Something lost in discussions of the placebo effect is that placebos have effects. Different cultures respond differently to different effects. Germans, for example, have a much higher response to shots than pills. Americans like pills. Statistical averages, obviously, but the fact of the matter is, a sugar pill has about a 30% chance of making you feel as good as an aspirin, even if I tell you it's a sugar pill. Homeopathics work on me, and I will freely and knowledgeably mock homeopathics. The fact of the matter is, I have an opinion, so I'm psychologically invested, and we don't understand a lot about the psychosomatic effects of medicine.
I'm all on-board with placebos. Totally fine with them. An effect is still an effect, right? In fact, I've had a long series of unrelated medical issues that have been plaguing me for about a year or so. I have a strong belief that they may be psychosomatic. Because literally the day after I am relieved of one ailment, another will magically appear in its place, and be just as bad, but completely unrelated. I'm fairly sure I have some sort of psychological issue I need to address. If for no other reason, than to reduce the number of copays I have to make! :-)
As part of some work I'm into I've been reviewing a bit of literature on anti-depressants recently. Holy fuck is that a mine field. Literally every study the patients feel better in a matter of days no matter what the treatment. Looking for a signal in the noise is a really heavy lift. So the two things they can look for are magnitude of change in symptoms and persistence of change in symptoms. Seems like the placebo effect is generally as strong as the effect of the best drugs, but the best drugs tend to make people better for longer. It's pretty wacky altogether.
Complicating the issue is the exquisitely individualized response of patients to psychotropic drugs. You can't do a study with an n of 1 so you end up averaging everybody, and then saying "look it beats placebo" and then leaving it to the psychiatrist to puzzle it out one pill at a time, ten minutes at a time. Our system is deeply imperfect, and I am utterly bereft of the expertise to suggest anything better.