Naked Science Forum
Life Sciences => Physiology & Medicine => Topic started by: cheryl j on 29/10/2011 07:15:43
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I've always wondered if the placebo effect is real and what experiments have shown it be real, and what is the mechanism behind it. This would seem to be an important question for two reasons - 1)the placebo effect is part of the reason for having double blind control groups in studies, and 2) if it exists, why not enhanse it, why not find even more effective ways to convince or trick people into thinking they will get better, instead of giving drugs with possible risks and side effects.
I don't believe the placebo effect is real for a few reasons. 1) Sometimes diseases go away on their own. They fizzle out, or the body heals itself. And that is not the same as a placebo effect. 2) I think patients sometimes lie, and report feeling better when they really don't because they don't want to disappoint the doctor who is trying to help them. They don't want to appear negative and complaintive. 3) And from personal experience, I have taken a drug fully expecting it to work, and was really surprised when it didnt.And I've experienced the opposite as well - I've been doubtful something would work and was surprised when it did. My expectations did not seem to alter the outcome, at least not for me.
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The Placebo effect is absolutely real, but it would depend on what one is treating. Whether it actually changes an outcome, or just a belief in an outcome is unclear.
If one is treating a disease that only responds to an antibiotic (for example syphilis), then treating it with a placebo like was done in the Tuskegee syphilis experiment would be unethical.
Likewise, individuals with severe post-surgery pain may require strong meds.
Occasionally for an ache, I'll take a few aspirin. Sometimes I wonder if it really is doing anything.
It is easy to fool oneself in cases such as pain, or a common cold that would get better with no specific treatment.
There are some alternative diet pills that are most effective with pill+diet+exercise. But, they would likely be equally effective with just diet+exercise, without the pills, as long as the people believe in the program.
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If you did a double blind experiment on placebos, would you have to give both groups a plaecebo? [::)]
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If you did a double blind experiment on placebos, would you have to give both groups a plaecebo? [::)]
You could quite easily give the non-control group pills in a manner that they can very easily realise they are taking a placebo. Or you could just tell them they are in the placebo group
If, after maintaining the blind, the results show that the group in which a fair percentage will have realised they were on a placebo has done significantly less well than the other group (who are on a placebo but without knowing it) then you have a conclusion. The importance is that in choosing which patients receive the placebo knowingly and those that are unknowing, must be done randomly and with safeguards against bias; and then the results must again be interpreted and collated etc before the groups are made known to the experimenters
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now, that's funny.
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Another way you might control for the "Placebo Effect".
Have 3 groups (perhaps can be done with two, but I'd prefer 3).
1st Group: No Treatment.
2nd Group: Placebo
3rd Group: Placebo + Explanation
4th Group: Might as well have an "active ingredient" group; just to justify the study.
Whatever your study is... Say a pain study (for mild, generally self-limiting, non surgical pain relief).
Group 1 gets no meds, but perhaps pain management counseling.
Group 2 gets a Placebo (and perhaps the same pain management counseling.
Group 3 is initially treated identically to the second group.
Group 4 is like 2nd group, but with the active ingredient.
At the end you hand groups 1, 2, & 4 a questionnaire about their pain levels and side-effects. The no treatment group may need further explanation, especially with respect to side-effects, but you can simply ask about things like nausea.
The third group, you would sit down at the end of the study and explain the concept of a placebo, and tell them that they were in the placebo group (you could present this with a written note if you wish uniformity, and could even present all groups a written note, with only the 3rd group getting the placebo note. After they read and understand that they were in the placebo group, then they would be presented the same questionnaire about the pain levels and side-effects.
You could do this with the normal Placebo group, but presenting the pain questionnaire twice might influence their answers. In fact, you might wish to give group 2 the "explanation", followed by a second questionnaire, just to see the differences caused by the first questionnaire.
Anyway, one might expect the placebo group that had the explanation of a placebo just before the questionnaire to actually still show more drug-like responses (benefit & side-effects) than the group with no treatment.
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The Placebo effect is real, and seems to be statistically significant even when knowing that you are taking it, according to new research, so you was 'on the dot' there Imatfaal. Why it is real? :) 'The last thing we lose is hope' someone said once, maybe that is it?
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And Cheryl, you have to remember that to hope completely is not the most sane approach, you strike me as a rather balanced personality, with a good mind. And that might make it harder to be persuaded to 'hope' blindly or have that 'faith', that sometimes seems to create wonders. Also it is so that some medicine either works, or works not, depending on the individuals physiology. But hope will make a difference for the sense of well-being though.
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What about the anti-placebo effect ?...Can ewe give people bona fide specific medication and have them believe it is a placebo for there to be no effect ?
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What about the anti-placebo effect ?...Can ewe give people bona fide specific medication and have them believe it is a placebo for there to be no effect ?
It's a bit like mind over matter, or, does it matter if you don't mind?
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The Placebo effect is real, and seems to be statistically significant even when knowing that you are taking it, according to new research, so you was 'on the dot' there Imatfaal. Why it is real? :) 'The last thing we lose is hope' someone said once, maybe that is it?
So if it is real, what would be a possible mechanism? Actually it would have to have multiple mechanisms, if it genuinely appears in studies involving drugs for variety of disorders involving different organ systems or chemical pathways. I know that there are many connections between the brain and nervous system and the endocrine system and the immune system. But even that would not seem to account for it showing up in every type of study.
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The brain is still a mystery. We used to define the senses to specific places but 'plasticity' introduce the idea that the brain 'synergize' them, explaining why some people can see colours in sounds, and sounds in tastes etc. Don't remember what they call that condition though, but there are people like that. It's like you have basic principles for how something work, and then you add layers of 'conceptual' complexity upon those principles. Makes you wonder how much of what we know when grown up is lost from what we knew when small, it seems that there are a lot of connections that disappear as we grow, others taking their place.
Cool question Neil, I never seen any research about that :)
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What about the anti-placebo effect ?...Can ewe give people bona fide specific medication and have them believe it is a placebo for there to be no effect ?
Is that like decaf coffee?
Now that I've been on decaf coffee for a while...
I got "dosed" by a double cappuccino I bought at an espresso stand a couple of months ago.
Fully expecting Decaf... I was able to recognize when it had gotten switched on me.
Such an anti-placdbo experiment would likely push experimental ethics, assuming there is a true "active" ingredient, however, it would be interesting for observing things like mild side effects (stomach ache, gas, etc).
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Whenever I hear placebo effect, I kept thinking about homeopathic remedies.
Placebo effect is definitely real.
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Whenever I hear placebo effect, I kept thinking about homeopathic remedies.
Placebo effect is definitely real.
If a homeopathic remedy advertizes that it works by "Placebo Effect" (or I've seen "Super Placebo Effect" advertized).... then it means that it does absolutely nothing. Certainly things like Chicken Soup may make a person feel good, whether or not it cures the common cold.
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If you did a double blind experiment on placebos, would you have to give both groups a plaecebo? [::)]
good question :)
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I've always wondered if the placebo effect is real and what experiments have shown it be real, and what is the mechanism behind it. This would seem to be an important question for two reasons - 1)the placebo effect is part of the reason for having double blind control groups in studies, and 2) if it exists, why not enhanse it, why not find even more effective ways to convince or trick people into thinking they will get better, instead of giving drugs with possible risks and side effects.
I don't believe the placebo effect is real for a few reasons. 1) Sometimes diseases go away on their own. They fizzle out, or the body heals itself. And that is not the same as a placebo effect. 2) I think patients sometimes lie, and report feeling better when they really don't because they don't want to disappoint the doctor who is trying to help them. They don't want to appear negative and complaintive. 3) And from personal experience, I have taken a drug fully expecting it to work, and was really surprised when it didnt.And I've experienced the opposite as well - I've been doubtful something would work and was surprised when it did. My expectations did not seem to alter the outcome, at least not for me.
i think placebo work in few conditions where the disease can be easily cured by our defense mechanisms n where will power dominates the damage caused by the disease condition .....it cant work on those conditions where our body defenses cant tackle perfectly n we need external support invariably where placebo dont work .....its purely a psychological mechanism where disease is mild n easily handled by our body defense section n d patient feel that its due to drug(placebo) given by the doctor
actually the whole work is done by our brain n body defense mechanisms if wrong plz correct me
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So how do you test the placebo effect? With a placebo? (https://www.thenakedscientists.com/forum/proxy.php?request=http%3A%2F%2Fbestsmileys.com%2Fclueless%2F1.gif&hash=ba6e884e2ac18d739c0e89967c82862b)
Researcher to assistant - "I want you to give these genuine placebo's to these ten volunteers and to the other ten, I want you give....... Ah! I seem to have hit a snag!!! Back to the drawing board."