SO what is a placebo? Generally, it is an ineffective treatment which actually alleviates symptoms. They are widely used in medicine and medical research and its effect is a phenomenon!
It shouldn’t work… but it does!!
We are conditioned to believe that medicine makes us better when we’re ill, because of our increased faith in the power of modern medicine. Our confidence in drugs being effective has grown, so any treatment that we receive makes us psychologically confirm this belief. This belief causes placebos to work. Take for example, Khan* who found that in 96 clinical trials, sugar pills were often as effective as antidepressants.
Those that think that a treatment will work, display a stronger placebo effect, than those who do not. This is because it is based on the perceptions and expectations that people have. Placebos can help smokers quit, reduce the effects of allergies, because we believe it does. It was found that when a placebo is prescribed as a stimulant, it has an effect on heart rhythm and blood pressure, but when prescribed as a depressant, it has the opposite effect, (Kirsch, 1997)* all because placebos are dependant upon perception and expectation.
Because of these perceptions and expectations, various factors can change how strong the placebo effect is. These factors include, the colour and size of the pills. Several studies have found that red and yellow pills worked better as a stimulant, whilst blue and purple pills worked better as depressants, (Craen et al, 1996)*.
Beecher (1955)* found that 35% of patients were satisfactorily relieved by a placebo alone, although it is worth noting that research into this, varies greatly and is often much higher, (Turner et al, 1994)*. However a more recent study by Hróbjartsson and Götzsche (2001)* found little evidence that placebos had clinical effects, suggesting that the placebo effect works selectively.
So while placebos may seem great, clearly a placebo does have its disadvantages.
Its use raises many ethical issues. For example, it creates false pretences, building up hopes of those who take it, offering it as a substitute or an alternative, when in reality, it is no such thing. Their effect is unreliable and unpredictable, and shouldn’t form the basis of any treatment. Another example is giving it, to act as a control. It is unfair not to give a group a treatment, which could actually work. Along side this, is the old debate of deception. Is it fair to maintain that deception, especially when the treatment is bogus? Well not really, no. We should not deceive people and have an obligation to relieve the pain and suffering.
Other disadvantages include unwanted side effects, such as drowsiness, nausea and rashes. The placebo can also hide symptoms of a possible serious illness. Withdrawal symptoms can also occur. 41% of women who has been on a placebo for 6years suffered moderate or severe withdrawal symptoms, (Women’s Health Initiative)*.
To conclude, the placebo effect is a real and powerful psychological response. It is generally a beneficial response, although due to the nature of its feel-good factor it is possible that symptoms of a serious illness could be masked by it. The placebo effect has been controversial in history, but has played a huge role in medical research and pharmacology, suggesting it does work. But does it truly work?! You decide….
1 http://www.rawfoodinfo.com/articles/art_placebovsdrugs.html
3 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2359128/pdf/bmj00573-0060.pdf
6 http://www.ncbi.nlm.nih.gov/pubmed/11372012
7 http://jama.ama-assn.org/content/294/2/183.full.pdf+html
alhoward 
I very much enjoyed reading your blog this week. With regards to your ethical issues, when you mentioned that it creates false pretences, I have to say that if the placebo effect does work, then surely it is better than putting drugs into our bodies. I think it is incredible that we can create such an effect that can relieve us from pain, and if it works then use of the placebo effect should continue. I would prefer the deception to suffering other symptoms of the actual drugs.
You said that it is unfair for the control group not to experience the possible benefits of the actual drug, however if society is to progress then we must have a controlled group from which we can see the effects of the drug in the experimental group. From the utilitarian point of view, ‘for the greater good’, maintains that the proper course of action should be one that maximizes the overall “happiness” or “benefit”. So those in the control group may not benefit now, but with their input, it may be possible to create a new treatment that could benefit everyone in the future.
Firstly, id like to say that i really enjoyed your blog this week, you’ve based it on a topic that we all know about but have never really bothered to investigate further, and the amount of evidence you have given really shows you’ve put some thought into it.
However, surely if a person does have a serious illness, giving a placebo would not work anyway.. even if the person believed that they were receiving a drug to help them, if the illness was that serious, the drug would not work and the person would stay suffering.
I personally have recently been diagnosed with an illness and am taking up to 6 tablets a day to control it, i must admit, i have no idea what these drugs are actually meant to do, only that i know what time to take them and how many i am meant to take. I must admit though, when i do not take them, the psychological impact of this is great and i often find myself feeling ill.. even though I’m fully aware I only believe i am ill because i have not taken my tablet, taking something like a a paracetamol usually takes this thought away as i then believe i have taken something that will help me.
Half of all drugs fail to reach the target market as they are not beaten in effectiveness by sugar coated placebo pills. http://www.wired.com/medtech/drugs/magazine/17-09/ff_placebo_effect?currentPage=all.
Overall, a really great blog and you included some really good points 🙂
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I really enjoyed reading your blog, you gave both sides of the argument and brought it all together at the end with a great conclusion. If I were to add anything to your blog it would be to the disadvantages section. Last semester I took part in a experiment that gave me a drug that was supposed to enhance my memory in a numbers task, where I had to repeat a string of numbers that increased in length each time. It was done professionally, I was told what the drug was meant to do, I took it, she then took a swab of my saliva to show it had worked but for some reason I just could not believe it. As I was aware what placebos were, I initially thought this drug cannot be real. However this may not be the case for the typical layman who is unaware of placebos in psychological research. I did not try harder or less when doing the experiment after taking the drug but I knew it would not have an effect and I did not recall more. So are demand characteristics in play here? That is the one disadvantage I would add. If people are aware it is a placebo and therefore not real will they act in a different way, will they try harder or not as hard.
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hey great blog! i think you made some clear points and it was easy to read. I like how you considered both sides and made a good conclusion. I think you could have included examples of people who have complained about these types of studies and using of the placebo drug. personally i think that if anything works without using drugs then go for it! 🙂 good blog
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Wicked blog, actually enjoyed reading it. So I thought it would be interesting to discuss the opposite of a placebo if you like. That is Psychosomatic disorder.
Psychosomatic means mind (psyche) and body (soma). A psychosomatic disorder is a disease which involves both mind and body. Some physical diseases are thought to be particularly prone to be made worse by mental factors such as stress and anxiety. Your current mental state can affect how bad a physical disease is at any given time.
I’ve come to the realization recently that I behave similarly sometimes, for every time I am stressed my cold gets worse, my asthma and eczema gets worse, I eat less, and then I feel like S***T.
Research suggests that such illnesses as psoriasis, eczema, stomach ulcers, high blood pressure, and heart disease. It is thought that the actual physical part of the illness (the extent of a rash, the level of the blood pressure, etc) can be affected by mental factors.
So the mind is an amazing thing ey, can either improve your health or make it worse!
I think an important point to add to your argument is also the point that if a placebo is just as effective why are drugs which can have dramatic side effects like an increased suicide rate (Prozac) and brain damage (some of the drugs used to treat schizophrenia); even less serious effects like nausea seem unnecessary if the drug is not even working any better than a placebo. I think your addressing of this point in your paragraph about side effects and withdrawal is important but there is just not the research that placebos have as severe side effects as drugs like Prozac.
Also to add to your ethical debate it could be seen as violating the ethics code to not treat or give a placebo pill to participants who suffer from something like depression as this could harm them.