Cognance: waste of money

Listen, I know shit can be frustrating. However, rejecting reality because you are upset only hurts you. The idea that everyone's biology is different is not an opinion. It's an outright fact. Ask any doctor that prescribes drugs if all their patients react the same way, and they will laugh at you. I have friends that are doctors, and we have long talks about all the variability they see in patients. Our lab director doesn't feel anything he takes, other than tongkat ali. He doesn't call them all bullshit, because he understands that it's his body/brain chemistry that is the factor in that. I have a friend that literally feels nothing from IV morphine. Are you going to tell me everyone getting effects from IV morphine are just getting placebo? That would be asinine. I have a friend that falls asleep after doing a line of cocaine. Was the 1970s and 80s all just a big placebo fest? Was the movie Blow just a fictional fantasy? Variability in response to things is literally built into the fabric of our society. If people didn't have variable biology, why would anyone need antidepressants? Everyone's brain chemistry is the same, right? Just walk it off! Why would we need warnings on the box that some people starting out on antidepressants might want to kill themselves more? If everyone reacts the same to things, why would we need to have doctors try 5 prescriptions before settling on one that works? Why would kids need different teaching methods to learn, or like different foods? Why doesn't everyone take aniracetam? They must love it just as much as you! We're all the same, right? We're not all the same! You know that, deep down inside. Don't let your frustration with your individual experience cloud what you know to be true.

I've also been very upfront about how not everyone is going to react to Cognance well from the start.

https://www.reddit.com/r/NootropicsDepot/comments/yq1qy3/tickler_to_be_released_soon_11122022/ivpcsq5/

That's just the reality of things. Yeah, it is frustrating for the people that don't react to it, but what are we going to do, reject reality and yell at clouds? Give up because not everyone reacts well to everything we develop? Shove everything off our desks in a fit of rage, then take our ball and go home? What about all the people that positively react to things you don't? They should just all get aniracetam like you, because YOU don't react well to something else? Don't react well to aniracetam? Tough luck! /u/Neurogence reacts well to it, so that's what everyone gets! It's a very close-minded and ego-centric view of the world. There are things I don't react well to as well, but I speak to others that do. I don't reject their experience and tell them they are experiencing placebo, just like I am not telling you that you are just experiencing nocebo. That's another big thing on Reddit lately. There are a lot of pseudo-intellectuals on here parroting around terms they don't understand. It certainly goes both ways, but a big one right now is using the term placebo incorrectly. I see most people fundamentally misunderstanding what that term means, and use it as a catch-all to explain away their own inability to look at the available data with nuance.

There are many different biases that result in statistical anomalies in clinical research. Response bias is a big one in studies that use self-reporting as a metric. That's a tendency for participants in a study to respond incorrectly to questions. It's hard to control for. Many people confuse a positive response bias for the placebo effect, but that's just a fundamental misunderstanding of things. There isn't even a consensus on whether or not a universal placebo response even exists that can't be explained by response bias or one of the others like selection bias, co-intervention bias, attrition bias, outcome reporting bias, and publication bias. Placebo is not taking an active compound, but then consciously convincing yourself of other effects. Placebo is taking an inactive compound and realizing statistically significant effects based on your study design. Unless you are actually blinding yourself and taking sugar pills some days, and Cognance on others, you are not experiencing the placebo effect. Nobody is getting a placebo effect with Cognance, because Cognance is not a placebo. Everyone parrots around the term, but what they really mean is response bias. Could early reports from Cognance be, partly or wholly, a result of response bias? Sure, that's a possibility, as it would be in any study. However, we have not sent sugar pills to some customers, and active ones to others. If people want to expand the term "placebo" to encompass any positive response bias towards a compound, then I think we lose all the nuance needed to actually understand what the placebo response really is, and if it even exists in a meaningful way consistently across the board. You also have selection bias big time here on Reddit. People on Reddit like to think they are a normal cross section of the population, but that's NOT the case. There is a massive selection bias happening here on Reddit, both from a demographics standpoint and a psychology standpoint. Anyone acting like random posts on Reddit are an objective sample of reactions is going to have a bad time. Then you also have a LOT of co-intervention bias to deal with. Almost everyone on here is taking something else when they try new things. Very few people washout to baseline before adding a new supplement into their regimen, so the anecdotes you see are colored by that co-intervention bias happening. This is a big one with Cognance, as what you combine it with drastically alters the effects. One pretty obvious link is combos with dopaminergic compounds. There is clearly a stronger acute effect from Cognance when taken in tandem with a dopaminergic substance. Without proper controls and a universal study design everyone adheres to, you as an observer won't know just how many reports are affected by that co-intervention bias. Then you also have compliance bias to an extent. Not everyone is just using 100mg of Cogance daily for a specific period. Some people jump immediately to 200-300mg. Some people take the whole damn bottle in 5 days... All those anecdotes are mixed together on Reddit, seemingly being given the same weight by readers without knowing the context or biases involved. This makes it impossible to make objective determinations using Reddit as a metric.

Placebo effect studies are susceptible to response bias and to other types of biases

Is the Placebo Powerless? — An Analysis of Clinical Trials Comparing Placebo with No Treatment

Back to placebo. People like to feel smart online, so they repeat words they think they understand. However, acting like it is scientific fact that a universal placebo response is a factor in every experience with a compound is not intellectually honest. Yes, some studies have shown placebo to give statistically significant effects in their study design. Other studies have shown that the placebo effect is getting stronger in America, but not in the rest of the world. It's causing real problems for drug development, especially for things like depression, where self reporting is the most common measure of statistical significance. The placebo effect is when those in the control group reach significant effects in the measures chosen for the study design. However, just because the control group had effects doesn't then also mean the active group's effects were due to placebo. I think that is where many people jump the shark. You can have a placebo effect in the control group that's independent of the effect from the active group. A study on fluoxetine used positron emission tomography to see if there were measurable differences between the placebo and actives groups.

The Functional Neuroanatomy of the Placebo Effect

Response to active fluoxetine treatment was also associated with significant regional metabolic changes (scan 3 minus baseline metabolism: beta-2=3.44, df=1972, p<0.0006). The pattern of metabolic change closely matched that seen with response to placebo (Table 2, right). Drug responders, however, showed additional changes in metabolism in subcortical and limbic regions (Figure 1, bottom). Specifically, fluoxetine response was associated with unique increases in brainstem metabolism and metabolic decreases in the striatum, hippocampus, and anterior insula. There were no regional changes that were unique to placebo responders at 6 weeks.

The interesting thing about this study was that they empirically measured changes in the brain, not just relied on self-reporting measures. They found common changes in the brain in the placebo and fluoxetine group. However, there were additional changes and stronger effects in the fluoxetine group. They also showed that there were drug non-responers AND placebo non-responders. This is what everyone has to realize with research. They are looking for STATISTICAL significance. That doesn't mean everyone reacted the same, both to the active and placebo. Sometimes statistical anomalies are just that, statistical. There is always variability between patients/participants. If we have drug responders, drug non-responders, placebo responders, and placebo non-responders in the same study, how can anyone deny the reality that our bodies and brains are incredibly complex and variable?!?

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