The placebo effect
| Author | Message |
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| Matt Smith Admin  Age: 33 Gender: Female Posts: 31134   | |
| Bleach Rotting On Here  Age: 33 Gender: Female Posts: 47505 | whats the placebo effect? i coundnt really understand what she meant  |
| Matt Smith Admin Age: 33 Gender: Female Posts: 31134 | Love You Like I Do.: Kay, i'll explain  Its where a doctor gives a person a 'placebo' (a fake dose of medicine such as tablets made from flour) to a person, and even though the medicine doesn't cure them their minds think they have had medicicne and their bodies begin to heal, without drugs. D'ya understand? Its quite amazing. |
| SARAnade King For A Couple Of Days  Age: 35 Gender: Female Posts: 2228 | |
| Lucifers Angel King For A Couple Of Days Age: - Gender: Female Posts: 4751 | |
| Bleach Rotting On Here Age: 33 Gender: Female Posts: 47505 | Bloodraine:yeah thats pretty good . but like, do the patients know that its a placebo?  |
| Buddy Christ Falling In Love With The Board  Age: 32 Gender: Male Posts: 5821 | Love You Like I Do.: if they did it wouldnt work because they think they have the drugs given to them. thats how the whole thing works. |
| Bleach Rotting On Here Age: 33 Gender: Female Posts: 47505 | dookie_#32:thats what i thought thats pretty cool  |
| whateveryasay King For A Couple Of Days  Age: 34 Gender: Female Posts: 4313 | Jovanna: Yeah, it can happen if you're reading medical books. You suddenly find out that you have a cancer, AIDS or mononucleosis.  But the positive effect of placebo is priceless. I remember that when I was about 10 and I was really nervous about school or something like that. My mum gave me propably vitamin B and I wasn't anxious any more. Strength of suggestion. |
| michaeldirnt Idiot Age: - Gender: - Posts: 737 | |
| newagecarny Was Here Two Weeks Ago  Age: 33 Gender: Female Posts: 42495 | |
| amistad. Addict  Age: 33 Gender: Female Posts: 14389 | |
| MarioGirl Geek  Age: 104 Gender: - Posts: 147 | |
| spill_no_sick Falling In Love With The Board Age: 31 Gender: - Posts: 8588 | |
| Be[lie]ve Jackass ![Be[lie]ve](/data/board-avatars/00001/118583216962264.jpg) Age: 33 Gender: Female Posts: 1301 | I think its a great idea, and it works like a charm!  Its also kinda funny too |
| cabot gal GSBitch  Age: 33 Gender: Female Posts: 76863 | |
| [Broken Pretty] Idiot Age: 36 Gender: Female Posts: 572 | |
| Comic tragedy Idiot  Age: - Gender: Female Posts: 546 | |
| Lucifers Angel King For A Couple Of Days Age: - Gender: Female Posts: 4751 | the psychological theory: it's all in your mind Some believe the placebo effect is psychological, due to a belief in the treatment or to a subjective feeling of improvement. Irving Kirsch, a psychologist at the University of Connecticut, believes that the effectiveness of Prozac and similar drugs may be attributed almost entirely to the placebo effect. He and Guy Sapirstein analyzed 19 clinical trials of antidepressants and concluded that the expectation of improvement, not adjustments in brain chemistry, accounted for 75 percent of the drugs' effectiveness (Kirsch 199 . "The critical factor," says Kirsch, "is our beliefs about what's going to happen to us. You don't have to rely on drugs to see profound transformation." In an earlier study, Sapirstein analyzed 39 studies, done between 1974 and 1995, of depressed patients treated with drugs, psychotherapy, or a combination of both. He found that 50 percent of the drug effect is due to the placebo response. A person's beliefs and hopes about a treatment, combined with their suggestibility, may have a significant biochemical effect. Sensory experience and thoughts can affect neurochemistry. The body's neurochemical system affects and is affected by other biochemical systems, including the hormonal and immune systems. Thus, it is consistent with current knowledge that a person's hopeful attitude and beliefs may be very important to their physical well-being and recovery from injury or illness. However, it may be that much of the placebo effect is not a matter of mind over molecules, but of mind over behavior. A part of the behavior of a "sick" person is learned. So is part of the behavior of a person in pain. In short, there is a certain amount of role-playing by ill or hurt people. Role-playing is not the same as faking or malingering. The behavior of sick or injured persons is socially and culturally based to some extent. The placebo effect may be a measurement of changed behavior affected by a belief in the treatment. The changed behavior includes a change in attitude, in what one says about how one feels, and how one acts. It may also affect one's body chemistry. The psychological explanation seems to be the one most commonly believed. Perhaps this is why many people are dismayed when they are told that the effective drug they are taking is a placebo. This makes them think that their problem is "all in their mind" and that there is really nothing wrong with them. Yet, there are too many studies which have found objective improvements in health from placebos to support the notion that the placebo effect is entirely psychological. Doctors in one study successfully eliminated warts by painting them with a brightly colored, inert dye and promising patients the warts would be gone when the color wore off. In a study of asthmatics, researchers found that they could produce dilation of the airways by simply telling people they were inhaling a bronchiodilator, even when they weren't. Patients suffering pain after wisdom-tooth extraction got just as much relief from a fake application of ultrasound as from a real one, so long as both patient and therapist thought the machine was on. Fifty-two percent of the colitis patients treated with placebo in 11 different trials reported feeling better -- and 50 percent of the inflamed intestines actually looked better when assessed with a sigmoidoscope ("The Placebo Prescription" by Margaret Talbot, New York Times Magazine, January 9, 2000).* It is unlikely that such effects are purely psychological. But it is not necessarily the case that the placebo is actually effective in such cases. the nature-taking-its-course theory Some believe that at least part of the placebo effect is due to an illness or injury taking its natural course. We often heal spontaneously if we do nothing at all to treat an illness or injury. Furthermore, many disorders, pains and illnesses, wax and wane. What is measured as the placebo effect could be, in many cases, the measurement of natural regression. In short, the placebo may be given credit that is due to nature. However, spontaneous healing and spontaneous remission of disease cannot explain all the healing or improvement that takes place because of placebos. People who are given no treatment at all often do not do as well as those given placebos or real medicine and treatment. the process-of-treatment theory Another theory gaining popularity is that a process of treatment that involves showing attention, care, affection, etc., to the patient/subject, a process that is encouraging and hopeful, may itself trigger physical reactions in the body which promote healing. According to Dr. Walter A. Brown, a psychiatrist at Brown University, there is certainly data that suggest that just being in the healing situation accomplishes something. Depressed patients who are merely put on a waiting list for treatment do not do as well as those given placebos. And -- this is very telling, I think -- when placebos are given for pain management, the course of pain relief follows what you would get with an active drug. The peak relief comes about an hour after it's administered, as it does with the real drug, and so on. If placebo analgesia was the equivalent of giving nothing, you'd expect a more random pattern ("The Placebo Prescription" by Margaret Talbot, New York Times Magazine, January 9, 2000).* Dr. Brown and others believe that the placebo effect is mainly or purely physical and due to physical changes which promote healing or feeling better. It is assumed that the physical changes are not caused by the placebo itself. So, what is the explanatory mechanism for the placebo effect? Some think it is the process of administering it. It is thought that the touching, the caring, the attention, and other interpersonal communication that is part of the controlled study process (or the therapeutic setting), along with the hopefulness and encouragement provided by the experimenter/healer, affect the mood of the subject, which in turn triggers physical changes such as release of endorphins. The process reduces stress by providing hope or reducing uncertainty about what treatment to take or what the outcome will be. The reduction in stress prevents or slows down further harmful physical changes from occurring. The process-of-treatment hypothesis would explain how inert homeopathic remedies and the questionable therapies of many "alternative" health practitioners are often effective or thought to be effective. It would also explain why pills or procedures used by conventional medicine work until they are shown to be worthless. Forty years ago, a young Seattle cardiologist named Leonard Cobb conducted a unique trial of a procedure then commonly used for angina, in which doctors made small incisions in the chest and tied knots in two arteries to try to increase blood flow to the heart. It was a popular technique -- 90 percent of patients reported that it helped -- but when Cobb compared it with placebo surgery in which he made incisions but did not tie off the arteries, the sham operations proved just as successful. The procedure, known as internal mammary ligation, was soon abandoned ("The Placebo Prescription" by Margaret Talbot, New York Times Magazine, January 9, 2000).* Of course, spontaneous healing or regression can also adequately explain why homeopathic remedies might appear to be effective. Whether the placebo effect is mainly psychological, misunderstood spontaneous healing, due to showing care and attention, or due to some combination of all three may not be known with complete confidence. the powerful placebo challenged The powerful effect of the placebo is not in doubt. It should be, however, according to Danish researchers Asbjørn Hróbjartsson and Peter C. Götzsche. Their meta-study of 114 studies involving placebos found "little evidence in general that placebos had powerful clinical effects...[and]...compared with no treatment, placebo had no significant effect on binary outcomes, regardless of whether these outcomes were subjective or objective. For the trials with continuous outcomes, placebo had a beneficial effect, but the effect decreased with increasing sample size, indicating a possible bias related to the effects of small trials ("Is the Placebo Powerless? An Analysis of Clinical Trials Comparing Placebo with No Treatment," The New England Journal of Medicine, May 24, 2001 (Vol. 344, No. 21)." According to Dr. Hróbjartsson, professor of medical philosophy and research methodology at University of Copenhagen, "The high levels of placebo effect which have been repeatedly reported in many articles, in our mind are the result of flawed research methodology."* This claim flies in the face of more than fifty years of research. At the very least, we can expect to see more rigorously designed research projects trying to disprove Hróbjartsson and Götzsche. the origin of the idea The idea of the powerful placebo in modern times originated with H. K. Beecher. He evaluated over two dozen studies and calculated that about one-third of those in the studies improved due to the placebo effect ("The Powerful Placebo," 1955). Other studies calculate the placebo effect as being even greater than Beecher claimed. For example, studies have shown that placebos are effective in 50 or 60 percent of subjects with certain conditions, e.g., "pain, depression, some heart ailments, gastric ulcers and other stomach complaints."* And, as effective as the new psychotropic drugs seem to be in the treatment of various brain disorders, some researchers maintain that there is not adequate evidence from studies to prove that the new drugs are more effective than placebos. Placebos have even been shown to cause unpleasant side effects. Dermatitis medicamentosa and angioneurotic edema have resulted from placebo therapy, according to Dodes. There are even reports of people becoming addicted to placebos. the ethical dilemma The power of the placebo effect has led to an ethical dilemma. One should not deceive other people, but one should relieve the pain and suffering of one's patients. Should one use deception to benefit one's patients? Is it unethical for a doctor to knowingly prescribe a placebo without informing the patient? If informing the patient reduces the effectiveness of the placebo, is some sort of deception warranted in order to benefit the patient? Some doctors think it is justified to use a placebo in those types of cases where a strong placebo effect has been shown and where distress is an aggravating factor.* Others think it is always wrong to deceive the patient and that informed consent requires that the patient be told that a treatment is a placebo treatment. Others, especially "alternative" medicine practitioners, don't even want to know whether a treatment is a placebo or not. Their attitude is that as long as the treatment is effective, who cares if it a placebo? Of course, if the placebo effect is an illusion, then another ethical dilemma arises: should placebos be given if it is known that deception does not really reduce pain or aid in the cure of anything? are placebos dangerous? While skeptics may reject faith, prayer and "alternative" medical practices such as bioharmonics, chiropractic and homeopathy, such practices may not be without their salutary effects. Clearly, they can't cure cancer or repair a punctured lung, and they might not even prolong life by giving hope and relieving distress as is sometimes thought. But administering useless therapies does involve interacting with the patient in a caring, attentive way, and this can provide some measure of comfort. However, to those who say "what difference does it make why something works, as long as it seems to work" I reply that it is likely that there is something which works even better, something for the other two-thirds or one-half of humanity who, for whatever reason, cannot be cured or helped by placebos or spontaneous healing or natural regression of their pain. Furthermore, placebos may not always be beneficial or harmless. In addition to adverse side effects, mentioned above, John Dodes notes that Patients can become dependent on nonscientific practitioners who employ placebo therapies. Such patients may be led to believe they're suffering from imagined "reactive" hypoglycemia, nonexistent allergies and yeast infections, dental filling amalgam "toxicity," or that they're under the power of Qi or extraterrestrials. And patients can be led to believe that diseases are only amenable to a specific type of treatment from a specific practitioner ---------------------------------------------------------------- In other words, the placebo can be an open door to quackery. But i did find the bit about the warts interesting. |
| Kurtni Admin  Age: 33 Gender: Female Posts: 34289 |
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