Placebos

[Tarantism]

the usefullness of placebo (sugar pill) has been proven by a study that shows that 80% of patients that believe they are on good medication get better regardless of wheather given sugar pill or actual medication.

 

B) whhat? how can that be??? does that mean that 80% of all illness is mental? could it mean that the amount of medication given is irrelivent if the patient does not believe that the meds are working?B)

[rockytriton]

I don't think it's that the illness is mental, but a good part of healing is mental. If you are depressed, your immune system is probably less dependable.

[IrishEyes]

the usefullness of placebo (sugar pill) has been proven by a study that shows that 80% of patients that believe they are on good medication get better regardless of wheather given sugar pill or actual medication.

Geez, I feel like the 'proof-nazi' today.

tart- can you share your sources for this study with the rest of us, so that we may evaluate it as well?

 

As for the implications, I think it's pretty common knowledge that a positive mental outlook aids in recovery. If part of that positive outlook is derived from a belief that prescribed medications will help the problem, then whether or not the pills are actual or placebo, they will help to some degree.

 

No, I don't have any factual studies on hand, just speaking as a mom. Band-aids work wonders for helping boo-bos feel better. How is that possible, when they have no healing powers except to cover the wound from sight? My belief is that it's because the power of Mommy's suggestion ("Let's put a band-aid on it and it will feel better") is much more effective sometimes than telling a kid to tough out the pain. They like to feel proactive, just like we do. B)

[Celeste]

Working in Epidemiology, I've studied the placebo effect quite extensively.

While I firmly believe in and have witnessed the sometimes stunning placebo effects first hand in many diseases, I would have a hard time swallowing the 80% of all illness part.

 

One fact not reported in the paper is what happened at the end of the study, when subjects were told what they really had received. Most of the placebo treated subjects had a deterioration of their mood, and ended up receiving medication. This is consistent with the traditional view of the placebo response, that it does not yield enduring benefit. Quoted in part from the Neuropsychiatic Institute

 

Two sayings that have forever stuck in my mind as ringing true:

 

"You get busy living, or get busy dying".

 

Pathologist to cancer patient: I'm sorry sir, there is nothing more we can do. At best, you have 6 months.

Patient to Pathologist: 6 months??? Thats not enough time!!!!

I'll be back in 6 years to prove you wrong. And he was.

 

To me, placebo effects work like that.

[Tarantism]

i express apologies, but i heard that bit of information on the radio, and i think that you may be right in sayin ghtat 80% was an exaggeration, but im not totally sure. HOWEVER i did find this article on the net that supports most of the information previously given.

 

Oestrogen therapy and the menopausal syndrome:

Campbell S, Whitehead M.

 

Sixty-four patients with severe menopausal symptoms completed a four month double-blind placebo trial with conjugated equine oestrogens (premarin). Using a graphic rating scale system of assessment, a statistically significant improvement with premarin was observed in 12 psychological and symptomatic scores (Table 3). From a comparison between these results and the results of the 20 patients without vasomotor symptoms it would appear that many of these symptomatic improvements result from the relief of hot flushes (i.e. a domino effect). However, the improvement in memory and reduction of anxiety in these 20 patients suggest that oestrogens have a direct tonic effect on the mental state which is independent of vasomotor symptoms. Sixty-one patients with less severe menopausal symptoms completed the second twelve month double-blind placebo trial and, as assessed by graphic rating scales, a significant improvement with premarin was observed in five psychological and symptomatic scores (Table 3). In both the twelve and four month studies the marked placebo effect of "youthful skin appearance", and on skin greasiness in the twelve month study, indicate that no reliance can be placed on patient judgement of skin texture and appearance. Despite the lessening of the domino effect there was a slight improvement with premarin over placebo in 15 of the remaining 16 symptoms and it is likely that the cumulative effect of these small improvements results in an overall enhancement of well-being. The relief of atrophic vaginitis by premarin did not result in an improvement in libido and this suggests that the ability and the desire to have sexual intercourse are not related. The strength and duration of the placebo effect were well demonstrated in the three standard psychiatric scoring systems, the Beck score (for depression), the General Health Questionnaire and the Eysenck Personality Index (formula: see text) (for neuroticism). We observed a highly significant placebo effect extending for six months in all three, the improvement with premarin over placebo being non-significant. We must conclude that these tests are not sufficiently sensitive to assess psychological or symptomatic changes in menopausal women and that these changes are best assessed by the graphic rating scales. The number of side-effects and complications was assessed in the 61 patients in the long study. A higher incidence of minor side-effects was observed during premarin therapy; this was most marked in relation to leg cramps but radio-isotope scanning revealed no evidence of leg vein thrombosis in these patients or indeed in any patient in the study. Premarin caused no elevation of systolic or diastolic blood pressure; indeed there was a progressive fall in blood pressure throughout the study with no significant difference between premarin and placebo...

[HydrogenBond]

The power of positive think should not be under emphasized. If one looks at it logically, the lymphatic system is throughout the body, from which the immune response is integrated. Nervous tissue and circulatory tissue is also throughout the body. Most meds work via the blood supply. But shouldn't local aternations in nervous potential, stemming from the brain and consciousness also have an impact on the local lymphatic potential? Positive thinking makes the immune system work better. This particular attitude means a particular cerebral potential flowing into the body that helps the lymphatic system.

 

In the older days, sickness was beleived to be causd by evil spirits. One could interpret this as meaning lousy mental attitudes that lower the nervous boost effectiveness of the immune system. A good ritual dance by the witch doctor would help drive out the evil spirit, so the person's state of mind would improve, thereby creating a better nervous potential for the immune system.

[Celeste]

No apologies necessary. I should have emphasized 80% of ALL diseases.

 

One of the most impressive studies I've seen of late showed an 50% to 60%and higher (up to 85%) relief of migraines in children using a placebo and the parents reassurance that "this will make you feel better". The adults however only showed about 35% relief with the placebo and were given no positive suggestions.

 

As Irish and Hydrogen pointed out, the power of positive suggestion/thinking can be astonishingly effective. B)

 

Some interesting notes:

 

Clip from Journal of Neuroscience

 

1. Just thinking that a medicine will relieve pain is enough to prompt the brain to release its own natural painkillers, and soothe painful sensations.

The study provides the first direct evidence that the brain's own pain-fighting chemicals, called endorphins, play a role in the phenomenon known as the placebo effect -- and that this response corresponds with a reduction in feelings of pain.

 

"This deals another serious blow to the idea that the placebo effect is a purely psychological, not physical, phenomenon," says lead author Jon-Kar Zubieta, M.D., Ph.D., associate professor of psychiatry and radiology at the U-M Medical School and associate research scientist at MBNI. "We were able to see that the endorphin system was activated in pain-related areas of the brain, and that activity increased when someone was told they were receiving a medicine to ease their pain. They then reported feeling less pain. "The mind-body connection is quite clear."

 

2. A study by J. Bruce Moseley, MD, and colleagues was published in the American Journal of Sports Medicine. Moseley and colleagues reported that subjects who underwent a fake operation had the same levels of relief from osteoarthritis as those who had received arthroscopy.

 

3. The first findings on placebo surgery were published in the NEJM in 1959. Leonard A. Cobb, MD, operated on 17 people suffering from angina, tying the arteries of 8 subjects — a procedure known as the Fieschi technique — and only making incisions in the 9 other patients. The fake procedure — now known as internal mammary artery ligation — proved as successful as the real ones.

[Tarantism]

yes, but didnt anyone with a deadly disease die out anyway back then? it just seems silly to me that if optimism makes your immune system work better wouldnt that make medication for small illnesses obsolite? Example:

 

i am a medical docter. i have two patients in my care, both with a common cold. i give one de-congestant and the other a blind placebo. the patient who took the medicine gets better in, say, 2 days. the patient who took the sugar pill gets better in 6.

 

i suppose obsolite might be a bit extreme, but my point is that madication doesnt seem to work the wonders that i once thought that it did, instead it seems only to speed up recovery, not cause it.

 

or maybe that was always the point of medication and i just didnt know.

[Tarantism]

The adults however only showed about 35% relief with the placebo and were given no positive suggestions.

 

well, that is probably because the adults have more to be stressed out about, so they worry more about little things like a cold. erm?

[Michaelangelica]

80% seems high, but I would happily accept 50%.

 

The placebo is the most powerful and useful drug we have.

 

it just shows the un-tapped healing power of the brain.

[Pyrotex]

I would like to relate a first-person experience with placebos.

 

In 1994, I was working for Baylor College of Medicine, and was chosen to work for a double blind experiment, using patients from the VA Hospital next door. I was responsible for data management for the landmark Placebo Knee Surgery experiment under Drs. Bruce Mosely* and Nelda Wray.

 

Patients with severe knee arthritis were carefully screened to rule out side-issues such as drugs or diabetes. They were volunteers and were told they might get a "placebo" operation rather than a real one. There were three possible surgeries: 1) debridement and lavage (polish the knee bone surfaces to remove scratches and flush out the inter-joint region to remove bone crumbles; 2) lavage only; 3) open the knee exactly as before and do nothing for exactly as long as normal surgery. All three surgeries left identical stitches.

 

At periodic times, the patients filled out surveys of their pain, how far they could walk, how many steps they could climb, how much meds they were taking. And they were asked which operation they thought they got.

 

About 1.5 years into the 2 year experiment, it was stopped. Patients with the placebo surgery showed just as much improvement as the other two. In fact, there was no statistical difference in the three surgeries.

 

*Dr. Mosely was, at one time, the sports surgeon for the Houston Astros basketball team.