I developed an acute interest in the placebo effect -- where a person improves on a fake drug because they believe they are taking an actual drug -- while working in drug development for a multinational pharmaceutical company.
We all experience placebo effects from time to time. Believing in a drug or in a physician who prescribed it can help it to work better. Reams of research now paint a picture that what we believe with regards to medication can have measurable effects on the body.
The same placebo can do opposite things, for instance, depending on what the person believes it is for. If patients are given a placebo and told it will relax their muscles then it will, but the same placebo can cause muscular tension if the person believes that's what it does. Similarly, believing that it is a stimulant will increase heart rate and blood pressure, but thinking that it is a depressant gives it the opposite effect: reducing heart rate and blood pressure.
Some people who are given alcohol placebos, thinking they are drinking real alcoholic beverages, even get drunk.
And placebos can enhance athletic performance. In a 2007 study, non-professional athletes had been given morphine during a pre-competition training phase. On the day of a competition the morphine was secretly swapped for a placebo but the athletes still experienced an increase in pain endurance and physical performance that would be expected from taking morphine.
In another study, 40 asthmatics were given an inhaler containing a placebo, which was water vapor, but were told that it contained allergens that would restrict their airways. Nineteen of them then suffered considerable constriction of their airways and 12 of them actually experienced a full-blown asthma attack. When they were given a different inhaler and told it would relieve their symptoms, it did, even though it was also a placebo. One person in the study developed symptoms of hay fever too after being told that the inhaler also contained pollen.
Color can matter with placebos
Where you live also affects the power of placebos. In a U.S. study of migraine treatments, placebo injections were 1.5 times more powerful than placebo pills. But a European trial found that placebo pills were marginally better than placebo injections. The reason for the difference is in our cultural language. U.S. patients tend to speak of 'getting a shot,' but Europeans talk of 'popping pills,' or at least they do in the UK.
Similarly, in trials of the anti-ulcer drug, Tagamet, which was popular in the 80s, the placebo was 59 percent effective in France but the drug itself was 60 percent effective in Brazil -- a difference of 1 percent.
Some of the variation comes down to communication between medical staff and patient. For relatively common ailments at least, a physician who shows optimism about the patient's recovery is more likely to see the patient recovering than one who is more unsure or pessimistic.
Perception of a medicine or placebo matters too. In a UK study, 835 women were given one of four different pills for headaches. One group received a well-known branded aspirin tablet. A second group received a simple tablet labelled 'analgesic,' which was typical of a cheaper mass-market brand. A third group received a branded placebo, while the last group received a basic placebo labeled 'analgesic.'
It turned out that the branded aspirin worked better than the unbranded one, but amazingly the branded placebo worked better than the unbranded placebo -- even though they were both inert.
The placebo effect might even lift the power of Viagra beyond its basic pharmacological effect, at least according to psychiatrist Aaron K. Vallance, who suggested in a 2006 paper that the medicine might be enhanced because the name 'Viagra' is similar-sounding to the words, 'vigour' and 'Niagara,' which might create a perception of vigorousness and power.
I wonder if it would work so well if it was called 'Flopsy!'
Of course, the drug works extremely well. Drugs are built to carry out biological functions in the body.
But research into the placebo effect is beginning to paint a picture of a strong interaction between the mind and the body such that what you think or believe about a drug or a physician really matters.
ENDNOTES
For the opposite effects of placebos, see, I. Kirsch, "Specifying non-specifics: Psychological mechanism of the placebo effect". In Harrington A. The Placebo Effect: An Interdisciplinary Exploration. (Harvard University Press, Cambridge, 1997, pp. 166-86)
For the Tagamet data, see D. Moerman, "Meaning, Medicine and the 'Placebo Effect'" (Cambridge University Press, 2002, pp. 80)
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Placebos Are Getting More Effective. Drugmakers Are Desperate to ...
there's hardly any research available on 'nocebo' the negative effects of placebo.
its such an interesting subject. great article.
William Anderson, LMHC, Licensed Psychotherapist, author of 'The Anderson Method', www.TheAndersonMethod.com
Not what you 'want', not what you 'think',
not what you 'understand your reality to be from others',
but what -"You"- actually b-e-l-i-e-v-e.
And if you want to change your reality,
you must first change your beliefs.
There is no other way.
We keep reading food labels and listening to "this is bad for you" warnings. Based on the placebo research we can all see how all that effects our health and physical condition and looks.
I believe that it's not what we take into our bodies that hurts us or makes us better, it's what we believe about them. The placebo research shows us exactly how that works.
I wish that the medical community would do a similar research about the mind's role in developing obesity, I bet that the study would be a real eye opener.
from all quarters-social, medical, religious, education, political, family, sports, etc. This country
and we ourselves run on the power of suggestion, from all forms of "survival of the fittest" to
suggestions about the afterlife to giving ourselves veiled suggestions without realizing what we
are doing.
Example: Have you ever said to yourself, "I have to have this book report ready for tomorrow's
10:00AM Literature class and I don't know if I'll make it or not," or "I told Marie that I would
meet her at 3:20 at the Library and it's already 3:10. Yipes!" or something similar?
Not only have you just given yourself the suggestion that you probably will not make it but
you compounded the problem by placing time restrictions on it, increasing the likelyhood
that you will not make it. And these suggestions oppose a suggestion that simply says "I'm
writing a book report for tomorrows Lit class" or "Marie and I will meet at the Library at
3:20 today." [and yes, there is a Big difference between the two different suggestions of time.]
One is that disease symptoms often wax and wane over time. Many conditions are also self-limiting and the variation in symptom severity or prevelance can be high as well. When you combine all these facts together, you end up with individuals being treated at different stages and severities of disease. So, when an individual actually improves from taking a drug, they may simply be following the normal disease course or a change in symptom severity.
There is also the potential for a variety of biases, especially when subjective outcomes are measured, like pain or fatigue. With more subjective outcomes the data is subject to psychological phenomena like reporting bias and confirmation bias.
http://www.sciencebasedmedicine.org/?p=24
http://www.sciencebasedmedicine.org/?p=1248
The placebo effect is a much more complicated issue than most people tend to realize, but also, not quite as mysterious as people tend to think it is either.
Can anyone provide information?