Placebo Effect: As a child, when you fell down or got hurt, your mom (or dad, or sibling or loved one) may have immediately picked you up, rubbed your wound, put a band aid over it and given it a magical healing kiss. Suddenly, you’d start to not feel the pain, and being a kid, you’d forget about the incident and go back to playing. A similar phenomenon is seen among older adults as well. Many people don’t feel better when the doctor just prescribes them ‘rest’ to cure their common cold, but feel better immediately after the doctor gives them an injection; the injection may contain saline or vitamins and may not have any property to heal you. You just feel better because you think that you have been given treatment.
The Placebo and the Placebo effect
A ‘placebo’ is a fake drug that is made to look like a real one. Often, it is known as the ‘sugar pill’. Doctors may prescribe this sugar pill when they feel that a patient may benefit from it. The ‘placebo effect’ is the phenomenon by which a person appears to benefit from the placebo. The placebo may be in the form of a tablet, an injection, or even a service. For example, you may feel better, if the doctor uses multiple instruments to check your body for an illness, instead of just his stethoscope.
Examples of Placebo studies
A famous study conducted to observe the pain intensity perceived by the patient after an operation yielded interesting results. In the study, the effect of a drug called ‘metamizol’ to reduce pain was used. One group of patients was administered ‘metamizol’ by the doctor in front of the patient through their IV, the other group of patients was administered the same drug, but it was managed by a computerized system and the patients did not physically see anyone giving them the drug. The patients were then asked to rate the amount of pain that they felt, and it was seen that the group that actually saw the doctor giving them the drug felt lesser pain. This is an example, of how the process or service can also act as a placebo. Another study saw that the patients who received only tablets experienced more pain than the other group of patients who received tablets as well as fake acupuncture.
As seen from the above examples, have those groups of patients succeeded in tricking their brains into treating themselves? Is the placebo effect real? The placebo effect is indeed real, and there are many studies that prove it. However, one must not take the placebo effect in a wrong way; you cannot make a cancerous tumour growing inside you disappear just by thinking that you have received the medicine.
Mechanism of the placebo effect
The mechanism of the placebo effect has been explained through classical conditioning and expectancy. Classical conditioning is the process by which learning occurs through pairing of two stimuli, one conditioned and one unconditioned, following which, the unconditioned response alone leads to the learned response.
This is explained very simply through Pavlov’s experiment. In his experiment, when he presented a dog with food, the dog begins salivating. The next time he rings a bell along with presenting food to the dog. After a while, when the bell is rung, even without food, the dog still salivates. The dog is conditioned to salivate. Some people are conditioned to believe that medicine will help them, and so it indeed does help them. There is also a relation between how much a person believes that they will experience a positive result and whether the positive result actually occurs. The stronger that the person feels that they will benefit, the more likely it is that it will indeed happen.
Just because the placebo effect is related to your expectations does not mean that it is a fake phenomenon. Many studies have found that when people feel that they are being treated, they tend to release ‘feel-good’ hormones such as endorphins. Endorphins act as the natural pain killers in the body and work in the same way that pain killers such as morphine work.
The Nocebo effect
Well, the placebo effect has a positive effect on you, but the ‘nocebo’ effect has a negative effect on you. In the ‘nocebo’ effect, the person believes that the treatment is harmful to them and leads to various side effects of the treatment like nausea, vomiting, and headaches.
Placebo effect and new drug development
The placebo effect plays a very crucial role in the development of new drugs and vaccines. The placebo, is considered as the ‘gold standard of testing’ when testing a new drug or vaccine. Two groups of patients or volunteers are created and one group receives the real drug or treatment and the other group receives the placebo. None of them are told what they have received. In some cases, even the experimenters or the analyzers of the study are not told which group received what, and such studies are called ‘double-blind control’ studies. Such studies are very important to check whether the said drug indeed has any effect or not.
Many people argue that the placebo effect is not real, while others do not understand the true meaning of it and use the placebo in a wrong way. However, numerous studies have confirmed the phenomenon. Lastly, the placebo effect would prove to be effective where there is no other treatment available.
Meissner, K., Kohls, N., & Colloca, L. (2011). Introduction to placebo effects in medicine: mechanisms and clinical implications.
Kaptchuk, T. J. (2001). The double-blind, randomized, placebo-controlled trial: gold standard or golden calf?. Journal of clinical epidemiology, 54(6), 541-549.
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Saunri Dhodi Lobo is pursuing M.Sc in Life Sciences with specialization in Neurobiology. Her interests include writing poetry, going for nature walks and swimming. Currently she is involved in research on Alzheimer’s Disease in fruit flies.
Read all Articles by Saunri Dhodi Lobo