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Placebo Effect: A Cure in the Mind
Feb. 25th, 2009 06:22 pmhttp://www.sciam.com/article.cfm?id=placebo-effect-a-cure-in-the-mind&print=true
Belief is powerful medicine, even if the treatment itself is a sham. New research shows placebos can also benefit patients who do not have faith in them
The latest research has shown that the placebo effect does not always arise from a conscious belief in a drug. Alternatively, it may grow out of subconscious associations between recovery and the experience of being treated, from the pinch of a shot to a doctor’s white coat. Such subliminal conditioning can control bodily processes, including immune responses and the release of hormones. Meanwhile researchers have decoded some of the biology of placebo responses, demonstrating that they stem from active processes in the brain.
( Read more... )
Despite the proved power of suggestion, investigators have been unable to identify personality traits that increase susceptibility to placebos. Personality, after all, has little effect on subconscious conditioning. For such subliminal responses, presentation matters more than personality does. Giving a medication a popular brand name or prescribing more frequent doses can boost the efficacy of a placebo. Similarly, a physician can maximize a placebo effect by radiating confidence or spending more time with the patient. Such tactics may subconsciously build a patient’s trust in a therapy.
A high price tag on the drug can apparently help, too. In one study, placebos reported to cost $0.10 worked considerably less well in relieving pain than did those priced at $2.50 per pill. Test subjects evidently distrusted the less expensive medication. Patients are also liable to benefit more from placebos that involve elaborate medical procedures than from those requiring simple measures. Thus, the most effective sham treatments may extend beyond dispensing inactive pills to a simulation of a multistep therapeutic regimen.
As evidence of this idea, counseling psychologist Cynthia McRae of the University of Denver and her colleagues reported in 2004 the surprising success of a sham brain surgery in improving the quality of life of patients with advanced Parkinson’s disease. Surgeons performed the sham operation to compare its efficacy with that of implanting human embryonic dopamine neurons into the brains of Parkinson’s patients, who suffer from a lack of dopamine. In McRae’s follow-up study, which assessed the patients’ quality of life up to a year later, the researchers found that the patients who received the sham surgery were doing just as well physically, socially and emotionally as were the patients who had received the new cells. What mattered was not the transplant itself but whether a patient thought he or she had received it.
In recent years extensive research revealing the many medical applications, types and mechanisms of placebo effects has given credence to this once orphaned phenomenon. Doctors are now considering placebo pills and procedures as a way of enhancing the effectiveness of drugs and surgery. Such uses may elicit new controversies and questions such as the use of placebos to boost athletic performance. In the meantime, sophisticated doctors might decide to manipulate the conscious and subconscious mind in ways that could cure—or at least, do no harm.
Belief is powerful medicine, even if the treatment itself is a sham. New research shows placebos can also benefit patients who do not have faith in them
The latest research has shown that the placebo effect does not always arise from a conscious belief in a drug. Alternatively, it may grow out of subconscious associations between recovery and the experience of being treated, from the pinch of a shot to a doctor’s white coat. Such subliminal conditioning can control bodily processes, including immune responses and the release of hormones. Meanwhile researchers have decoded some of the biology of placebo responses, demonstrating that they stem from active processes in the brain.
( Read more... )
Placebo Performance
Despite the proved power of suggestion, investigators have been unable to identify personality traits that increase susceptibility to placebos. Personality, after all, has little effect on subconscious conditioning. For such subliminal responses, presentation matters more than personality does. Giving a medication a popular brand name or prescribing more frequent doses can boost the efficacy of a placebo. Similarly, a physician can maximize a placebo effect by radiating confidence or spending more time with the patient. Such tactics may subconsciously build a patient’s trust in a therapy.
A high price tag on the drug can apparently help, too. In one study, placebos reported to cost $0.10 worked considerably less well in relieving pain than did those priced at $2.50 per pill. Test subjects evidently distrusted the less expensive medication. Patients are also liable to benefit more from placebos that involve elaborate medical procedures than from those requiring simple measures. Thus, the most effective sham treatments may extend beyond dispensing inactive pills to a simulation of a multistep therapeutic regimen.
As evidence of this idea, counseling psychologist Cynthia McRae of the University of Denver and her colleagues reported in 2004 the surprising success of a sham brain surgery in improving the quality of life of patients with advanced Parkinson’s disease. Surgeons performed the sham operation to compare its efficacy with that of implanting human embryonic dopamine neurons into the brains of Parkinson’s patients, who suffer from a lack of dopamine. In McRae’s follow-up study, which assessed the patients’ quality of life up to a year later, the researchers found that the patients who received the sham surgery were doing just as well physically, socially and emotionally as were the patients who had received the new cells. What mattered was not the transplant itself but whether a patient thought he or she had received it.
In recent years extensive research revealing the many medical applications, types and mechanisms of placebo effects has given credence to this once orphaned phenomenon. Doctors are now considering placebo pills and procedures as a way of enhancing the effectiveness of drugs and surgery. Such uses may elicit new controversies and questions such as the use of placebos to boost athletic performance. In the meantime, sophisticated doctors might decide to manipulate the conscious and subconscious mind in ways that could cure—or at least, do no harm.
