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12. THE PLACEBO EFFECT Previous | Next

Who’s being deceived

IT used to be thought of as just a manipulation, a mind-trick. Doctors wore white coats, spoke in soothing tones, exuding confidence and medical know-how, and if they told you a pill would make you better, it would. By the time you found out it was just a sugar pill, you were feeling great, so who cares? The placebo effect works.

Or does it? Recent experiments suggest things are a lot more complicated than that. Some prescription drugs that were judged to perform “better than placebo” in clinical trials don’t work unless you know you’re taking them. Where does that leave the gold standard of medicine, the placebo-controlled clinical trial? Looking slightly shaky, at the very least.

It gets worse. I went to the labs of the leading placebo researchers in Turin and subjected myself to some experimentation. It turns out, to the researchers’ surprise, that you can succumb to placebo even when you know you’re being fooled. However, many of the claims of the power of the placebo effect might be overstated: recent research also suggests that the placebo effect does much less than it’s generally given credit for. In most cases its effects are simply not clinically useful. Confused? Then don’t think about the neuroscience experiments that show the biochemical side of placebo – it has a real, chemical effect on the brain that researchers can learn to manipulate.

It turns out that there is no such thing as a straightforward placebo effect: there may be as many different effects as there are drugs, situations and people. In other words, it’s a bit like cosmology’s dark energy: something is going on, but no one has any idea what.

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Location:canada
Joined:14/08/2008
Posts:26

#1 - Posted: 20/08/2008 01:54

we are always inclined to attribute to placebo, the clinical successes of those treatment modalities that exceed our world-view.   we must realize that if we attribute such powers to placebo that it accounts for all the clinical successes of acupuncture or homeopathy, then we have some quite powerful placebos happening.  then i say, bring it on!  what we need is more powerful placebos!  of course it is a two edge sword.  we will have to attribute placebo-success to an equal percentage of or own system's clinical successes.  carrying this logic to its ultimate conclusion, all successes of all systems could be placebo, then it becomes a moot distinction.  at that point who cares.

a couple of decades ago it was shown that puncturing the skin with a needle induced endorphin production.  ah ha said the superior ones, that explains acupuncture.  of course, then it wouldn't matter where you punctured the skin, which acupuncture point you chose, they should all work equally well.  but of course that is not the case.  also how to explain that needles placed in the foot relieve pains in the head.  oh my my, the apemen walk around the monolith sniffing and sniffing.

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Location:Lewes, UK
Joined:23/07/2008
Posts:24

#2 - Posted: 20/08/2008 16:16

johnh, it does seem that we might be able to create more powerful placebos once we understand them more (see my posting on Medicine's Uncertainty Principle)...

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