Placebo Treatments work even if you know they’re fake

Written by on April 14, 2010 in in the news with 2 Comments

An interesting piece in the Australian media recently looking at whether treating patients knowingly with placebo treatments might actually offer some benefits.

I have always been fascinated with the whole placebo effect. How exactly can our belief in a treatment affect the outcome of that treatment ? The effect speaks to the whole mind <-> body link in a way that we can measure.

We know that the placebo effect is real. All successful clinical trials need to show that their active ingredient outperforms the baseline of a placebo treatment.

According to researchers quoted, it is not the sugar pill or fake injection that offers a benefit, but the “act of treatment switches on the brain to heal”.

What about a placebo treatment as the main treatment ? Crazy stuff. It might just work in some instances. Professor Michael Cousins says that placebos have very few adverse effects, speaking of them as if they are tangible treatment alternatives.

So, You Wanna buy some expensive fancy looking mumbo jumbo pills, lets call them RosaPlacebo (TM), to treat your rosacea? Only $49.95 a month. Send me your cash now. OK this paragraph is a joke, but you get my point right ? For any untested product, sugar pills are likely just as good.

The corollary is that only products that have proven double blind, placebo controlled, multi-centre results are worth your money. Don’t believe that a treatment works until you see proof that reaches past placebo efficacy.

The article ends with the usual preliminary research disclaimer that more study is needed before placebo treatments can be routinely used.

Placebos activate brain’s ‘heal switch’

Can the act of simply taking a pill make you feel better, regardless of what’s in it?

That’s the idea behind the placebo effect.

The concept has been studied since the end of World War II, when randomised control trials were first introduced.

Researchers found that people given a placebo improved, sometimes dramatically.

The new research shows that the placebo effect works, even if patients know they are getting a fake treatment.

The authors use the example of a trial, where a drug was far less effective if patients didn’t know they were getting the medication.

Pain expert Professor Michael Cousins believes placebos will play an important role in treating conditions such as chronic pain.

Another similar article just published in Forbes is also worth a read;

The Nothing Cure

Matthew Herper and Robert Langreth, 03.29.10, 12:00 AM ET

Though recurring tummy aches from irritable bowel syndrome are among patients’ most common complaints, drugmakers have had trouble coming up with a safe and effective treatment. But in 2008 Harvard’s Ted J. Kaptchuk devised a safe remedy that helps far more people than any designer drug ever did.

His magic cure: fake acupuncture delivered with lots of warm talk from a sympathetic acupuncturist–but no needles. In a trial of 262 patients with severe IBS, 62% of those who received the fake treatment got better, according to results published in the British Medical Journal. By comparison, only 28% of a control group of patients put on a waiting list saw their symptoms improve markedly. A third group who got the fake acupuncture, but without any warm talk, showed in-between results: 44% improved

The result, says Kaptchuk, shows just how much the expectation of a cure–and the rituals associated with medical treatment–can improve real-world symptoms. “Our own will, imagination and belief can modulate the course of illness,” says Kaptchuk


A placebo, he says, is the sum total of all the psychological benefits patients get from seeing their doctors and taking their pills. One theme of his research is that the bigger and more complicated the ritual, the greater the placebo effect. Surgery and medical devices often produce a bigger placebo effect than a pill because expectations for a cure are higher, he says. In a British Medical Journal article in 2006, for example, Kaptchuk and his colleagues reported treating 270 people suffering severe arm pain from repetitive-use injuries with either a placebo pill or fake acupuncture. The people who got the fake acupuncture reported significantly greater reductions in self-reported pain, even though there was no difference in posttreatment grip strength between the groups.

It could take decades for researchers like Kaptchuk and Wager to parse all the psychological and neurobiological mechanisms behind the placebo effect. They may never come up with a clear answer as to what is going on. Meanwhile, the next time your doctor recommends an expensive drug or complicated operation to relieve everyday symptoms, it may pay to ask him a simple question. Will the treatment beat a placebo?

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About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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2 Reader Comments

  1. Mumbo jumbo placebo pills called RoseaPlacebo would not be a first. Far from it. In fact, the data about mood disorder drugs, especially anti-depressives for instance, show that they do not work for the vast majority of people who are prescribed them. Yet the right to sell them is based on alleged efficacy as demonstrated in the great and holy arena of double blind clinical trials.

    There was a fun article in The Lancet a couple of years ago pointing out that the use of parachutes in cases of severe gravity challenge had not been subject to double blind study and hence parachutes could not be considered safe and effective interventions for people who fell or jumped out of airplanes. The authors also pointed out that cases where people had died as a result of severe gravity challenge had not been studied to address potential co-morbidities such as smoking which could have skewed the data. The actual experience of survivors was dismissed as “ancedotal” and without scientific merit.

    When Gandhi was asked what he thought about western civilization he said he thought it would be a good idea. Same thing with the application of science to new drug development.

  2. E.L. Hodge says:

    I trust that article was peer reviewed, Gaelle, otherwise I will have to retain my quirky faith in parachutes.

    Placebo comes from ‘please’ or ‘placate.’ Placate better catches the spirit.

    In some Derm offices, ‘placate’ is pronounced MEH-TRO -JEL.

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