In class, we have talked about whether research is experimental or observational. The experimental studies that have been conducted as double blind randomized control trials have both an experimental group and a control group. In the control group in clinical trials, there is a placebo that is given to the patients for example, so that they are unaware of which group they have been randomly placed in. This made me think about placebos and made me wonder how much of an impact psychologically a placebo can have. In other words, do placebos make people think that they are getting treated and as a result think that they being affected but in reality they are not? In this cause the patient think that the drug or substance they are given caused certain results, but as we know… Correlation does not always equal causation.
Research has shown that when a placebo treatment is given, it may cause positive effects towards a person even if the actual treatment is not in fact the treatment given to the patient. This phenomenon is know as, “The placebo effect” (Drugs.com). This article goes on to explain that this phenomenon happens in a small but noticeable percent of people in certain studies. One of these studies is a study done on patients with Parkinson’s disease and it shows that the when the patient is given a placebo, dopamine has been activated in the brain (Drugs.com). This shows that although the patient is not given the actual treatment, their brains may be tricked into thinking that they have, leading to the placebo effect.
On the other hand, a meta-analysis of 202 trials, that compared trials that have placebo treatments and no placebo treatments, found that there was no major health benefits from the placebos. However, it did have an impact on what the patients reported, and the authors contributed this to the way the trials were set up or how the patients were informed about their treatments (Drugs.com).
The American Cancer Society also says that there is a link between the brain’s response and a placebo. Although it is very difficult to make conclusions, many think that the placebo effect happens because, “the patient believes in the substance, the treatment, or the doctor” (ACS). This means that the patient expects to feel better so in the short-term, the patient does feel a little better.
Researchers are also looking into an effect called, “the nocebo effect,” which is when a person has negative side effects after they are given a placebo. Many believe that this is explained by messages that are sent through the nervous system. For example, when a person is anxious, this substance in the body is activated and the person in turn then feels more pain than a person who is not anxious (ACS). So what this means is that if someone is expecting something to hurt or be painful, they are more likely to feel more pain than a person who is calm and not expecting pain.
Ted Kaptchuk conducted a randomized clinical drug trial where some patients were given a pain relieving medicine and the others went to acupuncture to help relieve pain. Only two weeks into his first trial, “nearly a third of his 270 subjects complained of awful side effects” (Harvard Magazine). This was found to be rather odd and when Keptchuk said, “The side effects were simply amazing,” he explained that this was exactly what these treatments might produce (Harvard Magazine). What made this study even more confusing was that even more of his subjects found these pain remedies to be successful, and the acupuncture worked better than the painkillers. Nobody had ever proven this before and neither did Kaptchuk… His study was conducted with cornstarch pills and retractable shams that did not even pierce the skin. So this study was not conducted to compare these two treatments, it was to compare the two fakes! (Harvard Magazine)
Later on in the article, Kaptchuk goes on to say, “Sham treatment won’t shrink tumors or cure viruses,” but he does not reject the alternative in that you can simply think yourself better when you are tricked into thinking that you have been given a treatment (Harvard Magazine). His challenge now is to find a mechanism for the placebo effect and the psychological responses. Last year, he created the Program in Placebo Studies and the Therapeutic Encounter, headquartered at Beth Israel Deaconess Medical Center (Harvard Magazine).
So the answer is not completely known, Kaptchuk is still searching for an explanation behind the placebo effect. Both positive and negative reactions have come from the placebo effect so we cannot say whether the placebo effect is truly evident in all cases but we are making progress toward the understanding. Not only is Kaptchuk interested in this specifically, but also he is interested in whether or not we can increase the placebo effect in certain ways and see if this can be more effective than the actual treatments themselves (Harvard Magazine). Now wouldn’t that be interesting…
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