked, when he had anything in his hand, as if he was pushing something in front of him'" (Kunhardt, Kunhardt, and Kunhardt 1992, p. 321). It would be interesting to know if SCA5 somehow makes persons more susceptible to heavy metal poisoning. Abraham Lincoln, arguably our greatest president, remains endlessly fascinating. Ranum's findings should reinvigorate the call to test Lincoln's DNA (from existing hair and bone fragments) for SCA5, among other diseases proposed (McKusick 1991). Ian A. Greaves Department of Environmental and Occupational Health University of Minnesota School of Public Health igreaves@umn.edu 115 Greencroft Gardens London NW6 3PE, U.K. bertzpoet@yahoo.com References Hirschhorn, N., R. G. Feldman, and I. A. Greaves. 2001. Abraham Lincoln’s blue pills: Did our 16th president suffer from mercury poisoning? Perspect Biol Med 44:315–32. Google Scholar Ikeda, Y., et al. 2006. Nat Genet 38:184–90. Google Scholar Kunhardt, P. B., Jr., P. B. Kunhardt III, and P. W. Kunhardt. 1992. Lincoln: An illustrated biography. New York: Knopf. Google Scholar McKusick, V. A. 1991. The defect in Marfan syndrome. Nature 352:279–81. Google Scholar Views of President Lincoln, 1861. http://www.eyewitnesstohistory.com/lincoln2.htm. [End Page 632] Copyright © 2006 The Johns Hopkins University Press

Book Review: The Rise of Viagra: How the Little Blue Pill Changed Sex in America

Book Review: The Rise of Viagra: How the Little Blue Pill Changed Sex in America

Book Review: The Rise of Viagra: How the Little Blue Pill Changed Sex in America

Book Review: The Rise of Viagra: How the Little Blue Pill Changed Sex in America

"Let's Just Say It Works for Me": Rafael Palmeiro, Major League Baseball, and the Marketing of Viagra

On October 28,2003, representatives of Pfizer pharmaceuticals gathered at corporate headquarters in New York City to celebrate the fifth anniversary of the launch of their wonder drug Viagra. The guest list for the big event, along with the requisite press, public relations executives, NASCAR luminaries, and satisfied customers, featured erstwhile Texas Rangers first baseman and designated hitter Rafael Palmeiro. (1) Not only has Palmeiro had a spectacular career, both at bat and in the field, but during the 2002 and 2003 seasons Palmeiro, currently of the Baltimore Orioles, also played the role of Viagra pitchman. The connection of Viagra--an official and, as its ads would have us know, proud sponsor of Major League Baseball since 2002--is not limited to Palmeiro's endorsement, nor did it end with his term as pitchman. Prominent outfield signage, a sweepstakes tied into the 2003 All-Star Game, and even an online fantasy baseball game entitled Clutch Performances[TM] reintroduced for the 2004 season, reinforce the connection between Major League Baseball and Pfizer's drug. What is it about baseball, as opposed to any other professional sport, that prompted Pfizer's marketing wizards to link it to their performance-enhancing drug? Why associate Viagra with professional sports in the first place? And what is it about Rafael Palmeiro, certainly a high-profile player but hardly Johnny Damon or Derek Jeter, that makes him the right spokesman for this particular product? After all, Palmeiro is not the first well-known celebrity to endorse Viagra. Who can forget the image of Bob Dole offering enthusiastic testimonials for Pfizer's little blue pill in those early ads, which became so familiar to American consumers that the former U.S. Senate majority leader went on to parody them in spots for Pepsi, along with Britney Spears? So why should consumers pay attention when Palmeiro steps forward with the bold statement, take Viagra. Let's just say it works for me? Looking at the way pharmaceutical companies brand and advertise prescription drugs, as well as the specific challenges presented by marketing this particular preparation, I will attempt to answer some of these questions. I will also consider recent attempts by Pfizer's competitors in the marketplace, perhaps inspired by Viagra's success, to market similar performance-enhancing preparations with their own sports tie-ins. NUXATED IRON At the outset the connection between baseball and pharmaceuticals seems tenuous at best. Yet Viagra is hardly the first drug to advertise using baseball imagery, and Palmeiro is hardly the first baseball star to endorse a pharmaceutical product. As far back as the nineteenth century advertisers sold American consumers patent medicines with the help of testimonials from a variety of celebrities, famous European physicians, and other quacks. Celebrity endorsers of patent elixirs were, for the most part, women. But baseball players such as Ty Cobb, chief promoter of Nuxated Iron, a performance-enhancing concoction of sorts, also played on this particular field. Still, athlete endorsers of such patent preparations were few and far between. With time, and with the eventual enactment and enforcement of the Pure Food and Drug Act of 1906, patent medicines gave way to more efficacious remedies, ones with an official stamp of approval by the U.S. Food and Drug Administration (FDA). Still, the legitimate pharmaceutical industry did not really blossom as a commercial force until the years following World War II. Even when drug companies began to grow exponentially, and advertising for over-the-counter medications proliferated, ads for these products did not, for the most part, feature figures from the baseball world. There are undoubtedly scattered examples, but drug endorsements by baseball players were certainly not the norm. Recently, however, things have changed. Having retired after pitching for the New York Mets, California Angels, Houston Astros, and Texas Rangers, Nolan Ryan went on to pitch for Advil. …

Erections for Sale: The Rise of Viagra: How the Little Blue Pill Changed Sex in America by Meika Loe New York University Press, 2004, 287 pages

Erections for Sale: <i>The Rise of Viagra: How the Little Blue Pill Changed Sex in America</i> by Meika Loe New York University Press, 2004, 287 pages

The rise of Viagra: how the little blue pill changed sex in America

Acknowledgments Preface: Bob Dole, Bill Clinton, Bazooms, and Me 1 Introducing Viagra 2 The Rise of Erectile Dysfunction 3 Fixing the Broken Male Machine 4 The Pill Doesn't Always Thrill 5 The Search for the Female Viagra 6 APill for Everything? Epilogue: A Hard Act to Follow Appendix: Studying Up NotesIndex About the Author

The Viagra Myth

The Viagra Myth

Red, red pill?

Red, red pill?