Understanding and Using the Placebo Effect
Understanding and Using the Placebo Effect
   Most physicians make at least some use of the placebo effect to enhance
   extent of the placebo effect in patients with psychiatric illness, and
   reviews what is known about how placebos work. It then discusses the
   application of the placebo response in enhancing the effects of
   this time, no differences in outcome between active drug and placebo
   are evident. After about 2 weeks, the placebo response reaches a
   but during the period when most of the improvement occurs, placebo and
   In fact, the strength of the placebo response can be quite significant
   to placebo, with a nearly 50% improvement in symptoms among patients
   stress disorder or depression, the placebo response is greater than
   (OCD) and psychosis, are less likely to exhibit a placebo response.
   Clearly, the placebo response is not uniformly strong in all
   with psychiatric disorders always include a placebo arm.^1
   Placebo vs pharmacotherapy or psychotherapy
   How do responses to placebo compare with those achieved with
   panic disorder who are treated with placebo become panic-free,
   underscoring the magnitude and importance of the placebo effect in this
   improvement in about 60% to 70% of patients, while placebo
   unlikely to respond to placebo. Patients with
   expect a robust response to placebo in this patient group.
   ill. Some were randomized to clinical management and placebo; they
   attended a clinic, were given a placebo pill, and asked how they were
   over the 2 psychotherapies and placebo. Although there was a difference
   between the psychotherapies and placebo, it was not statistically
   than any other treatment modality, but placebo was about as good as the
   compared cognitive therapy with a pill placebo in the treatment of
   placebo.
   The benefits of placebo treatment are, of course, not limited to
   reducing blood pressure to the normal range, while placebo was
   asthma, and certain pain problems are also responsive to a placebo
   What is a placebo response?
   In my opinion, the term placebo is misleading. In fact, patients who
   receive "placebo" treatment get much more than a sugar pill, whether
   they are enrolled in a placebo-controlled clinical trial or are the
   evocative term than "placebo treatment," and it includes several
   are part of the placebo treatment or treatment situation. Hippocrates
   Placebo response vs placebo effect
   No doubt some of the improvements observed in placebo-treated patients
   that are most placebo-responsive, including insomnia, pain, asthma,
   of the improvement we see associated with placebo is a result of
   that placebo treatment actually adds something that goes beyond the
   mere passage of time. Some would propose that the placebo effect should
   be defined as the placebo response minus the no-treatment response, or
   that you obtain with a drug minus the placebo response, we can also say
   that the placebo effect is what we obtain from a placebo response minus
   The conditions that seem to be most likely to respond to placebo are
   Placebos tend to help illness--but how? Expectation has been subjected
                             How placebos work
   locomotor responses persist even when placebo is substituted for the
   amphetamine. In some pain experiments, placebos may increase endorphin
   levels, and placebo analgesia can sometimes be blocked by naloxone.
   receive placebo, atenolol, or no treatment. Before drug treatment was
   administered, blood pressure was similar in patients taking placebo and
   use of placebo caused a significantly greater antihypertensive response
   placebo response obtained after atenolol had been administered was not
   receiving placebo and fluoxetine. A strong placebo response went
   depression, whether active drug or placebo is administered. Patients
   patients who do not respond to placebo. Patients who respond to placebo
   from those seen in patients who do not respond to placebo.^15