The Placebo Effect: How Far Can It Go?

Originally published here.

What is a placebo? It’s a control substance that isn’t supposed to affect the person treated in any way [1]. When researchers try to determine if a new drug is effective, they give some subjects the actual drug and the others a ‘fake’ treatment — the placebo treatment. By comparing the effectiveness of the active drug and the placebo, such as measuring pain relief, it’s possible to determine the efficacy of the new drug. The placebo serves as the control in these experiments. It provides a baseline to measure any changes from. While studying the placebo groups in various contexts, however, a strange phenomena has been observed, called the “placebo effect” [2].

Many may be familiar with the placebo effect. Scientists observed that even though control groups aren’t given any active treatment, their belief that they were getting the treatment elicited a bodily response. Further research theorizes that the placebo response itself may be associated with a genetic marker [3]. Surprisingly, the placebo effect is observed in many situations, even seeming to speed up patient recoveries.

The placebo effect can be observed in treatments for sleep disorders, asthma, cardiac surgery, migraine relief and many other conditions [2]. When individuals with Parkinson’s disease were given a placebo, their dopamine levels actually increased. According to researchers, it was the very expectation of getting a certain treatment that released dopamine in these individuals [4]. As for depression, a 2010 study by the Journal of the American Medical Association found that “most (if not all) of the benefits are due to the placebo effect” [5]. More recently, Meike Shedden-Mora and Winfried Rief found that “optimizing patient’s presurgery expectations”, namely through a placebo, fostered an improvement in the long-term recovery of individuals undergo cardiac surgery [6]. Clearly, the placebo effect has a rather broad reach in the scientific field and operates consistently on expectation.

Generally, individuals that receive the placebo aren’t supposed to know that they are receiving an inert pill. However, Dr. Kaptchuk, director of the Harvard placebo program, conducted a study along with his colleagues regarding “open-label” placebos. In this type of study, the individuals were told upfront they were going to be given a placebo. The placebo was twenty percent more effective than those who received no treatment, even though the individuals receiving it know that it isn’t the actual treatment [2].

Another notable aspect of the placebo is that there may be a genetic marker that indicates if a person can elicit a response to placebo treatments [3]. Since the nature of the placebo effect varies from each individual, it can be beneficial to understand how disposed to potential treatments some people are to this. Understanding the placebo effect on an individual level can be beneficial for researchers in designing clinical studies and interpreting results [3].

This idea that the expectation or belief in treatment can actually stimulate a response in an individual is truly fascinating and has been a topic of study by many. While the placebo effect can be observed treating conditions such as depression, Parkinson’s disease, and pain, it is also important to consider the effect on an individual level. Research into aspects such as the genetic marker can help us design better clinical studies and hopefully offer greater benefits to the people being treated [2, 3].

References

1. “Placebo.” Oxford Dictionaries. N.p., n.d. Web. 25 Jan. 2017.
2. “Putting the Placebo Effect to Work.” Harvard Health. Harvard Health Publication, Apr. 2012. Web. 25 Jan. 2017.
3. “Genetic Marker Predicts Placebo Response, a Recent Study Finds.” National Institutes of Health. U.S. Department of Health and Human Services, 28 Nov. 2012. Web. 25 Jan. 2017.
4. Schmidt, Liane, Erin Kendall Braun, Tor D. Wager, and Daphna Shohamy. “Mind Matters: Placebo Enhances Reward Learning in Parkinson’s Disease.” Nature Neuroscience 17.12 (2014): 1793-797. Nature Neuroscience. Web. 23 Jan. 2017.
5. Kirsch, Irving. “Antidepressants and the Placebo Effect.” Zeitschrift Fur Psychologie. Hogrefe Publishing, 2014. Web. 25 Jan. 2017.
6. Shedden-Mora, Meike, and Winfried Rief. “Capitalizing Placebo Effects to Improve Outcome in Cardiac Surgery.” On Medicine. BioMed Central, 10 Jan. 2017. Web. 23 Jan. 2017.