What is a placebo?

In 1955, the American doctor Henry Beecher published his observations on US soldiers during World War II in his book “The Powerful Placebo”. To relieve pain, he administered morphine. When he ran out of this, he replaced it with weak saline, with the effect that the “ineffective” substance took the pain away from many soldiers. The word “placebo” comes from the Latin and means: “I will please”.

Preparations without therapeutic effect

Placebos are preparations that have no therapeutic effect. Instead of an  active ingredient , placebo pills only contain fillers, such as lactose or starch. Today, placebos are often used in clinical trials designed to test the effectiveness of new  drugs  . In these so-called double-blind studies, some of the subjects get the drug and others the placebo. Surprisingly, subjects who took the “ineffective dummy drug” over the course of the study repeatedly showed changes as a result of taking it. Both positive effects and side effects, so-called nocebo effects, can be observed with these.

Imagination, self-healing, miracle?

But what about the placebo effect? Do patients only imagine that the placebo will improve symptoms of their illness? Can the observed effect be attributed to the attention that a patient receives under placebo treatment (talking to the doctor, examinations, etc.), or do the body’s self-healing powers come into play, which appear through belief in the drug? Many scientists are concerned with the placebo effect. Here are some approaches:

  • Placebos have no effect. Effects observed after taking a placebo are explained by the natural course of a disease. The amelioration of the condition coincidentally coincides with the intake.
  • The placebo effect is explained by an interaction between the nervous system and the  immune system  .
  • A more recent study (Lichter et al.; Changes in brain function of depressed subjects during treatment with placebo; Am J Psychiatry 2002 Jan;159(1):122-9) shows that placebo intake leads to changes in brain function. Furthermore, it was shown that placebos could cause the release of endorphins.

The statistician Dr. John Bailar III explains the placebo effect as follows: “The belief in the existence of the placebo effect has become a kind of secular religion. And as with any religion, there is no evidence to dissuade a believer.”

 

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