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The Placebo Effect

GNC said:
If paracetamol was only 20% effective then why would anyone buy it in the 1 in 5 chance it might work on you? You'd try aspirin or codeine instead, wouldn't you? Sounds like a conspiracy to keep sales up and prevent the truth coming out! (Note to self: try those tinfoil hats)
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Some people can't use aspirin because of the meds they're on already. It has a blood-thinning effect and can cause high levels of stomach acid.
 
Mythopoeika said:
Some people can't use aspirin because of the meds they're on already. It has a blood-thinning effect and can cause high levels of stomach acid.
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I know, I was just using aspirin as an example of a painkiller.
 
But if you were one of the ones it worked on, you wouldn't need to would you? And a lot of people I know use paracetamol in conjunction with ibruprofen, so how would you know which one was working?

I'm simply not buying it being mostly placebo.
 
catseye said:
But if you were one of the ones it worked on, you wouldn't need to would you? And a lot of people I know use paracetamol in conjunction with ibruprofen, so how would you know which one was working?

I'm simply not buying it being mostly placebo.
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I suppose believing over the counter medicines are placebos is one step away from anti-vaxxers, and look where that's got us. Also, if paracetamol was mostly placebo, there would not be paracetamol overdoses which have real and damaging effects.
 
GNC said:
I suppose believing over the counter medicines are placebos is one step away from anti-vaxxers, and look where that's got us. Also, if paracetamol was mostly placebo, there would not be paracetamol overdoses which have real and damaging effects.
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Well I guess the painkilling effect could be placebo but the chemicals could kill you without affecting your pain.
 
Whilst out running today I got to thinking about the placebo effect. I was wondering whether it's actually the drug that causes the effect or the fact that someone is paying attention to your illness (I'm talking here about medical placebos of the kind found in trials or administered by doctors). I got to thinking that maybe you feel better whatever you take, simply because you know that someone is paying attention to your symptoms and how you feel (and also maybe a little by knowing that doctors are, hopefully, not going to let you die). You're asked how you are, and how the drugs are working and someone is listening to you.

I know I've found in the past a couple of times when having health worries, that simply telling someone else, even if they are not a health professional, can make the worries dissipate and the pain or whatever it is, seem to lessen. It happened quite recently when I was a bit worried about something I perceived to be a lump. I showed it to my - absolutely not medical in any way shape or form - friend, and she said 'that just looks like you've been bitten by something.' Whereupon the mysterious lump instantly resolved itself into a non threatening JOTT, and promptly vanished within the requisite few days.

Have there ever been any trials with placebos where people have been given them without any examination or consultation with a doctor?
 
catseye said:
I know I've found in the past a couple of times when having health worries, that simply telling someone else, even if they are not a health professional, can make the worries dissipate and the pain or whatever it is, seem to lessen. It happened quite recently when I was a bit worried about something I perceived to be a lump. I showed it to my - absolutely not medical in any way shape or form - friend, and she said 'that just looks like you've been bitten by something.' Whereupon the mysterious lump instantly resolved itself into a non threatening JOTT, and promptly vanished within the requisite few days.
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Yes. Also, I wonder if when say, you go to the doctor with an ailment you've had for a good while and it seems to vanish as soon as you walk in the surgery, if it's to do with 'the worst is over' kind of thing. You've spent the last few days, or more often weeks, thinking ''I've got to go the the doctors in two weeks'' and you forget about it for a few hours, then remember again throughout the days and weeks and it plays on your mind off and on all day. Then, once you're there, at least that part is done. In other words, just being in the surgery/hospital itself is the placebo in these cases. ?
A bit like how the thought of winter while in the summer months is much worse than when winter actually arrives.
 
catseye said:
Whilst out running today I got to thinking about the placebo effect. I was wondering whether it's actually the drug that causes the effect or the fact that someone is paying attention to your illness (I'm talking here about medical placebos of the kind found in trials or administered by doctors). I got to thinking that maybe you feel better whatever you take, simply because you know that someone is paying attention to your symptoms and how you feel (and also maybe a little by knowing that doctors are, hopefully, not going to let you die). You're asked how you are, and how the drugs are working and someone is listening to you.

I know I've found in the past a couple of times when having health worries, that simply telling someone else, even if they are not a health professional, can make the worries dissipate and the pain or whatever it is, seem to lessen. It happened quite recently when I was a bit worried about something I perceived to be a lump. I showed it to my - absolutely not medical in any way shape or form - friend, and she said 'that just looks like you've been bitten by something.' Whereupon the mysterious lump instantly resolved itself into a non threatening JOTT, and promptly vanished within the requisite few days.

Have there ever been any trials with placebos where people have been given them without any examination or consultation with a doctor?
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l’m sure it was either in Cults of Unreason or The New Apocrypha where the author hypothesises that that is the secret behind all “New Age” pish. lf a sufferer goes to his GP with a complaint, the doctor will brusquely tell him, “You’ve got ailment A. Here’s a prescription for pill B. Now, go away.”

On the other hand, if the sufferer goes to a New age “shaman”, he’ll be listened to intently, probably over cups of tea. Hands will be patted. Time will be spent. Horoscopes consulted. Chakras invoked. Crystals brandished. Etc.

People don’t want bare facts and simple solutions. They want to be fussed over, because they’re special. Just like everybody else.

maximus otter
 
Floyd1 said:
Yes. Also, I wonder if when say, you go to the doctor with an ailment you've had for a good while and it seems to vanish as soon as you walk in the surgery, if it's to do with 'the worst is over' kind of thing. You've spent the last few days, or more often weeks, thinking ''I've got to go the the doctors in two weeks'' and you forget about it for a few hours, then remember again throughout the days and weeks and it plays on your mind off and on all day. Then, once you're there, at least that part is done. In other words, just being in the surgery/hospital itself is the placebo in these cases. ?
A bit like how the thought of winter while in the summer months is much worse than when winter actually arrives.
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It's the same in reverse too. If you have a minor pain or injury that you show to someone else, whereupon they suck in their breath, say 'ohhh, that looks nasty, you should go to the doctor with that', it instantly starts to feel much much worse.
 
catseye said:
But if you were one of the ones it worked on, you wouldn't need to would you? And a lot of people I know use paracetamol in conjunction with ibuprofen, so how would you know which one was working?

I'm simply not buying it being mostly placebo.
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The last time I needed pain-killers, I was coached (by doctors) to take paracetamol first and if that wasn't quite doing it, add ibuprofen, but don't do that for more than (say) three or four days and don't exceed the maximum dose of either. Mrs. Coal was interested that paracetamol was always the first thing (layer) to try and then add the ibuprofen.

maximus otter said:
l’m sure it was either in Cults of Unreason or The New Apocrypha where the author hypothesises that that is the secret behind all “New Age” pish. lf a sufferer goes to his GP with a complaint, the doctor will brusquely tell him, “You’ve got ailment A. Here’s a prescription for pill B. Now, go away.”

On the other hand, if the sufferer goes to a New age “shaman”, he’ll be listened to intently, probably over cups of tea. Hands will be patted. Time will be spent. Horoscopes consulted. Chakras invoked. Crystals brandished. Etc.

People don’t want bare facts and simple solutions. They want to be fussed over, because they’re special. Just like everybody else.
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I think there is something in this. There are a lot of minor physical ailments that are somatic, that is, linked to low level mental issues, what I would describe as situational mental health issues (no job, can't pay rent, dysfunctional relationship with partner, the type of thing that could be resolved by easing that burden).

Human beings do have a need to unload and talk and the now almost defunct GP system did provide this to some extent. There's also quite good evidence that most talking therapies work about the same and that 'the talking' is the key thing.

My own (hypothesis?) opinion is that situational mental health issues can often be resolved with talking therapy and if possible changing the situation, but that pathological mental illnesses (e.g. sczhophrenia) are unlikely to be. I'd further suggest that correctly triaging the difference is a very big deal.
 
The placebo effect is real, as it works on some people who heal themselves to some degree based on their belief in the doctors.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2814126/
The placebo effect has been a source of fascination, irritation, and confusion within biomedicine over the past 60 years. Although scientific investigation has accelerated in the past decade, with particular attention to neurobiological mechanisms, there has been a dearth of attention to developing a comprehensive theory of the placebo effect. In this article, we attempt to address this gap by reviewing evidence relating to the reality and clinical significance of the placebo effect. We suggest the hypothesis that the placebo effect operates predominantly by producing symptomatic relief of illness, such as pain, anxiety, and fatigue, rather than by modifying the pathophysiology of disease. The placebo effect as a clinical phenomenon is characterized as representing the interpersonal component of healing, as distinct from spontaneous natural healing and technological healing dependent on physiologically active pharmaceuticals or procedures. Speculations regarding the evolution of the placebo effect are entertained. Finally, we argue that research on the placebo effect has the potential to revitalize the art of medicine and discuss ethical issues relating to the use of placebo interventions in clinical practice and in research on the placebo effect. We hope that this preface to developing a theory of the placebo effect will provoke debate and alternative conceptualizations and theoretical hypotheses in service of promoting a deeper and more fruitful understanding of this elusive phenomenon.
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Hypnosis has been shown to also effect healing:
https://news.harvard.edu/gazette/story/2003/05/hypnosis-helps-healing-2/
Four years ago, Ginandes and Daniel Rosenthal, professor of radiology at the Harvard Medical School, published a report on their study of hypnosis to speed up the mending of broken bones. They recruited 12 people with broken ankles who did not require surgery and who received the usual treatment at Massachusetts General Hospital in Boston. In addition, Ginandes hypnotized half of them once a week for 12 weeks, while the other half received only normal treatment. The same doctor applied the casts and other care, and the same radiologists took regular X-rays to monitor how well they healed. A radiologist who evaluated the X-rays did not know which patients underwent hypnosis.


The result stood out like a sore ankle. Those who were hypnotized healed faster than those who were not. Six weeks after the fracture, those in the hypnosis group showed the equivalent of eight and a half weeks of healing.
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Has anybody performed a study to see if they could be doubled up, for instance the placebo effect gains being furthered in a measured way by using it in conjunction WITH hypnosis?
 
I wonder whether the modern propensity for including a comprehensive list of possible side effects with every medicine that you buy or are prescribed works to make them less effective. Sort of a nocebo but also undermining the effectiveness of the treatment which is a bit different.

The doctor used to just prescribe a bottle of something (often pink) which just had, it's name, your name and instructions on how to take it on the label. You were usually told "Take this, and come back in a week if you are no better." Now there is a description and a list of side effects and often the instruction to report any they haven't thought of. It rarely gives any figures for success rate in treating the condition. It gives the impression that this medicine is experimental and almost hints that the side effects are more likely than a cure. Sort of a nocebo but also undermining the effectiveness of the treatment which is a bit different.

Now should I not take this stuff and put up with the spotty elbow given that there is a 1 in 100,000,000 chance that it will make my kneecaps rotate and my willy go yellow?
 
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