MYSTERY OF PLACEBO EFFECT
Decaffeinated coffees are becoming increasingly popular nowadays. Are they still stimulating & energizing without caffeine – the main stimulating agent? The Answer is yes and it is due to the “mysterious placebo effect”.
Word placebo ,Latin for ‘I shall please’ is defined as ‘any medicine or other kind of treatment that seems therapeutic, but in reality is inert and pharmacological inactive’. And this phenomenon of an inert substance resulting in a patient’s medical improvement is called the placebo effect.
History of this strange phenomena dates back to early 18th century. However, the major breakthrough occurred during World War 2. There were heavy casualties, which lead to shortage of morphine (a powerful analgesic); and operations had to be performed without analgesia. On one such occasion, Henry Beecher, an American Anesthetist was preparing to treat a terribly injured soldier. He was worried that without morphine operation would be extremely painful – it might even induce a fatal Cardiovascular shock. But then something very strange happened.. In desperation, one of her nurse injected the patient with harmless solution of saline, just as if he has been given morphine. Not only did the soldier felt little pain during operation, but the full-blown shock didn’t develop either. Henry tried the trick on several other injured soldiers and it worked; salt water proved to be as effective as one of the most powerful analgesics. The mystery behind this peculiar phenomena is still unrevealed .However, many researchers have proposed different mechanisms to explain this effect. Placebos themselves don’t do anything. The phenomenon is related to the perception and expectation which the patient has; if the substance is viewed as helpful, it can heal, but if it is viewed as harmful, it can cause negative effects, which is known as the nocebo effect. Expectations of how well a drug or procedure will work may activate the same neural pathways as prescription medicines. Moreover, patient’s belief in the treatment will reduce anxiety by allowing the problem to seem more controllable.
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Another explanation is the idea of conditioned stimuli; where a placebo and an actual stimulus are used simultaneously until the placebo is associated with the effect from the actual stimulus. Thus, inactive drugs and procedures can function as conditioned stimuli for the alleviation of symptoms if powerful unconditioned stimuli has been positively associated repeatedly with the relief of symptoms.
An additional possible explanation for the effects of placebo is that responses may be caused by endogenous opiate release in the central nervous system. It is thought that possibly the placebo effect is a stimulates release of our body’s own natural narcotics, such as endorphins and enkephalins;hence depressing pain circuitry.
Placebo response not only Depends upon an individual’s motivation and goal to feel better but also on doctor – patient relationship. If there is a positive rapport between the two, then most often there will be a positive enthusiasm for the treatment, and therefore a positive outcome.
Some interesting placebo related facts:
* Placebo surgery works better than placebo injections
* Placebo injections work better than placebo pills
* Capsules work better than tablets
* Big pills work better than small
* The more doses a day, the better
* The more expensive, the better
* The color of the pill makes a difference; with “hot-colored” pills working better as stimulants while “cool” colored pills work better as depressants.
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* Telling the patient, “This will relieve your pain” works better than saying “This might help.”
Placebo effect has been successfully used in several medical conditions like : Anxiety, asthma, Depression, epilepsy, Hypertension, Migraine , Pain, Peptic ulcers and various Phobias.
Perhaps the placebo decreases anxiety. Perhaps it meets the expectations of the patient. Perhaps it is a conditioned response. Yet, the issue here is that it works. The placebo effect is proof of the fact that the mind can influence the body in a powerful and therapeutic way.
