Placebo treatments stronger than doctors thought

Feb 18, 2010 By MARIA CHENG , AP Medical Writer

(AP) -- When it comes to the placebo effect, it really may be mind over matter, a new analysis suggests.

In a review of recent research, international experts say there is increasing evidence that fake treatments, or placebos, have an actual biological effect in the body.

The doctor-patient relationship, plus the expectation of recovery, may sometimes be enough to change a patient's brain, body and behavior, experts write. The review of previous research on placebos was published online Friday in , the British medical journal.

"It's not that placebos or inert substances help," said Linda Blair, a Bath-based psychologist and spokeswoman for the British Psychological Society. Blair was not linked to the research. "It's that people's belief in inert substances help."

While doctors have long recognized that placebos can help patients feel better, they weren't sure if the treatments sparked any physical changes.

In the Lancet review, researchers cite studies where patients with Parkinson's disease were given dummy pills. That led their brains to release dopamine, a feel-good chemical, and also resulted in other changes in .

"When you think you're going to get a drug that helps, your brain reacts as if it's getting relief," said Walter Brown, a clinical professor of psychiatry at Brown and Tufts University. "But we don't know how that thought that you're going to get better actually translates into something happening in the ."

With growing proof that placebos work, some doctors are trying to figure out how to capitalize on their effects, without being unethical.

Blair said that to be completely honest with patients - to tell them they were receiving a fake treatment - would sabotage their belief in the drug, and thus, undermine any potential benefit.

But Brown didn't agree. For certain patients, like those with mild or anxiety, he said placebos were likely to work just as well as established therapies.

He said that even if doctors acknowledge they are giving such patients a medication, but say it could be beneficial, "it might just actually work."

Explore further: Evidence lacking for long-term opioid use in low back pain

More information: http://www.lancet.com

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User comments : 17

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Mr_Frontier
not rated yet Feb 18, 2010
Who gets the money to perpetuate the new super expensive placebo pill that will not be covered under insurance, and is a 3000% mark-up on sucrose?
bertrand_ducharme
not rated yet Feb 18, 2010
Placebo effects are not always linked to people's belief according to the paper Psychol Bull. 2004 Mar;130(2):324-40.Here is a citation from the paper: "...in other cases conditioning procedures appear to shape placebo effects that are not mediated by conscious cognition".
otto1923
5 / 5 (4) Feb 18, 2010
"It's that people's belief in inert substances help."
I suppose, one could say, that this is how religion works. God doesn't exist but a persons belief and expectations, based on the powerful perception of authority that the church can conjure, makes him appear as reality and absolutely beyond reproach. Faith healers can get much mileage on the placebo effect. In some peoples minds the Eucharist really does change into the blood and body of Christ. Anything less and it wouldn't work.
freethinking
2 / 5 (4) Feb 18, 2010
Ive used red, not green, jelly beans to releave side aches, cranberry pills to cure headaches, and recently grapeseed extract pills as a local painkiller before I pulled a tooth.

I think if more parents us placebo cures, there would be less doctor visits.

The only problem occures when the kids get old enough and hear about placebos. Then my cures loose their effectiveness.
maxcypher
3.5 / 5 (2) Feb 18, 2010
Yikes, don't you guys get it? Belief makes the difference. Whether you're talking about religion or medical placebos, belief is key. The question is why is belief so powerful. You want a Nobel? Then answer that question.
Kedas
3 / 5 (1) Feb 19, 2010
I think it is just an other way to deceive ourself.
More like a habit of how things are suppose to go.
action and reaction.
The body itself is a big fixing machine so the only thing you need is some trigger to put it in the right gear.

The illusion is that we think that the body can only repair itself with external help.
That is the lie that makes placebo's work.
(everybody know that feeling depressed or not seeing a future/cure makes the body stop working right)
kasen
5 / 5 (4) Feb 19, 2010
The way I see it, the placebo effect just cancels out the nocebo one(induced by an overreaction to the reality of the illness), on a purely psychological level. So if the real body is in a certain state of health but the patient perceives it as an actually worse state, placebos can, at best, bring that perception on par with the real situation.

The only physiological effect of this perceptual improvement is, as noted in the article, the release of dopamine. I get that after passing a test, it's nothing spectacular. On the other hand, psychosomatic effects induced by negative perceptions and stress are far more visible. So, basically, the placebo effect is less than, or equal to the nocebo effect.

They should do personality tests before administering placebos. Most likely the least worrisome persons will also be the least responsive to the treatment.
random
not rated yet Feb 19, 2010
(everybody know that feeling depressed or not seeing a future/cure makes the body stop working right)


the placebo effect just cancels out the nocebo one(induced by an overreaction to the reality of the illness)


That pretty much sums it up. It's no secret that negative states of mind have a debilitating effect on recovery, just as positive states have a enforcing effect. The placebo is simply the induction of healthy positive states of mind.

I see no ethical dilemma in using placebos without informing the patient just as long as each one results in an equal or higher rate of recovery than the conventional method of treatment.

Funny enough the 3000% markup might be necessary for the treatment to work. Who would trust a painkiller that's as cheap as cheap candy?
Sancho
not rated yet Feb 19, 2010
Good point, Random. Was it Freud or one of those Indian gurus who famously said it was necessary to charge people for services rendered in order for them to take therapy seriously?

But back to article: where's the news angle? Certainly not that mental states affect physical ones. Any hypnotist can demonstrate that.
Skeptic_Heretic
not rated yet Feb 19, 2010
Yikes, don't you guys get it? Belief makes the difference. Whether you're talking about religion or medical placebos, belief is key. The question is why is belief so powerful. You want a Nobel? Then answer that question.

It's called Biofeedback and it's a known element.
RJ32
not rated yet Feb 19, 2010
When it finally understood and accepted that the mind, not the brain, controls the body functions of which brain activity is one, the whole concept makes sense. However, when the mind is conditioned to accept the overriding value of money, it is difficult for the concept to be changed without the patient's acceptance that what he had previously accepted was false. The decision to change your mind will change everything else.
dirk_bruere
5 / 5 (1) Feb 20, 2010
If you want a well established placebo look no further than homeopathy. Why reinvent the wheel?
marjon
5 / 5 (1) Feb 20, 2010
Yikes, don't you guys get it? Belief makes the difference. Whether you're talking about religion or medical placebos, belief is key. The question is why is belief so powerful. You want a Nobel? Then answer that question.

That was the entire theme of the Bible, believe without proof (faith).
Skeptic_Heretic
not rated yet Feb 22, 2010
That was the entire theme of the Bible, believe without proof (faith).

Now you're comming around.

All the good feelings you get from religion aren't any sort of holy spirit or the hand of god, it's a placebo effect.

BECAUSE IT ISN'T REAL.
whippsa
not rated yet Feb 22, 2010
One simple reason that people have a positive effect from a pill is that they 1) stop what they are doing. 2) wash the pill down with some water.

Do people taking placebos simply drink more water?

I'd like to see placebo pill studies done like this:
Groups A, B, C.
A) people taking the real medicine pill
B) people taking the placebo pill
C) people who must stop at the appropriate pill time, find some object in a drawer or purse, and drink a glass of water.

I'd like to see injection studies done where a third group has to show up, roll up a sleeve, and have someone just touch their arm with an eraser end of a pencil. Why? Because the activity disrupts the normal (sometimes negative) focus of a daily routine.
marjon
not rated yet Feb 22, 2010
That was the entire theme of the Bible, believe without proof (faith).

Now you're comming around.

All the good feelings you get from religion aren't any sort of holy spirit or the hand of god, it's a placebo effect.

BECAUSE IT ISN'T REAL.

If belief helps you survive a NAZI concentration camp, then I would call that real.
VitalFire
not rated yet Mar 06, 2010
The power of the mind to heal really is at play with placebos. So wouldn't a physician be able to optimize the effects of active treatments by "selling" the benefits of the medications they are about to prescribe? We just posted an article on this topic... http://ow.ly/1f1zY

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