The Mysteriously Powerful Placebo
The placebo effect is one of the most powerful, and yet most mysterious, effects seen in medicine and health fields. As the below video demonstrates extremely well, lots of research has focused on the effects of placebos and how it can differ across situations.
Interestingly, it also turns out that placebos are, for some reason, getting stronger compared to two decades ago.
Some products that have been on the market for decades, like Prozac, are faltering in more recent follow-up tests. In many cases, these are the compounds that, in the late ’90s, made Big Pharma more profitable than Big Oil. But if these same drugs were vetted now, the FDA might not approve some of them. Two comprehensive analyses of antidepressant trials have uncovered a dramatic increase in placebo response since the 1980s. One estimated that the so-called effect size (a measure of statistical significance) in placebo groups had nearly doubled over that time.
And now, researchers have very cleverly shown that placebos can work even in people who know they are just placebos. Dr. Ted Kaptchuck and his colleagues published work in PLOS One that showed that telling patients they were being given placebos did not make the placebo effect disappear.
We found that patients given open-label placebo in the context of a supportive patient-practitioner relationship and a persuasive rationale had clinically meaningful symptom improvement that was significantly better than a no-treatment control group with matched patient-provider interaction.
In summary, our study suggests that patients are willing to take open-label placebos and that such a treatment may have salubrious effects. Further research is warranted in IBS and perhaps other illnesses to confirm that placebo treatments can be beneficial when provided openly and to determine the best methods for administering such treatments.
Very interesting stuff, especially given that a vast majority of medical professionals have given or prescribed a placebo at some point in their careers. In some specialty areas, it appears to even be fairly normative to do so on a regular basis.
Although there are numerous problems with the study (including lack of really solid outcome measures or behavioral logs rather than clinician- and self-report; the fact that they were told the placebos “have been shown in clinical studies to produce significant improvement in IBS symptoms through mind-body self-healing processes,” which says they were told that it would work; and finally that the placebo itself – in terms of what it is composed of – may actually cause some changes in the gut environment), I think it is a very interesting start and should certainly be followed up on.
One of the assignments I give the students in my Science vs Pseudoscience course after we discuss alternative medicine is to answer the following question. I’d be interested to hear your responses in the comments.
If these (the impact on health of alt-med) are just placebo effects, and some people benefit from them, what is your opinion regarding people using complementary and alternative medicine (CAM) if there is no health risk?