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'''A placebo is a substance or treatment which is designed to have no therapeutic value. However, when administered to patients under the guise that it works, seemingly paradoxically an effect (termed the placebo effect) is shown''' (see '''Figure 1''')'''.''' This is thought to be caused, by [[priming]] via [[Psychosomatics|psychosomatic]] mechanisms. | '''A placebo is a substance or treatment which is designed to have no therapeutic value. However, when administered to patients under the guise that it works, seemingly paradoxically an effect (termed the placebo effect) is shown''' (see '''Figure 1''')'''.''' This is thought to be caused, by [[priming]] via [[Psychosomatics|psychosomatic]] mechanisms. | ||
=== '''Why does the placebo effect exist?''' | == History == | ||
[[File:Perkins tractors.png|alt=Perkins tractors|thumb|'''Figure 2'''. Perkins tractors a magical pain reliever.]] | |||
Have you ever heard of a Perkins Tractor ? ('''Figure 2''') In 18th-century London, people paid five guineas for these metal rods, which was said to, when waved over aching body parts relieved pain. Surprisingly, they worked — or at least people believed they did. British doctor John Haygarth tested this by using fake tractors made of wood and found they were just as effective, revealing one of the earliest demonstrations of the placebo effect. | |||
== Placebo strength variance == | |||
Today, placebos come in many forms — pills, creams, even injections — and not all are equally effective. A study from Tufts Medical Center<ref>Bannuru RR, McAlindon TE, Sullivan MC, Wong JB, Kent DM, Schmid CH. Effectiveness and Implications of Alternative Placebo Treatments. ''Annals of Internal Medicine''. 2015;163(5):365-372. doi:<nowiki>https://doi.org/10.7326/m15-0623</nowiki> | |||
</ref> found that intra-articular (injected) placebos relieved osteoarthritis pain more than topical ones, which in turn outperformed oral placebos. In fact, the difference in effectiveness between an injected and an oral placebo was greater than that between acetaminophen and an oral placebo. Beyond the type of placebo, other factors influence its power — for example, how warm and competent the physician seems, or even the patient's age<ref>APA PsycNet. Apa.org. Published 2025. Accessed March 24, 2025. <nowiki>https://psycnet.apa.org/doiLanding?doi=10.1037%2Fhea0000499</nowiki> | |||
</ref>. Children, for instance, tend to respond more strongly to placebos than adults, which can skew drug trial results and make effective medications seem less impressive<ref>Sylvain Rheims, Cucherat M, Arzimanoglou A, Philippe Ryvlin. Greater Response to Placebo in Children Than in Adults: A Systematic Review and Meta-Analysis in Drug-Resistant Partial Epilepsy. ''PLoS Medicine''. 2008;5(8):e166-e166. doi:<nowiki>https://doi.org/10.1371/journal.pmed.0050166</nowiki> | |||
</ref>. | |||
This all leads to a major issue: the placebo effect has grown stronger in the U.S. over time, narrowing the gap between active drugs and placebos. Between 1996 and 2013, the relative advantage of pain relief drugs dropped from 27.3% to 8.9%, contributing to a higher rate of drug trial failures — especially in late-stage cancer pain treatments. It's a reminder that the placebo effect isn’t just a quirky medical footnote but a powerful, variable force that can shape the future of medicine and drug approval. | |||
== '''Why does the placebo effect exist?''' == | |||
A key aspect of evolutionary success is the speed at which organisms respond to stimuli. Faster reactions increase survival rates, allowing those genes to persist in the species. This development is likened to an arms race, where genetic mutations evolve to enhance quick responses. Initially, simple chemical messengers were used, triggered by stimuli and resulting in responses, such as hormone release. | A key aspect of evolutionary success is the speed at which organisms respond to stimuli. Faster reactions increase survival rates, allowing those genes to persist in the species. This development is likened to an arms race, where genetic mutations evolve to enhance quick responses. Initially, simple chemical messengers were used, triggered by stimuli and resulting in responses, such as hormone release. | ||
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In one study<ref>'''Tripping on nothing: placebo psychedelics and contextual factors'''. Psychopharmacology (Berl). 2020 May;237(5):1371-1382. doi: 10.1007/s00213-020-05464-5. Epub 2020 Mar 7. Accessed 12 Sep 2024 via: https://pubmed.ncbi.nlm.nih.gov/32144438/ | In one study<ref>'''Tripping on nothing: placebo psychedelics and contextual factors'''. Psychopharmacology (Berl). 2020 May;237(5):1371-1382. doi: 10.1007/s00213-020-05464-5. Epub 2020 Mar 7. Accessed 12 Sep 2024 via: https://pubmed.ncbi.nlm.nih.gov/32144438/ | ||
</ref> exploring the relationship between placebo and psychedelics thirty-three students completed a single-arm study ostensibly examining how a psychedelic drug affects creativity. The 4-h study took place in a group setting with music, paintings, coloured lights, and visual projections. Participants consumed a placebo that we described as a drug resembling psilocybin, which is found in psychedelic mushrooms. To boost expectations, confederates subtly acted out the stated effects of the drug and participants were led to believe that there was no placebo control group.The result of this study, showed '''t'''here was considerable individual variation in the placebo effects; many participants reported no changes while others showed effects with magnitudes typically associated with moderate or high doses of psilocybin. In addition, the majority (61%) of participants verbally reported some effect of the drug. Several stated that they saw the paintings on the walls "move" or "reshape" themselves, others felt "heavy… as if gravity [had] a stronger hold", and one had a "come down" before another "wave" hit her. | </ref> exploring the relationship between placebo and [[psychedelics]] thirty-three students completed a single-arm study ostensibly examining how a psychedelic drug affects creativity. The 4-h study took place in a group setting with music, paintings, coloured lights, and visual projections. Participants consumed a placebo that we described as a drug resembling psilocybin, which is found in psychedelic mushrooms. To boost expectations, confederates subtly acted out the stated effects of the drug and participants were led to believe that there was no placebo control group.The result of this study, showed '''t'''here was considerable individual variation in the placebo effects; many participants reported no changes while others showed effects with magnitudes typically associated with moderate or high doses of psilocybin. In addition, the majority (61%) of participants verbally reported some effect of the drug. Several stated that they saw the paintings on the walls "move" or "reshape" themselves, others felt "heavy… as if gravity [had] a stronger hold", and one had a "come down" before another "wave" hit her. | ||
''' | '''References''' | ||