For most of us, the “placebo effect” is synonymous with the power of positive thinking; it works because you believe you’re taking a real drug. But a new study rattles this assumption…

Placebos—or dummy pills—are typically used in clinical trials as controls for potential new medications. Even though they contain no active ingredients, patients often respond to them. In fact, data on placebos is so compelling that many American physicians (one study estimates 50 percent) secretly give placebos to unsuspecting patients.

Because such “deception” is ethically questionable, HMS associate professor of medicine Ted Kaptchuk teamed up with colleagues at BIDMC to explore whether or not the power of placebos can be harnessed honestly and respectfully.

To do this, 80 patients suffering from irritable bowel syndrome (IBS) were divided into two groups: one group, the controls, received no treatment, while the other group received a regimen of placebos—honestly described as “like sugar pills”—which they were instructed to take twice daily.

“Not only did we make it absolutely clear that these pills had no active ingredient and were made from inert substances, but we actually had ‘placebo’ printed on the bottle,” says Kaptchuk. “We told the patients that they didn’t have to even believe in the placebo effect. Just take the pills.”

For a three-week period, the patients were monitored. By the end of the trial, nearly twice as many patients treated with the placebo reported adequate symptom relief as compared to the control group (59 percent vs. 35 percent). Also, on other outcome measures, patients taking the placebo doubled their rates of improvement to a degree roughly equivalent to the effects of the most powerful IBS medications…

The authors caution that this study is small and limited in scope and simply opens the door to the notion that placebos are effective even for the fully informed patient—a hypothesis that will need to be confirmed in larger trials.

Har!

I may take up the practice of psychosomatic medicine after all.




  1. Dallas says:

    Is the TSA the largest placebo in the world or is it trickle down economics?

  2. Pinkerton says:

    #1 – The honor of largest placebo has to go to The Church. Merry Christmas.

  3. deowll says:

    #1 Its the idea of many that if they make the government all powerful the government will make life better rather than simply getting more abusive, intrusive, and corrupt.

    Power corrupts and absolute power corrupts absolutely or as Bill Clinton said about his sex scandal. “I did it because I could.”

    Homeopathic drugs are already here and have been for some time.

  4. Benjamin says:

    The new medical practices under ObamaCare. Instead of real medicine, we get a placebo. Oh joy.

  5. MikeN says:

    Sample size of 40 people, 14 in one group vs 24 in the other. I’d guess this is not statistically significant.

    For that matter, how did they get 59%. 24 out of 40 is 60%. So they are measuring decimal points as well.

  6. Colorado says:

    The illegal drug dealers have known this for years.

  7. Zybch says:

    This is a pathetically small study.
    There are others that were performed on groups with thousands of people which proved again and again that placebos (or more specifically, the Placebo Effect) is bunk and results in no statistically different results.

    On the other hand, it HAS been proven that a $1 painkiller works better than a .25c one even if the active ingredients are the same.
    Dan Ariely book “Predictably Irrational” goes into some depth about it all and really is a good read.

  8. Dallas says:

    #2 You’re right!

  9. eaze says:

    but how do the people receiving the placebo know that they are being told the truth?

    surely the fact that they could suspect that what they are taking is actually medicine defeats the entire purpose of this study?

  10. Glenn E. says:

    On the face of it, this sounds mostly like a junk science study. Invented just to earn a grant. The so-called inert substance in the pills may still have acted as a antacid, or at least cause the digestive process to slow down to handle it. Thus effecting IBS unintentionally. The study should have been done with something not even remotely concerned with digestion. Like chronic join pain. Or hypertension.

    #1- Good question Dallas. But the TSA is more like a suppository, than a placebo. It’s an enema for constipated airline security.

    #2- Pinkerton, at one time I would have taken offense at that remark. But now it merely inspires some deeper thought. Most religions probably started out as frameworks for guiding those to seek an inter strength and peace. Rather than simply praying to a god to solve all life’s problem. But then tough times ensued. And just about anyone with money and connections could be an officer in some belief. Whether they truly grasped the meaning of their religion, or not. And desperate for support from the near starving masses. It became easier just to relate God to them on a grade school level. And then never to contradict that, by upgrading anyone’s understanding much later. So instead of God being an elemental force within, he remains a guy with a big white beard, on a thrown in the clouds. Explanations otherwise are designed more for bring in the cash, than clarifying and rectifying these over-simplifications.

    Just as the placebo pills may have allowed these patients to tap in some level of inter strength. Belief systems were originally intended to do a similar function, mentally. Eastern religions appear to still function in the purer form. While western ones, kind of got lost in the pomp and circumstance. But those went thru the period of the Dark Ages. So you can’t really fault them for losing touch with their origins. I’m sure a lot of “word of mouth” stuff simply got lost.

    And then there’s the “beast”, or military mindset. That probably prefers it all forgotten and muddled. Eastern religions today shy away from condemning warfare. To do otherwise, would probably get them labeled as subversive, by most governments.

    Merry Christmas

  11. bobbo, the mind body connection doesn't make Big Pharma any money says:

    Animby–you say: “I do not believe I would ever prescribe a placebo and tell the patient what I’m doing.” //// Thorny position that one. Ultimately, I think you will find yourself acting in your own perceived self interest rather than the patients. I can hypothesize rare instances where such lies and misinformation is warranted, but even then for short terms with the patient ultimately being informed. Do you falsify the medical record as well or just the info you personally give to the patient?

    Just caught an excellent full hour with Dr Gabor Mate on the mind-nervous system-white blood cell-hormone-body connection/feedback. Of interest, he notes every 2-3 years a study is published showing the “controlling” effect here but the results while universally accepted as valid, are also univerally ignored.

    Modern Medicine: make the symptoms go away with a pill.

    What needed: long term counseling to find the source/cause of the symptom.

    And so it goes across the board with all so much of what it is to be born human. I had an Ophra “ah-hah” moment watching that show. The job of raising our kiddies is the first victim of our capitalist “all for the job” society we are busily making for ourselves.

    Key example: last year some book almost got the pulitzer for noting that kiddies don’t need parents as they get all the socialization they need from their peer groups. As Dr. Gabor noted: imagine saying kittens don’t need a mother cat, or cumbs a mother bear. Fact is, humans need their parents even more than any other species. We are all born about two years premature in order that our large heads can pass thru the pelvis.

    Silly Hoomans – eating our young by design.

  12. bobbo, the mind body connection doesn't make Big Pharma any money says:

    The special one hour interview with Dr. Gabor Mate was on Dec 24 and is first on on the website. That will probably change with time?

    Dr. Gabor Maté on the Stress-Disease Connection, Addiction, Attention Deficit Disorder and the Destruction of American Childhood

    http://democracynow.org/

  13. Greg Allen says:

    >> Benjamin said, on December 24th, 2010 at 6:31 am
    >> The new medical practices under ObamaCare. Instead of real medicine, we get a placebo. Oh joy.

    Compared to the conservative “just go die” healthcare system?

  14. Greg Allen says:

    It would be very interesting to do a full study with more than 80 subjects on placebos vs. just doing nothing.

    The placebo effect has to be the best documented “drug” of them all since they are used in most double-blind studies.

    But, as I understand it, the effectiveness of pacebos get over-stated because some people just get better anyway.

    One of my theories is that placebos are not psychological trickery but that the effort of being in a study and the reminder of taking a pill encourages people to take better care of themselves.

  15. Rich says:

    “thrown in the clouds”

    You can’t hurt God that way- he has wings! Just check out any of Michelle DeAngelo’s many ochre drawings!

    Jeeze, you people gotta bone up on your art stuff.

  16. bobbo, it takes two fools to have an argument says:

    Greg Allan–one of your weaker posts. The entire purpose of double blind studies and why placedbo’s are given is to “zero out” the notion of taking a pill and getting better on your own. BTW, how do hospitalized patients who have everything ordered, measured, reviewed “take better care of themselves” than the control group in the same circumstances?

    No, the placebo effect goes to a reality beyond the self help of thinking positively. Its more a feedback loop wherein the brain can send signals having the white blood cells manufacture any hormone the body regularly makes in response to externally provided medicine. Thats only one of several real physical mechanisms the body uses under the rubric of “placebo effect.”

    Pragmatism. It works.


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