- Placebo - the power of suggestion
- Placebo for nerves and asthma
- Wonderful possibilities of placebo
- Placebo effect
- Ethical problem
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The placebo effect has been used in medicine for centuries. What is it about? Identical pills are lying in front of two people. They swallow them and after a dozen or so minutes they both feel better. And they should not, because one of these people took the so-called Placebo, which is something that is not a medicinal substance but still gives good results. Why?
Placeboin Latin means "I will like it". This is what doctors define as a substance or effect indifferent to he alth and used as a therapy. But the sick person doesn't know that what was applied is not realtreatment .
Placebo - the power of suggestion
Until the nineteenth century, the placebo effect was quite often used unconsciously in medicine. Specifics containing powders from the lizard's tail and unicorn's horn more than once (surprisingly!) Gave an improvement. But what really helped was the faith of the healers and those treated in the effectiveness of the preparation used.
Although it is hard to believe, many studies (including the Office of Technology Assessment) show that only in the case of 20 percent of the most commonly used drugs today, their effectiveness has been proven scientifically. That is, they were the subject of clinical tests that clearly explained the mechanism of their action! The other preparations are simply placebo.
Of course, this does not mean that their use is of no benefit. However, it must be clearly stated: in some cases the mere fact of undergoing treatment (visiting a doctor and taking pills) helps the patient to recover.
An interesting example is research on the effectiveness of propranolol. This drug was prescribed to patients after a heart attack to regulate the heart rate and prevent further organ damage. It was observed that the death rate was halved in people taking the drug regularly compared to those who forgot to do so. The study group consisted of 2,000 people, so the study was statistically reliable. Only the results of patients treated (also regularly and irregularly) with placebo were astonishing. They were identical! Propranolol is actually a drug that works. But the study showed that suggestion, or a placebo, works in a similar way.
Placebo for nerves and asthma
In 1984, the Hungarian psychiatrist Mihly Arato assessed the results of research into the treatment of depression. It turned out that in nearly half of the sick patientsless than three months, and those treated with placebo showed a marked improvement. It was not present in patients suffering from depression for more than one year, with elevated levels of cortisol (stress hormone) in the blood serum. The results are so encouraging that it is tempting to start deliberately treating a placebo in the onset of depression.
Placebo helps in many ailments, especially patients suffering from headache, anxiety, tension, depression, cough, insomnia, motion sickness, asthma and … hypertension.
The experiment by Thomas Luparello of the University of New York confirmed the effect of a placebo in the treatment of asthma. Patients were given an inhaler containing only saline spray and told that they would inhale an irritant or an allergen. All of them experienced shortness of breath. When the same group of subjects was told that the inhaler contained an asthma medication (which was also saline), the airways relaxed.Important
Nocebo - the bad twin
Placebo - although it is indifferent to he alth from a formal point of view - can also cause side effects, such as vomiting, headaches, drowsiness, insomnia, increased heart rate, diarrhea, rash, edema. Such effects of using an inert substance are called nocebo - "I will harm" (from Latin nocere - to harm). Most often they are caused by the patient's bad attitude to the therapy, e.g. the appearance of the drug that is not accepted by him, the negative attitude of the doctor, suggesting that the treatment is harmful.
Wonderful possibilities of placebo
The placebo effect in neoplastic diseases cannot be overestimated. Doctors know the story of a patient at Long Beach Hospital, California, Mr. Wright: he was in such a serious condition (a tumor the size of a tennis ball) that he was only given a few days to live. It was then that he heard that a serum that was effective in fighting cancer had been discovered - Krebiozen - and forced the doctor to administer it. The injection was made on Friday afternoon, and on Monday an astonished doctor found a patient in good shape, joking with the nurses. The examinations were done and - as the doctor commented - the tumor melted like a snowball on a hot stove. Two months later, Wright read an article in which there was unfavorable speech about Crebiosis. From then on, the relapse of the disease began.
It is known that even 60 percent of placebo. it is as effective as the most active painkillers. This is because it can influence the release of natural morphine-like substances called endorphins through the brain.
Stress has been shown to increase cortisol secretion. It has been studied that cortisolnegatively affects the immune system. If a placebo eliminates stress, the effectiveness of the immune system increases, and thus - fighting infectious diseases and cancer. There may also be special molecules to help create a placebo effect. For example, recent research shows that animals under stress can produce a substance in the brain similar to the sedative relanium. Maybe the brain "cheated" by a placebo can also produce similar substances to fight cancer?
Studies have shown that the placebo effect is influenced by the patient's positive attitude towards the doctor and the recommended therapy, but also factors that seem to be insignificant are important. Placebo is more effective when the tablet is large, red and bitter, and when recommended by a well-known doctor. The effect is increased by the Latin name of the preparation, the high price and difficulties in obtaining it. Credibility is also increased by the leaflet informing about … side effects.
The atmosphere surrounding the patient during treatment is also important. And doctors often forget about it. Careful analysis of the patient's complaints improves his well-being (and the healing effect) much more than immediate diagnosis with the use of modern equipment - no matter how accurate it may be.
The effect of the placebo is obvious. The problem is whether the effect is large enough to consciously use neutral substances instead of classic drugs in selected cases. Is it ethical to deprive the patient of the possibility of treatment with a recognized therapeutical agent? Is it possible not to inform the patient that he is taking a placebo? On the other hand, the informed will no longer be susceptible to its influence. The discussion continues, but are there any possible answers?
Only in one case science does not question the use of a placebo. It is used for drug testing and therapy in a clinical experiment.
The beneficial effects of the placebo effect, without any ethical doubts, every doctor can use on a daily basis. The fact that someone has bronchitis can become apparent to a specialist within seconds. The further five minutes of the examination, during which the doctor puts the receiver to the chest, will probably not affect the accuracy of the diagnosis, but will certainly increase the patient's confidence. And it works wonders.Important
Patients suffering from the same disease are told that they will be treated with a certain drug. Some get real medicine, some get identical-looking placebo. The drug will be effective if the percentage of cure (or improvement) in the group taking it is much greater than in the case ofplacebo treated group, and the side effects are also compared. Those that occur more frequently in the group treated with the test drug can be attributed to the effect of this drug. Research is conducted on the basis of the so-called double-blind. The patient does not know whether he is receiving an active drug or a placebo. Also, the doctor (during the experiment) does not know whether he is administering a therapist or a neutral substance.