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The power of placebos
December 22nd, 2010
05:41 PM ET

The power of placebos

Hoping to get around the practice of deceiving patients with fake treatments, researchers tried to determine whether placebos, also known as dummy pills, would work even if the patients knew they weren't taking an active drug. 

Patients knowingly taking a placebo still found relief from symptoms of irritable bowel syndrome (IBS) a new study published in the journal PLoS ONE found.

 Harvard Medical School and Beth Israel Deaconess Medical Center divided eighty IBS patients into two groups.  The control group got no treatment at all.  The other group of volunteers was told to take one sugar pill twice a day. All of the patients were monitored for three weeks.

"Not only did we make it absolutely clear that these pills had no active ingredient and were made from inert substances, but we actually had 'placebo' printed on the bottle," said Ted Kaptchuk, study author and Associate Professor of Medicine, Harvard Medical School and Beth Israel Deaconess Medical Center. "We told the patients that they didn't have to even believe in the placebo effect.  Just take the pills."

They did, and nearly twice as many patients in the placebo group had reduced symptoms compared to the control group.  In fact, the placebo patients relief was equal to taking the most powerful IBS medications. 

Kaptchuk says the study is a proof of principle.

"These findings suggest that rather than mere positive thinking, there may be significant benefit to the very performance of medical ritual," said Kaptchuk. "I'm excited about studying this further. Placebo may work even if patients knows it is a placebo."

Anthony Lembo, study co-author and expert on IBS didn't think it would work. "I felt awkward asking patients to literally take a placebo," Lembo said. "But to my surprise, it seemed to work for many of them."

Placebos usually contain an inactive substance like sugar, distilled water, or saline solution. They can sometimes improve a patient's condition simply because the person thinks they are taking a medication that will help.

Researchers say this study opens the door for larger trials on just how effective placebos can be for fully informed patients and might also give doctors another option, if they have ethical concerns about deceiving patients by giving them placebos.  Irritable bowel syndrome is a common gastrointestinal disorder also known as spastic colon. Approximately 20% of adult Americans have IBS.  Symptoms vary, but sufferers–more often women–experience abdominal pain, cramping, bloating, constipation and diarrhea.  It can cause a great deal of discomfort and pain.  According to the International Foundation for Functional Gastrointestinal Disorders (IFFGD) there are between 2.4 and 3.5 million IBS-related doctor visits each year in the U.S.

Kaptchuk has been involved in research on the placebo effect for nearly 20 years, trying to find ways to harness the power of placebo so that it might be valuable to clinicians.  Is it conceivable that placebos may be a possible treatment for some patients down the line?  Kaptchuk says he is not ready to go there–yet.  But he already has two new studies looking at its use in other illnesses.


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