Save Email Print Share Placebo Effect and Lessons for the Physician-Patient Relationship Sep. 19, 2013 — The findings of a comprehensive review of the placebo phenomenon and its consequences for clinical medicine are contained in a new article, "Placebo and the New Physiology of the Doctor-Patient Relationship," published in Physiological Reviews. The effort, undertaken by physician-researcher Fabrizio Benedetti of the Department of Neuroscience, University of Turin Medical School, and National Institute of Neuroscience, Turin, Italy, provides an in-depth biological and evolutionary approach to examining the placebo effect in relationship to the doctor-patient relationship. __________________________________________________________________ -- Share This: Placebo, in Latin, means "I shall please," and its role in research and medicine is a fascinating story. One of the first recorded use of placebos involved Benjamin Franklin who was commissioned by the French king Louis XVI to test the effectiveness of mesmerism, a kind of healing practice which was supposed to act through a healing fluid released from the healer. Franklin's team utilized blind assessments and placebo interventions to women patients and determined that their improvements were spurred on by the imagination. Over time there was awareness to both researchers and physicians that clinical trials were -- fake). For many years placebos have been used for the validation of therapies, but they have also traditionally taken as an example of the powerful interaction between mind and body with associated commentary research appearing in psychology literature. Dr. Benedetti's research is aligned with the current state of placebo research, a complex field of investigation which ranges from psychology to psychophysiology, from pharmacology to neurophysiology, and from cellular/molecular analysis -- and the many physiological functions of the human body. This new discipline acknowledges that placebos and placebo responses with their wide range of physiological responses involving numerous mechanisms across a number of conditions, systems, and interventions represent an active field of neurobiological research. With that, Dr. Benedetti, using biochemical, cellular and physiological tools, aptly summarizes research new findings on describing the placebo effect on psychology and biology and their impact on the doctor-patient relationship. Among the issues discussed in detail are: o There is no one "the placebo effect." There are different mechanisms in play across a variety of medical conditions and therapeutic interventions. For example, a placebo effect takes place because there is expectation. The patient expects a therapeutic benefit, and this kind of expectation actually has an effect on the brain and the body. -- reward mechanism by the region of the brain known as the nucleus accumbens (which also governs pleasure, reinforcement learning, laughter, addiction, aggression, fear, impulsivity and the placebo effect.) o When a treatment is given to a patient, be it a placebo or real, it is administered in a complex set of psychological states that vary from patient to patient and from situation to situation. For example, when a placebo is given to relieve pain, it is administered along with stimuli which tell the patient that a clinical improvement should be occurring shortly. These stimuli can include the color and shape of the pill, -- o Recent research has revealed a reduced efficacy of drugs when they are administered covertly to the patient. In fact, if the placebo/expectation component of a treatment is eliminated by means of a hidden administration (unbeknownst to the patient), the psychological component of the therapy is absent as well. -- Journal Reference: 1. Fabrizio Benedetti. PLACEBO AND THE NEW PHYSIOLOGY OF THE DOCTOR-PATIENT RELATIONSHIP. Physiological Reviews, September 2013 DOI: 10.%u200B1152/%u200Bphysrev.%u200B00043.%u200B2012 -- Articles * Double blind * Placebo effect * Clinical trial * Evidence-based medicine * Nocebo - Placebo * List of medical topics -- __________________________________________________________________ Intranasal Application of Oxytocin Appears to Enhance Placebo Response (Oct. 22, 2013) — A study has been conducted to test whether oxytocin enhances the placebo response in an experimental placebo analgesia ... > read more Doctor-Patient Relationship: Physicians' Brain Scans Indicate Doctors -- researchers have provided the first scientific evidence indicating that ... > read more Nocebo Effect, Not Placebo Effect: Induced Illness Studied (July 12, 2012) — Negative suggestion can induce symptoms of illness. Nocebo effects are the adverse events that occur during sham treatment and/or as a result of negative expectations. 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