Placebos Work -- Even if Patients Are in on the
WEDNESDAY, Dec. 22 (HealthDay News) -- Confronting the
"ethically questionable" practice of prescribing placebos to
patients who are unaware they are taking dummy pills, researchers
found that a group that was told their medication was fake still
reported significant symptom relief.
In a study of 80 patients with irritable bowel syndrome (IBS), a
control group received no treatment while the other group was
informed their twice-daily pill regimen were placebos. After three
weeks, nearly double the number of those treated with dummy pills
reported adequate symptom relief compared to the control group.
Those taking the placebos also doubled their rates of
improvement to an almost equivalent level of the effects of the
most powerful IBS medications, said lead researcher Dr. Ted
Kaptchuk, an associate professor of medicine at Harvard Medical
School and Beth Israel Deaconess Medical Center.
A 2008 study in which Kaptchuk took part showed that 50 percent
of U.S. physicians secretly give placebos to unsuspecting
Kaptchuk said he wanted to find out how patients would react to
placebos without being deceived. Multiple studies have shown
placebos work for certain patients, and the power of positive
thinking has been credited with the so-called "placebo effect."
"This wasn't supposed to happen," Kaptchuk said of his results. "It really threw us off."
The test group, whose average age was 47, was primarily women
recruited from advertisements and referrals for "a novel mind-body
management study of IBS," according to the study, reported online
in the Dec. 22 issue of the journal
PLoS ONE, which is published by the Public Library of
Prior to their random assignment to the placebo or control
group, all patients were told that the placebo pills contained no
actual medication. Not only were the placebos described truthfully
as inactive pills similar to sugar pills, but the bottle they came
in was labeled "Placebo." Health care providers also spent about 15
minutes explaining how placebos can have powerful effects and that
a positive attitude, while not essential, could help.
At the end of the study, which was funded by the National Center
for Complementary and Alternative Medicine and the Bernard Osher
Foundation, 59 percent of the women in the placebo group reported
adequate symptoms relief, vs. 35 percent of the control group.
"Some patients were very disbelieving, some were very enthusiastic, but by the end many really enjoyed themselves," Kaptchuk said. "They felt empowered."
He theorized that the very ritual of taking pills to treat
illness -- even fake ones -- initiates a brain response that
changes the way patients perceive and experience their
"There's nothing that's not in our heads," Kaptchuk said. "Our emotions, sadness, anxiety, all interact with our symptoms."
Dr. Andrew Leuchter, a professor of psychiatry and biobehavioral
sciences at the David Geffen School of Medicine at UCLA, noted the
research indicates that patient ignorance of their placebo
treatment may not be necessary to achieve results.
"It's a very interesting study and, I think, a very clever design," said Leuchter, also vice chair of UCLA's academic senate. "Part of this could be a conditioned response."
Leuchter noted that research participants typically don't want
to disappoint investigators, which could also have contributed to
their perceptions. Also, those placed in the control group may have
been disappointed not to receive placebos, which could account for
some of their reactions, he said.
"I think we want to see how long-lasting this improvement would be," Leuchter said. "If we follow the subjects for a couple of months, do the benefits last?"
The study authors noted that the finding would need to be
confirmed with a larger trial. For his part, Kaptchuk said he hopes
to study long-term effects in future studies, as well as patients
with various other illnesses.
"This is a very preliminary, first-step study," he said, adding that the small size of the trial group was a limitation. "I think the ethical question was a very important component."
For more information on the effect of placebos on certain
illnesses, visit the archives of the
American Psychological Association.
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