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Placebos contain no active ingredients and yet sometimes they make people feel better. How can that possibly happen and does it mean there is a place in medicine for 'dummy' treatments? And why are placebo treatments now included in clinical trials?

How would you feel if you found out your doctor had given you a ‘placebo’ , in other words something that would not specifically treat your condition, but was a sugar pill designed to ‘keep you happy ‘?  Does it matter what it is, so long as you feel better after taking it?

Most doctors admit to having given placebos to patients, but is there anything wrong in that, if the patient feels better?

What are placebos?

Placebo means ‘I please’ and placebo treatments with no active ingredients, which are given purely to please, have been administered since time immemorial.  For most of that time it was believed that they fulfilled a need to maintain patients’ faith in medicine, when the doctor really had nothing he/she could – or wanted – to offer them.  (And before the modern medicines we have today became available, doctors often had very little to offer, other than placebos).

What form do placebos take?

They have occurred in all different forms through the ages. In older times they might have been what were called bread pills’, or bottles of colored water that looked potent.  In more modern times injections of water under the skin and sugar pills have been given.  Nowadays some might consider the prescribing of multivitamins or tonics, to be the modern equivalent of placebos ie something not intended to treat a specific condition.

Are they completely useless?

For many years it was thought that the only benefit of placebos was psychological

In other words if you took something you believed was doing you good, your mind would tell you that you felt better. 

It was thought that the lower the person’s intelligence, the more likely they were to be influenced by placebo.  But in 1955 the first work was published which alleged that the effects were not all in the mind, but that placebos do actually bring about physical effects.  

This early work also put a figure on the level of susceptibility to placebo – finding that 35% (more than a third!) of people given placebo will feel some benefit from taking it.

This figure has been confirmed by more than one piece of research.

In modern clinical research there is also something known as the placebo ‘effect’, which applies equally to activeas well as to ‘dummy’ medication. 

This is a beneficial effect which comes just from knowing that a treatment has being given.
Continue reading after recommendations

  • Kaptchuk TJ. Powerful placebo: the dark side of the randomised controlled trial. Lancet, 1998, 351, 1722-25
  • Lichtenberg P. The Role of the Placebo in Clinical Practice. Mcgill J Med. 2008, 11(2), 215–216
  • Lichtenberg P, Heresco-Levy U, Nitzan U. The ethics of the placebo in clinical practice. J Med Ethics 2004,30,551–554
  • www.ncbi.nlm.nih.gov/pmc/articles/PMC2582669/
  • www.ncbi.nlm.nih.gov/pmc/articles/PMC1733989/pdf/v030p00551.pdf

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