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The honest response is to stop designing trials around inert placebos and build more credible control conditions. That means active comparators like low-dose stimulants, niacin, or sub-the****utic microdoses, combined with centralized raters who are blinded to the patient's do****g experience and kept structurally separate from the the****utic team. These designs are harder to exe****e and more expensive. They're also what the regulatory bar now requires. Sponsors who haven't internalized that yet are going to find out the hard way.
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