#The Brain Bank » Feed The Brain Bank » Comments Feed The Brain Bank » The Placebo Effect: A treatment of the mind? Comments Feed Ketamine: from drug of abuse to anti-depressant. Why can’t we tickle ourselves while schizophrenics can? -- Why can’t we tickle ourselves while schizophrenics can? → The Placebo Effect: A treatment of the mind? Posted on December 16, 2012 by thebrainbank -- simple amino acids and mineral oil, with no active ingredients. This drug was actually a placebo! Placebo treatments are usually given to patients in the form of sugar pills, but can also include injections and sham surgery. The key to the placebo’s success is ensuring the patient believes the treatment will improve their condition. Belief in the treatment can lead to a perceived or actual improvement of the condition. The so-called ‘placebo effect’ appears, at first glance, to make no sense whatsoever. How could a simple sugar pill alleviate serious medical symptoms? The answer may be as simple as a positive mental -- I was first inspired to write this article by a programme I watched a few weeks ago on Channel 4 titled Derren Brown: Fear and Faith. This show demonstrated the power of the placebo effect through a fake clinical trial. Subjects on this trial were given a placebo drug (Rumyodin) and were told that it could inhibit feelings of fear. Over the course of few weeks, we saw each of the subjects overcome their respective fears ranging from heights and confrontation to singing in public. The drug was also effective as a cure for smoking and allergies. The strength of the placebo was enhanced by the very convincing story behind the drug’s development, including a fictitious pharmaceutical company and the use of doctors to administer the drug. The placebo’s extremely powerful effects were probably due to this attention to detail, meaning subjects were convinced that the treatment would work. So if placebos can offer such amazing results without the need for any active ingredient and all the side effects these may bring, why are they not used more regularly? The ability of a placebo to alleviate symptoms is variable both in how often they succeed and the strength of the resulting symptom alleviation. Placebos appear to be more effective when symptoms are subjective such as pain or nausea and less effective for non-subjective symptoms such as abnormal blood pressure or heart rate. -- A recent study in the US has suggested that genes may also play an important role in deciding whether or not an individual responds to a placebo. Preliminary results indicate that if a particular gene is present, individuals with irritable bowel syndrome are more likely to respond to placebo acupuncture. Whether this effect may be replicated for other conditions is unclear. However, these results do offer an explanation as to why some people are more susceptible to the placebo effect than others. A study from 1985 hypothesised that the placebo effect relies heavily upon a belief that the medicine will make you feel better. Indeed, one study showed that the attitude of the prescribing doctor towards both the drug and the patient significantly altered the patients prognosis. In this study patient’s responses to a placebo rose from 44% to 62% when the doctor prescribing the treatment made a conscious effort to be positive. This means that scientists are faced with a paradox when it comes to the use of placebos. Although there are clear ethical issues arising from their use, such as the controversy of introducing dishonesty into the patient-doctor relationship, ethical issues also arise from NOT using placebos. Is it unethical not to use something that could help improve a patient’s health? Despite this, the UK Parliamentary Committee for Science and Technology think that the placebo effect is unreliable and should not be used as a sole treatment on the NHS. In contrast, a study of GPs in Denmark has shown that 48% had previously prescribed placebo as treatments at least 10 times over the last year. Moreover, a study in 2004 uncovered that approximately 60% of physicians in Israel has used placebos in their practice. What is important to remember, is that placebos are not a ‘one-size-fits-all’ cure that works for everyone. The effect that placebos have can be highly variable and often unreliable. Whilst some people respond positively to treatment with placebos, others experience no change to their condition. This positive effect appears to depend not only on the type of ailment the patient is suffering with, but also their mental attitude towards the treatment. However, what is clear is that a lot more research needs to be carried out to investigate exactly how and why placebos work, and why their success is so variable. IFRAME: -- Why can’t we tickle ourselves while schizophrenics can? → 3 Responses to The Placebo Effect: A treatment of the mind? 1. Jan says: December 21, 2012 at 1:37 am “What is important to remember, is that placebos are not a ‘one-size-fits-all’ cure that works for everyone. The effect that placebos have can be highly variable and often unreliable. Whilst some people respond positively to treatment with placebos, others experience no change to their condition. ” The same can be said of any individual medicine and yet we -- December 21, 2012 at 9:35 am Great. I was particularly pleased to see the ethical question of not trying a placebo raised – at least you are taking it a bit seriously. Isn’t the placebo effect interesting? We do know that a lot of things can stimulate the immune system – though this itself has given rise to many bogus claims. It sounds like a testable -- and sometimes cures for illness based on the patient’s belief that they have been given an effective treatment. It’s start, but I still see a lot of dismissal of such things as “merely placebo effect” as though it is inconsequential. Shrinking tumours are hardly inconsequential. Nor are many of the other effects that are -- help with illness. It’s not medical science, but it might help to provide clues into the kinds mental changes that need to take place for a placebo to be effective. Reply 3. Mark Uribe says: December 23, 2012 at 7:05 am Surely the point here is that the key factor is a positive optimistic attitude, whether the “placebo” is a pill, a self help book, a religious belief, humour, a supportive partner, a pet, etc.. If I’m not mistaken, all these things have been shown to have