Placebos work -- even without deception

[Telarus]

Placebos work -- even without deception
http://www.medicaldaily.com/news/20101223/4831/placebos-work--even-without-deception.htm

For most of us, the "placebo effect" is synonymous with the power of positive thinking; it works because you believe you're taking a real drug. But a new study rattles this assumption.

Researchers at Harvard Medical School's Osher Research Center and Beth Israel Deaconess Medical Center (BIDMC) have found that placebos work even when administered without the seemingly requisite deception.

The study published on December 22 in PLoS ONE.

Placebos—or dummy pills—are typically used in clinical trials as controls for potential new medications. Even though they contain no active ingredients, patients often respond to them. In fact, data on placebos is so compelling that many American physicians (one study estimates 50 percent) secretly give placebos to unsuspecting patients.

Because such "deception" is ethically questionable, HMS associate professor of medicine Ted Kaptchuk teamed up with colleagues at BIDMC to explore whether or not the power of placebos can be harnessed honestly and respectfully.

To do this, 80 patients suffering from irritable bowel syndrome (IBS) were divided into two groups: one group, the controls, received no treatment, while the other group received a regimen of placebos—honestly described as "like sugar pills"—which they were instructed to take twice daily.

"Not only did we make it absolutely clear that these pills had no active ingredient and were made from inert substances, but we actually had 'placebo' printed on the bottle," says Kaptchuk. "We told the patients that they didn't have to even believe in the placebo effect. Just take the pills."

For a three-week period, the patients were monitored. By the end of the trial, nearly twice as many patients treated with the placebo reported adequate symptom relief as compared to the control group (59 percent vs. 35 percent). Also, on other outcome measures, patients taking the placebo doubled their rates of improvement to a degree roughly equivalent to the effects of the most powerful IBS medications.

"I didn't think it would work," says senior author Anthony Lembo, HMS associate professor of medicine at BIDMC and an expert on IBS. "I felt awkward asking patients to literally take a placebo. But to my surprise, it seemed to work for many of them."

The authors caution that this study is small and limited in scope and simply opens the door to the notion that placebos are effective even for the fully informed patient—a hypothesis that will need to be confirmed in larger trials.

"Nevertheless," says Kaptchuk, "these findings suggest that rather than mere positive thinking, there may be significant benefit to the very performance of medical ritual. I'm excited about studying this further. Placebo may work even if patients know it is a placebo."

[Phox]

Placebos work -- even without deception
http://www.medicaldaily.com/news/20101223/4831/placebos-work--even-without-deception.htm

For most of us, the "placebo effect" is synonymous with the power of positive thinking; it works because you believe you're taking a real drug. But a new study rattles this assumption.

Researchers at Harvard Medical School's Osher Research Center and Beth Israel Deaconess Medical Center (BIDMC) have found that placebos work even when administered without the seemingly requisite deception.

The study published on December 22 in PLoS ONE.

Placebos—or dummy pills—are typically used in clinical trials as controls for potential new medications. Even though they contain no active ingredients, patients often respond to them. In fact, data on placebos is so compelling that many American physicians (one study estimates 50 percent) secretly give placebos to unsuspecting patients.

Because such "deception" is ethically questionable, HMS associate professor of medicine Ted Kaptchuk teamed up with colleagues at BIDMC to explore whether or not the power of placebos can be harnessed honestly and respectfully.

To do this, 80 patients suffering from irritable bowel syndrome (IBS) were divided into two groups: one group, the controls, received no treatment, while the other group received a regimen of placebos—honestly described as "like sugar pills"—which they were instructed to take twice daily.

"Not only did we make it absolutely clear that these pills had no active ingredient and were made from inert substances, but we actually had 'placebo' printed on the bottle," says Kaptchuk. "We told the patients that they didn't have to even believe in the placebo effect. Just take the pills."

For a three-week period, the patients were monitored. By the end of the trial, nearly twice as many patients treated with the placebo reported adequate symptom relief as compared to the control group (59 percent vs. 35 percent). Also, on other outcome measures, patients taking the placebo doubled their rates of improvement to a degree roughly equivalent to the effects of the most powerful IBS medications.

"I didn't think it would work," says senior author Anthony Lembo, HMS associate professor of medicine at BIDMC and an expert on IBS. "I felt awkward asking patients to literally take a placebo. But to my surprise, it seemed to work for many of them."

The authors caution that this study is small and limited in scope and simply opens the door to the notion that placebos are effective even for the fully informed patient—a hypothesis that will need to be confirmed in larger trials.

"Nevertheless," says Kaptchuk, "these findings suggest that rather than mere positive thinking, there may be significant benefit to the very performance of medical ritual. I'm excited about studying this further. Placebo may work even if patients know it is a placebo."

Confirmation bias?

[Epimetheus]

"Nevertheless," says Kaptchuk, "these findings suggest that rather than mere positive thinking, there may be significant benefit to the very performance of medical ritual."

Here's the thing. I mean, it's still a placebo effect.

[Phox]

"Nevertheless," says Kaptchuk, "these findings suggest that rather than mere positive thinking, there may be significant benefit to the very performance of medical ritual."

Here's the thing. I mean, it's still a placebo effect.

Exactly.

[Mesozoic Mister Nigel]

Soooo what? Isn't that the point of the study? To better understand the placebo effect?

I kind of think that maybe you don't understand the placebo effect.

[Phox]

Soooo what? Isn't that the point of the study? To better understand the placebo effect?

I kind of think that maybe you don't understand the placebo effect.

Yeah, you're right. But, I guess I figured that this isn't/shouldn't be news. I've always thought the placebo effect was more somatic than psychological anyway.

[Epimetheus]

Soooo what? Isn't that the point of the study? To better understand the placebo effect?

I kind of think that maybe you don't understand the placebo effect.

Are you agreeing or disagreeing with my post?

[Phox]

Soooo what? Isn't that the point of the study? To better understand the placebo effect?

I kind of think that maybe you don't understand the placebo effect.

Are you agreeing or disagreeing with my post?

Both, I think.

[Cainad (dec.)]

Soooo what? Isn't that the point of the study? To better understand the placebo effect?

I kind of think that maybe you don't understand the placebo effect.

Yeah, you're right. But, I guess I figured that this isn't/shouldn't be news. I've always thought the placebo effect was more somatic than psychological anyway.

The general understanding most people have of the placebo effect, afaik, is that in order for it to happen the patient has to believe that what they're taking is somehow a biomedically active drug. This study suggest that general understanding may be at least partially incorrect/incomplete.

The idea that a placebo is effective even when the patient knows there's nothing going on in terms of biochemical effects of the pill they're taking is pretty newsworthy.

[Phox]

Soooo what? Isn't that the point of the study? To better understand the placebo effect?

I kind of think that maybe you don't understand the placebo effect.

Yeah, you're right. But, I guess I figured that this isn't/shouldn't be news. I've always thought the placebo effect was more somatic than psychological anyway.

The general understanding most people have of the placebo effect, afaik, is that in order for it to happen the patient has to believe that what they're taking is somehow a biomedically active drug. This study suggest that general understanding may be at least partially incorrect/incomplete.

The idea that a placebo is effective even when the patient knows there's nothing going on in terms of biochemical effects of the pill they're taking is pretty newsworthy.

Yeah, but I've always thought of it as the idea of a placebo is to trick the body, not necessarily the mind. Deceiving the mind is helpful to that end, I just never thought it was completely necessary.

Back to the topic at hand, something that may not be accounted for is if the people participating in the study think they are being given a real drug, but being told it's a placebo. Say, a person has a good week, right after they start the placebo. They might think that it's a double dupe. I mean, really, who would tell you they were giving you a placebo, unless they wanted you to think it wouldn't work? Hence my earlier statement of "confirmation bias". If someone deceives themselves into thinking the placebo isn't really a placebo, then how do we interpret that?

[Mesozoic Mister Nigel]

Soooo what? Isn't that the point of the study? To better understand the placebo effect?

I kind of think that maybe you don't understand the placebo effect.

Yeah, you're right. But, I guess I figured that this isn't/shouldn't be news. I've always thought the placebo effect was more somatic than psychological anyway.

The general understanding most people have of the placebo effect, afaik, is that in order for it to happen the patient has to believe that what they're taking is somehow a biomedically active drug. This study suggest that general understanding may be at least partially incorrect/incomplete.

The idea that a placebo is effective even when the patient knows there's nothing going on in terms of biochemical effects of the pill they're taking is pretty newsworthy.

Yes, this. The really interesting part was summed up, IMO, in the line "these findings suggest that rather than mere positive thinking, there may be significant benefit to the very performance of medical ritual."

To dismiss the results as being meaningless or insignificant because it's "still just placebo effect" seems to blithely dismiss placebo effect as being without medical value, when the reason it's being studied in the first place is because it's been proven to have medical value.

[Rumckle]

http://www.youtube.com/watch?v=AaO0qmJQIk4

[Phox]

Soooo what? Isn't that the point of the study? To better understand the placebo effect?

I kind of think that maybe you don't understand the placebo effect.

Yeah, you're right. But, I guess I figured that this isn't/shouldn't be news. I've always thought the placebo effect was more somatic than psychological anyway.

The general understanding most people have of the placebo effect, afaik, is that in order for it to happen the patient has to believe that what they're taking is somehow a biomedically active drug. This study suggest that general understanding may be at least partially incorrect/incomplete.

The idea that a placebo is effective even when the patient knows there's nothing going on in terms of biochemical effects of the pill they're taking is pretty newsworthy.

Yes, this. The really interesting part was summed up, IMO, in the line "these findings suggest that rather than mere positive thinking, there may be significant benefit to the very performance of medical ritual."

To dismiss the results as being meaningless or insignificant because it's "still just placebo effect" seems to blithely dismiss placebo effect as being without medical value, when the reason it's being studied in the first place is because it's been proven to have medical value.

I wasn't dismissing the study, and I certainly wasn't dismissing the medical value of the placebo effect. I understand how you could read it that way, however.

[Cainad (dec.)]

Soooo what? Isn't that the point of the study? To better understand the placebo effect?

I kind of think that maybe you don't understand the placebo effect.

Yeah, you're right. But, I guess I figured that this isn't/shouldn't be news. I've always thought the placebo effect was more somatic than psychological anyway.

The general understanding most people have of the placebo effect, afaik, is that in order for it to happen the patient has to believe that what they're taking is somehow a biomedically active drug. This study suggest that general understanding may be at least partially incorrect/incomplete.

The idea that a placebo is effective even when the patient knows there's nothing going on in terms of biochemical effects of the pill they're taking is pretty newsworthy.

Yes, this. The really interesting part was summed up, IMO, in the line "these findings suggest that rather than mere positive thinking, there may be significant benefit to the very performance of medical ritual."

To dismiss the results as being meaningless or insignificant because it's "still just placebo effect" seems to blithely dismiss placebo effect as being without medical value, when the reason it's being studied in the first place is because it's been proven to have medical value.

Quoted for troof!

The placebo effect is not something that should be ignored or dismissed as hogwash.

Quack cures like homeopathy, which claim to be biomedically active but contain no biomedically active ingredients in any meaningful quantity, should be recognized as the baloney they are, but that doesn't mean the effects they have on their patients aren't interesting.

In medicine, what matters in the end is whether or not the patient's condition improves, not whether or not the pill they're popping is doing anything on a biological/chemical level. The placebo effect is a perfectly valid way to accelerate the process of feeling better, as long as the patient's life or well-being is not at risk.



EDIT: but, apparently Nigel and I derped up our reading comprehension and are posting up the wrong tree.

[Requia ☣]

Soooo what? Isn't that the point of the study? To better understand the placebo effect?

I kind of think that maybe you don't understand the placebo effect.

Yeah, you're right. But, I guess I figured that this isn't/shouldn't be news. I've always thought the placebo effect was more somatic than psychological anyway.

The general understanding most people have of the placebo effect, afaik, is that in order for it to happen the patient has to believe that what they're taking is somehow a biomedically active drug. This study suggest that general understanding may be at least partially incorrect/incomplete.

The idea that a placebo is effective even when the patient knows there's nothing going on in terms of biochemical effects of the pill they're taking is pretty newsworthy.

I kindof wonder just how many of the patients didn't believe them when told it was a placebo, or didn't understand the concepts and thought it really did something anyway.

Then of course the idea that placebos can do things is part of our culture, so they might have thought it could do something *because* it was a placebo.