I disagree.

It is not that posters underestimate the placebo effect.

It is that the placebo effect doesn't really matter since it is folded into the total effect of treatment. Further, only the outcome matters. And more importantly, it is the mass outcome - the total experience of a group of people taking a treatment - that matters.

No individual person can monitor how much of an effect a treatment has can be attributed to 1) true effect of the treatment, 2) placebo effect, 3) spiritual effect (which is totally unmeasurable since it is not scientific) or 4) the effect of another simultaneously occurring factor.

Every psychotropic agent has a placebo effect. Always.

Using the example of opiate pain medications: Opiate pain medications have a HUGE placebo effect. This does not discount that they are effective pain medications. The mechanism of action is clear. But they are simply GREATLY MORE EFFECTIVE of the prescriber exaggerates the expected response the patient will have to the opiate and shows enthusiasm for the treatment - i.e. does a fantastic sales job. If the doctor fails to do a fantastic sales job on the opiate pain medication, then he or she is completely failing to do their job - the opiate clearly will not be as effective since its placebo effect will be weakened.

It is common sense that everyone will have a different response to any given treatment.

Even among the opiate pain medications, everyone responds differently to the same medication due to differences in genetically determined response, environmental influences on response, and the person's placebo response. Some people get relief of pain, some people get worse pain, some people have no relief of pain. Yet everyone agrees that opiate pain medications are effective treatments because the group effect is positive.

For those who respond well to an opiate pain medication, it does not matter how much is true effect versus placebo effect. The only thing that matters is the outcome: whether or not the treatment reduces suffering and whether or not it improves one's ability to function.

The same is true for the nootropics. The only thing that matters is whether or not function is demonstrably improved over time.

Each person posting is a single case study. It is the SUM OF ALL THE CASE STUDIES that has a MASS EFFECT - and a power that can be just as good as a double-blind placebo controlled study over time.

Note: there is no rigorous double-blind self-experiments that will eliminate the placebo effect. Everyone has different tendencies for the placebo effet of any given substance. And knowledge that you are doing a self-experiment will itself skew that outcome.

Valid studies that eliminate the placebo effect have to use numerous subjects, not an N of 1.

I do not think it is helpful to force people to use vague wishy-washy words like "seems to" or "may have". Their experiences are not rigorous experiments. That is like having an English teacher constantly correcting your grammar. That is terribly OCD and rule bound thinking.

I would rather have people tell me in their own words what happened, what their opinion is, then make up my own mind of what happened - correlating it with the experience of others taking the same nootropic.

Anyone taking a psychotropic agent can only report their response to it as they see it. And for many people, correlation is causation - since they are in an experiment with only one subject - i.e. N = 1. No need to weasel word the experience. Just report it.

In the end, the mass effect is what matters - what a population of people using the nootropic experience.

Additionally, the placebo effect lasts about 2 years. So as a person continues to take a nootropic, the important point is: does the improvement in function persists over time or does it end.

Reports over time are particularly important to determine how well a given treatment works.

Then with time, the group experience helps determine the effectiveness of a given nootropic. Like Amazon's ratings, the number of negative experiences helps determine the effectiveness of a given nootropic.