Delving Into the Mystery of Placebos07/13/11
WEDNESDAY, July 13 (HealthDay News) -- A new study finds that
the power of the placebo effect left asthma patients thinking that
real and fake drugs were doing the same level of good, even though
the real medication actually had a much greater physical effect on
The effect was so strong that it convinced patients they were
breathing much better even if they hadn't taken a real drug and
hadn't actually improved much, as measured by a breathing test.
"The placebo doesn't change the actual breathing in asthma patients. But it changes people's experience of what's going on as much as a real drug does," said study co-author Dr. Ted J. Kaptchuk, an associate professor of medicine at Harvard Medical School.
Kaptchuk has noted that the ritual of treatment itself is very
powerful, and that in the study "it was apparent that the placebos
were as effective as the active drug in making people feel
As researchers have long known, you can give a sugar or dummy
pill to someone and they often will feel better. Placebos don't
cure diseases such as cancer. But they can offer relief from pain,
ease gastrointestinal disorders and lower a patient's blood
pressure, even though they don't have any active ingredient other
than whatever a patient chooses to believe.
The new study aims to find out how the effect of a real drug
compares to a fake drug in two areas: the actual effect (in this
case, on a patient's ability to breathe) and the perceived
The researchers studied 39 asthma patients who were randomly
assigned to be treated with an albuterol asthma inhaler (a common
treatment), a placebo inhaler and a sham (fake) acupuncture
treatment (in which acupuncture needles are used but the clinician
does not stimulate any known acupuncture points ). They also
underwent sessions of being treated with nothing at all.
The patients were randomly exposed to each approach during
several visits during which their ability to exhale was tested. The
visits were three to seven days apart for a total of 12
interventions in all.
Overall, the albuterol inhaler improved exhaling by 20 percent.
Each of the other approaches (including no treatment) improved it
by just 7 percent overall.
So what did the patients think? Overall, they thought both
inhalers (the real and fake ones) and the sham acupuncture improved
their breathing by about the same amount (the albuterol inhaler by
50 percent, the fake inhaler by 45 percent, and the sham
acupuncture by 46 percent). They thought doing nothing only
improved it by 21 percent.
The research raises plenty of questions, said Dr. Len Horovitz,
a pulmonary specialist at Lenox Hill Hospital in New York City. For
one, he said, "how reliable are patients in terms of their
subjective reporting of their symptoms? When a patient tells you
that they feel better, and you think they really need more than
what you're doing, should you stop? It really calls into question
what we're doing, whether it's good enough to help the patients
The study authors had a similar view of the placebo effect. Due
to the wide gap between asthma patients' self-reports and their
actual lung function, the researchers concluded that for optimal
asthma care, health providers should test lung function rather than
rely on patients' self-assessments.
And in clinical trials in general, the authors added, "reliance
solely on subjective outcomes may be inherently unreliable."
The study appears in the July 14 issue of
The New England Journal of Medicine. It was funded by the National Center for Complementary and Alternative Medicine.
For more on the
placebo effect, try the U.S. National Library of Medicine.
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