Thursday, June 19, 2014

Placebo


The Placebo Effect

Why an inert substance, a so-called "sugar pill," or a fake surgery or therapy would be effective,  is not completely known. Placebo medications are sometimes prescribed when no drug is really needed because they make patients feel well taken care of. Placebos are also used as controls in scientific studies on the effectiveness of drugs. 
So-called double blind experiments, where neither the doctor nor the patient knows whether the given medication is the experimental drug or the placebo, are often done to assure unbiased, statistically reliable results. The "placebo effect is an improvement in health due not to any treatment but only to the patient's belief that he or she will improve (as by taking a dummy pill that is thought to be a cure). 
An opposite, or "negative placebo effect, has been observed when patients believe their health will get worse. Research has confirmed that a fake treatment, made from an inactive substance like sugar, distilled water, or saline solution, can have a "placebo effect"--that is, the sham medication can sometimes improve a patient's condition simply because the person has the expectation that it will be helpful. For a given medical condition, it's not unusual for one-third of patients to feel better in response to treatment with placebo. 
"Expectation is a powerful thing," says Robert DeLap, M.D., head of one of the Food and Drug Administration's Offices of Drug Evaluation. "The more you believe you're going to benefit from a treatment, the more likely it is that you will experience a benefit." 
To separate out this power of positive thinking and some other variables from a drug's true medical benefits, companies seeking FDA approval of a new treatment often use placebo-controlled drug studies. If patients on the new drug fare significantly better than those taking placebo, the study helps support the conclusion that the medicine is effective.
So, a placebo is an inert substance, or "fake" surgery or therapy, used as a control in an experiment or given to a patient for its possible or probable beneficial effect.In a drug study, one group of patients is given a placebo and another the experimental drug, to see if the drug group's health improvements sufficiently surpass those from placebo. Significance is measured by relation to chance: if an event is not likely due to chance, then its occurrence is significant. 
A double-blind test is a control group test where neither the evaluator nor the subject knows which items are controls. A random test is one which randomly assigns items to the control or experimental groups. The purpose of controls, double-blind and random testing is to reduce error, self-deception and bias. 
The Placebo Effect is one of the most common phenomena observed in medicine, but also a very mysterious one. It is powerful. In a study carried out at the University of Harvard, its effectiveness was tested in a wide range of disturbances, including pain, arterial hypertension and asthma. The result was impressive: 30 to 40% of the patients obtained relief with the use of placebo. Furthermore, the placebo effect is not limited to medicines but it can appear with any kind of medical procedure. 
In a trial to test the value of a surgical procedure (ligature of an artery in the thorax) to treat angina pectoris (pain in the chest caused by chronic heart ischemia), the placebo procedure consisted in anesthetizing the patient and only cutting his skin. The thus fictitiously treated patients showed an 80% improvement while those actually operated upon only 40%. In other words: placebo acted better than surgery.  Similarly, the Placebo Effect accounts for up to fifty percent of improvement in depressed patients taking antidepressants. So, what counts is the reality present in the brain, not the pharmacological one of the pharmacist or even the real conditions of the environment. 
The placebo effect is the measurable or observable effect on a person or group that has been given a placebo treatment. A placebo is an inert substance, or "fake" surgery or therapy, used as a control in an experiment or given to a patient for its possible or probable beneficial effect. Why an inert substance, a so-called "sugar pill," or a fake surgery or therapy would be effective,  is not completely known. 
Many believe the placebo effect is psychological, due to either a real effect caused by belief  or to a subjective delusion. If I believe the pill will help, it will help. The psychological theory is that it's all in your mind. But even in animals several environmental stimuli can unite to each other, forming a chain. Any of those stimuli can act as a sign and turn the conditioned reflex on. 
Placebos are not always given wittingly. Homeopathy or even some conventional treatments may work through the placebo effect and that patients with cancer gain in optimism because of complementary treatments. When the placebo response works by expectancy, it apparently does so by turning on the biochemical pathways that produce endorphins
Automatically our brains filter all sensory data for threats of danger ready to trigger an alarm reaction. Madison Avenue has careful studies showing just what words, shapes and colors command our attention. Unchecked, these artificially elevated levels of stress related hormones begin to take a toll on the body's immune system and over-all stamina. 
So there is a opposite to the placebo effect: fear. For example, in voodoo death, the victim must believe in the curse or spell for it to be effective. All people experience physiological reactions to anticipation and stress, something like the fight-or-flight response, that help them to survive and cope. The body responds by producing adrenaline, dopamine or nor epinephrine so that we can think and act more quickly and are generally more alert. 
Stress overload is quite real in contemporary life, but it is usually up to us to independently find whatever remedy we can. The complexity of our lives, compounded by technology behooves us to take an active role in finding rest and repose: bliss. If there is an organic impetus toward the divine it may have its roots here. Before science and medicine there was no place to turn in crisis but religion or "magic." 
We know that positive emotions increase creativity, our immune responses, and can even elevate the IQ. Most of us have learned that the the principles of meditation and creative visualization work, even if we don't practice them. Whatever we pay attention to is what we become.  Dr. Joe Dispenza has several very good YouTube presentations  about the Placebo, offering a good overview of how synchronizing thoughts and emotions empowers the placebo.
In order to usher in a new society propagating peace, harmony, and wholeness, we must change our perspectives of what is valued.



LINKS
The Placebo Effect
PLACEBOS Placebos are putatively inactive substances tested in controlled studies for comparison with presumed active drugs or prescribed for relief of symptoms or to meet a patient's demands.  Placebo Effect: The Power of the Sugar Pill
Julio Rocha do Amaral, MD e Renato M. E. Sabbatini, PhD. The placebo effect is powerful. In a study carried out at the 
University of Harvard, its effectiveness was tested in a wide range of disturbances, including pain, arterial hypertension 
and asthma. The result was impressive: 30 to 40% of the patients obtained relief with the use of placebo. 
Amazon.com: buying info: The Placebo Effect : An Interdisciplinary Exploration
Books All Products Explore this book buying info table of contents editorial reviews customer reviews rate this item See more by this author all books by Anne Harrington 
Univ. of Connecticut - Antidepressants, Placebo Effect
News release for a study exploring how antidepressants are effective due to the placebo effect. 
The Healing Power of Placebos        Part 2       Part 3
A sham medication can sometimes improve a patient's condition simply because the person has the expectation that it will be helpful. 
Mental Health: A Report of the Surgeon General - Chapter 2
Overview of Treatment -   Introduction to Range of Treatments
The placebo effect is the healing force of nature
In a series "Placebos in Medicine", published recently by The Lancet, this topic was discussed by several authors (1-5). The article "Is there a logic in the placebo?" reveals the main concern of modern medicine, how to define it scientifically,......... 
Placebo Effect Accounts for Fifty Percent of Improvement in Depressed Patients Taking Antidepressants
APA news release reveals research that patients receiving antidepressants can attribute 50% of their improvement to the placebo effect of the medication. Thus, the psychological effect of the medication is just as strong as its chemical components. 
HANDS ON HEALTH
WHAT'S WRONG WITH THE PLACEBO EFFECT? In my years as a Physical Therapist, I have read many research articles that attributed the positive effects of Physical Therapy to the Placebo Effect... 
The Placebo Effect
Health professionals and researchers have long been aware of a strange phenomenon associated with their attempts to identify appropriate treatments for the broad array of human ailments. 
The Placebo Effect. January 10, 2000. The Connection with Christopher Lydon. 
Second Hour: The Placebo Effect 
CSICOP / Skeptical Inquirer / January 1997 / The Mysterious Placebo
The Mysterious Placebo One of the most significant but widely misunderstood phenomena is the placebo effect. Research shows that the placebo effect can be greater and is far more ubiquitous than commonly thought. 
Mind Over Matter
The power of a simple breath. The unbelievable placebo effect. Hypnosis, a powerful mind-tool or fiction? "sometimes the greatest challenges come from within" 
The Placebo Response by Howard Brody with Daralyn Brody 
Find out about the book, read latest news about the placebo response, use exercises to improve your own health 
MDD July/August 1999: The Mysterious Placebo Effect
Modern Drug Discovery July/August 1999 Modern Drug Discovery, 1999, 2(4) 30-40 . © 1999 American Chemical Society. 
The Placebo Effect. January 10, 2000. The Connection with Christopher Lydon.
Second Hour: The Placebo Effect 
Skeptic's Dictionary - Placebo Effect
Read a definition of the "placebo effect" and learn about how a control group is used during an experiment. 


Bibliography
 
  • The Powerful Placebo : From Ancient Priest to Modern Physician by Arthur K., Md
  • The Power of Hope : A Doctor's Perspective by Howard M. Spiro 
  • The Placebo Response : How You Can Release the Body's Inner Pharmacy for Better Health by Howard Brody, Daralyn Brody (Contributor) 
  • From Placebo to Panacea : Putting Psychiatric Drugs to the Test by Seymour Fisher (Editor), et al