All posts by Michael Doneman

Placebos in sport

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There’s so much attention right now given to Olympic atheletes’ use of ‘placebo’ rituals and objects, from favourite items of underwear to ancient Chinese ‘cupping’ techniques and herbal supplements.

“Judo gold medalist Kayla Harrison wears the lucky socks that were a gift from her grandmother. Hockey player Alex Danson spins her stick 15 times before each game. Tennis player Rafael Nadal takes alternating sips from two water bottles at every break between games.”

Quartz looks in some depth into the phenomenon.

It’s unpacked further here.

“In sports, it’s a little different in that in the vast majority of cases relying on the placebo effect probably won’t hurt, and in many cases might actually help because of the power of belief. Aside from some potential BO, is it really a problem that an athlete regularly wears the same t-shirt under his uniform to help with on-field success? In fact, savvy coaches regularly use various placebo approaches when trying to help their team with belief — and often these tactics work.”

‘Useless’ surgery is still popular

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It seems that the placebo ‘hierarchy’ still plays out – a pill is trumped by a saline injection, which is trumped by ‘surgery’. Studies suggest that patients in the USA are opting for ineffective knee surgery in the belief this will relieve pain, even though it is likely that such an effect is … well, a placebo effect

“I personally think the operation should not be mentioned.” … But if a doctor says anything, Dr. Guyatt suggests saying this: “We have randomized clinical trials that produce the highest quality of evidence. They strongly suggest that the procedure is next to useless. If there is any benefit, it is very small and there are downsides, expense and potential complications.”

Oh no, you’re not going after oysters!!

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I’m afraid, so, folks. It seems the valiant, fleshy oyster’s reputation as an aphrodisiac may be be down to … you guessed it … the placebo effect.

My co-worker Zara literally told me every time she has an oyster, she feels a tingling sensation in her nipples. My mind was blown. What in the world?! Am I asexual? Why doesn’t that happen to me??!

I decide to consult with Dr. Nicole Prause, principal investigator at the Sexual Psychophysiology and Affective Neuroscience Lab at the University of California, to find out what’s actually going on in our brains every time we eat oysters.

Read more in Oysters Only Make You Horny If You Believe They Will, According To An Expert

Prescribe a placebo?

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In Why Placebos Really Work: The Latest Science the Wall Street Journal points to the increasing frequency of ‘serious’ science envisioning health interventions that consciously include placebos and invoke the placebo effect. It seems the mind-body divide is something of an illusion!

Nevertheless, even though at least 50% of doctors actively prescribe placebos – often active drugs in such low doses that there is no apparent therapeutic benefit, or vitamins, antibiotics or over-the-counter analgesics like aspirin – they are still disinclined to prescribe a sugar pill. I guess they feel like it’s cheating, somehow.

Placebos DO work: Bogus pills ‘trigger similar healing process to real drugs’

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… and have helped people with migraines, IBS and Parkinson’s.

Placebos have been shown to work for migraines, toothache and IBS

Parkinson’s patients continued to get relief after switching to placebos

After drugs, body becomes pre-conditioned to expect treatment and reacts

50% of American doctors found to prescribe placebos instead of drugs

New studies in the Boston suggest that placebos may causes changes in the body as well as the mind. Even with patients knowing they are being given a non-medicinal drug substitute they have still reported reduced pain and other symptoms in everyday, debilitating conditions such as irritable bowel syndrome or migraines.

THIS COLUMN IS GOOD FOR YOUR HEALTH, AS LONG AS YOU THINK IT IS.

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So you want to run faster — but you’re not ready for steroids?

No problem: just swallow a pill made of sugar and water that you think is a steroid — and you’ll run faster, because you believe you can.

A recent Scottish study found runners told they were getting performance-enhancing pills felt stronger and ran faster than normally — even though the pills were fake.

It’s just the latest example of the Placebo Effect, one of the most powerful effects known to humans, along with the Greenhouse Effect, the Brexit Effect and the Trump Defect.

Placebos are fake drugs you think are real — and a third of the time, they’re more effective than most drugs in the pharmacy at reducing everything from headaches, pain, nausea, coughs and colds to anxiety caused by fear that the pills your doctor gave you are actually placebos.

Read the full article here.

The ethics of placebo use in medicine

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As practitioners become a little more ‘open’ about their use of placebos, it’s time now to discuss the ethics of such use. From Glackin’s abstract:

It is widely supposed that the prescription of placebo treatments to patients for therapeutic purposes is ethically problematic on the grounds that the patient cannot give informed consent to the treatment, and is therefore deceived by the physician. This claim, I argue, rests on two confusions: one concerning the meaning of ‘informed consent’ and its relation to the information available to the patient, and another concerning the relation of body and mind. Taken together, these errors lead naturally to the conclusion that the prescription of placebos to unwitting patients is unethical. Once they are dispelled, I argue, we can see that providing ‘full’ information against a background of metaphysical confusion may make a patient less informed and that the ‘therapeutic’ goal of relieving the patient of such confusions is properly the duty of the philosopher rather than the physician. Therapeutic placebos therefore do not violate the patient’s informed consent or the ethical duties of the doctor.

The whole paper can be found here. It seems the article has stirred up something of a hornet’s nest among ‘psychopharmacologists’ – see the recommendations listed at the foot of the website.

Placebo’s dark side: the ‘Nocebo’

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A detailed and comprehensive meta-analysis of the literature on the ‘nocebo effect’. We note that they report on studies using ‘placebo controlled trials’. Is it just us, or does this read a bit circular? You be the judge!

“Our intention here is to portray the neurobiological mechanisms of nocebo phenomena. Furthermore, in order to sensitize clinicians to the nocebo phenomena in their daily work we present studies on nocebo phenomena in randomized placebo-controlled trials and in clinical practice (medicinal treatment and surgery).”

Download the full article here.