Tag Archives: Mind and Body

What does ChatGPT ‘think’ about placebos?

“لسبب ما أنا مغطاة بالدم”: لغة GPT-3 تضم تحيزات مزعجة ضد المسلمين


We’re creatures of our times here at Universal Placebos, so we had to get amongst ChatGPT on the topic of placebos.

Universal Placebos:
Write a blog post on the pros and cons of using placebo medication.

ChatGPT:
Introduction:

Placebo medication is a type of treatment that is often used in clinical trials to test the effectiveness of new drugs or treatments. It is a substance that looks and tastes like a real medication, but does not contain any active ingredients. The purpose of a placebo is to create a control group for comparison, allowing researchers to determine whether a new drug or treatment is truly effective. In this blog post, we will explore the pros and cons of using placebo medication.

Pros:

  1. Creates a Control Group: One of the most significant benefits of using placebo medication is that it creates a control group that can be used for comparison. In clinical trials, researchers typically divide participants into two groups: one group receives the new drug or treatment, while the other group receives a placebo. By comparing the outcomes of the two groups, researchers can determine whether the new drug or treatment is effective.
  2. Minimizes Bias: Another benefit of using a placebo is that it can help minimize bias in clinical trials. When participants know that they are receiving a new drug or treatment, they may have higher expectations for its effectiveness, which can skew the results. Placebos can help prevent this by creating a more objective comparison between the two groups.
  3. Safe: Placebo medication is safe and has no side effects, which makes it an ideal choice for use in clinical trials. In contrast, some drugs and treatments can have serious side effects, which can be harmful to participants.

Cons:

  1. Ethical Concerns: One of the main ethical concerns associated with using placebo medication is that it involves deceiving participants. Participants are often not informed that they are receiving a placebo, which raises questions about whether they have truly given informed consent. While some argue that this is necessary to ensure the integrity of the trial, others argue that it is unethical to deceive participants in this way.
  2. Limited Use: Another disadvantage of using a placebo is that it can only be used in certain types of clinical trials. For example, it is not possible to use a placebo when testing the effectiveness of surgery or other invasive procedures. This limits the applicability of placebo medication as a research tool.
  3. Reliability Issues: Finally, there are concerns about the reliability of placebo medication as a control group. Some argue that the placebo effect (the phenomenon in which a person experiences a perceived improvement in symptoms simply because they believe they are receiving treatment) can skew the results of clinical trials. This can make it difficult to determine whether a new drug or treatment is truly effective.

Conclusion:

In conclusion, placebo medication has both pros and cons when it comes to its use in clinical trials. While it can create a control group and minimize bias, it also raises ethical concerns and has limited use in certain types of trials. Ultimately, the decision to use a placebo should be made on a case-by-case basis, taking into account the specific circumstances of the trial and the ethical considerations involved.

Universal Placebos:
For which conditions and under what circumstances might be consider a placebo treatment for a complaint?

ChatGPT:
Placebo treatments are typically used in clinical trials as a control group to determine the effectiveness of a new drug or treatment. However, in certain cases, placebo treatments may also be used as a therapeutic intervention for a complaint. Here are a few examples of conditions and circumstances where placebo treatment may be considered:

  1. Pain Management: Placebos have been shown to be effective in reducing pain in some cases. They may be used as a complementary treatment in conjunction with other pain management strategies, such as physical therapy or medication.
  2. Irritable Bowel Syndrome (IBS): IBS is a condition that can be difficult to treat, and many patients experience symptoms that are not fully relieved by medication or other therapies. Placebo treatments have been shown to be effective in reducing symptoms in some patients with IBS.
  3. Depression: Placebo treatments have been used in clinical trials to test the effectiveness of antidepressant medication. However, some studies have also shown that placebo treatments can be effective in reducing symptoms of depression on their own.
  4. Anxiety: Placebos have also been used in clinical trials to test the effectiveness of anti-anxiety medication. However, some studies have shown that placebos can also be effective in reducing symptoms of anxiety.
  5. Sleep Disorders: Placebos have been used in clinical trials to test the effectiveness of sleep medication. However, some studies have shown that placebos can also be effective in improving sleep quality.

It is important to note that the use of placebo treatments as a therapeutic intervention is still controversial, and there are ethical considerations to take into account. In general, it is important to discuss the potential risks and benefits of placebo treatments with a qualified healthcare provider before considering this type of intervention. It is also important to note that any use of placebo treatments should be transparent and fully informed, with patients fully understanding the nature of the treatment they are receiving.

Universal Placebos:
Do you have an opinion on the efficacy of placebo treatments?

ChatGPT:
As an AI language model, I don’t have personal opinions or beliefs. However, I can provide information on the scientific consensus regarding the efficacy of placebo treatments.

Placebo treatments have been shown to have some level of effectiveness in reducing symptoms in various conditions, including pain, depression, anxiety, and sleep disorders. The exact mechanism by which placebo treatments work is not fully understood, but it is thought to involve a combination of psychological and physiological factors.

Some studies have found that the placebo effect can be quite powerful, with some patients experiencing significant improvements in symptoms even when they are aware that they are receiving a placebo. Other studies have suggested that the placebo effect may be more modest, and that factors such as the severity of the condition being treated and the expectations of the patient may play a role in determining the magnitude of the effect.

It is important to note that while placebo treatments may be effective in reducing symptoms, they are not a substitute for evidence-based treatments. In some cases, placebo treatments may be used in combination with other therapies, such as medication or cognitive-behavioral therapy, to provide additional symptom relief.

Overall, the scientific consensus is that placebo treatments can be effective in reducing symptoms in some cases, but the exact magnitude of the effect may vary depending on the specific condition being treated and the individual patient. It is also important to note that the use of placebo treatments as a therapeutic intervention raises ethical concerns, and should be done with full transparency and informed consent.


The placebo value-add

A placebo might be given as a stand-alone remedy, or as recent research claims, given as an augmentation to another remedy, adding value to its effect while introducing no extra chemical agent in the process. Just the influence of expectation and will.

The prestigious journal Nature, has published this study – Harnessing the placebo effect to enhance emotion regulation effectiveness and choice

“… There is extensive placebo literature showing how forming positive expectancies can augment the effectiveness of already effective treatments. In that sense, placebo effects are not limited to inert treatments, but also represent a powerful mechanism for boosting outcomes following the administration of active treatments.”

It’s still not fully understood how placebos work – but an alternative theory of consciousness could hold some clues

Photo: rightbluelabs

Research has shown that a vast array of different conditions benefit from placebos. This includes acne, Crohn’s disease, epilepsy, ulcers, multiple sclerosis, rheumatism, Parkinsons’s disease and colitis. A recent study also found that placebos had a highly significant effect on erectile dysfunction.

But it may be that an account of the placebo (and nocebo) effect can be sought, if not found, in a science expanded beyond the simply neurological, which is to say, in a science that understands ‘mind’ as integrated in the complex web of energies interacting with the brain.

This fascinating article discusses this perspective.

Did you know these three facts about the placebo effect?

You may be surprised to read of three ‘effects’ of placebos proposed recently by Eve M. Krakow in Psychology Today.

Dr Krakow takes pains to emphaise that the placebo effect is a physical phenomenon. There’s nothing magical about it. It will seem magical (as Isaac Asimov once wryly observed) until there’s sufficient science.

First, the placebo has a negative ‘flipside’. This is the nocebo effect, and it’s noted and discussed elsewhere on this site (check the tags column). A placebo effect can have either positive or negative outcomes.

Second, and very weirdly (if not ‘magically’) the placebo effect seems to become stronger and more proncounced over time. Placebos seem to get stronger!

Thirdly, the placebo effect does not necessarily require deception – that is, the practitioner lying to a patient that the (inert placebo) treatment is actually the ‘real’ treatment. We cover this too, on this site – look for ‘white label placebos’ in the tags.

Nocebo Effects: How to Prevent them in Patients

We’ve posted elsewhere about the placebo’s dark twin, the nocebo, the phenomenon of the mind provoking negative and damaging effects through the same mechanism that accounts for the positive effects of a placebo.

This paper brings focus to ‘nocebo algesia and hyperalgesia (ie, the occurrence and worsening of nocebo-induced pain, respectively)’ and makes practical suggestions for reducing the incidence of this. As always, these relate to the patient-practitioner relationships and interactions, and strongly reinforce the ‘subjective’ and ‘negotiated’ nature of the experience of pain.

‘In general, the literature shows that uncaring interactions that convey a message of invalidation and lack of warmth may trigger nocebo effects. Avoiding negative communication and interactions with a patient may help to shape a safe and positive environment that not only promotes placebo effects but that also reduces nocebo effects.’

Open Label Placebos … again

An article in Big Think entitled People are knowingly taking placebos—and its working starts to untangle some of the theories about the functionality of ‘open label’ placebos – which describes the engagement of a placebo effect even when people know they’re taking a placebo. 

“Even though they were told that what they were taking was placebo and contained nothing of therapeutic value, those patients who received the placebo reported a 30% reduction in usual pain and maximum pain and a 29% drop in their disability. Incredibly, the placebo worked better than the real pain medication. Participants who took the pain pills reported feeling 9% less usual pain, and 16% less maximum pain. Furthermore, patients taking the real medication reported no change in their level of disability.”

The Man Who Overdosed on Placebo

The Nocebo effect, dramatically illustrated …

Several years ago, a published case study describes a 26-year-old man who was taken to the emergency room. After arguing with his ex-girlfriend, he attempted suicide by swallowing 29 capsules of an experimental drug that he obtained from a clinical trial that was testing a new antidepressant. When he arrived at the hospital, he was sluggish, shaking, and sweating and had rapid breathing. His blood pressure was extremely low at 80/40, and his pulse was 110.

Doctors were successful at raising his blood pressure. Over the course of four hours, they injected him with 6 liters of saline solution. His blood pressure increased to 100/62, which is at the lower end of the normal range, but his pulse remained high at 106.

What finally cured the patient wasn’t anything the emergency room staff did. Instead, a doctor from the clinical trial arrived at the hospital. He told the patient that those antidepressant pills weren’t antidepressants because he had been randomized into the control arm of the trial. Yes, that’s right: He overdosed on placebos.

Oh.

Within 15 minutes, the patient’s blood pressure stabilized at 126/80, and his heart rate dropped to a perfectly normal 80 beats per minute.

Read the entire article here.

Patients may be experiencing placebo effect, but it’s still an effect: “Placebo is active treatment”

 

In Respect the Needle in OA (osteoarthritis),  a rheumatologist says:

“… Dealing with osteoarthritis, both patients and their physicians often have a hard time understanding what to make of novel “cures” such as platelet-rich plasma (PRP), stem cell treatments, and so-called prolotherapy.

Although these are typically marketed as halting or reversing joint degeneration in OA, there is virtually no evidence that they actually do. Yet it’s impossible to discount the countless reports from patients that the treatments helped them in terms of pain and function.

The explanation may very well lie in the placebo effect, said Joel Block, MD, a well-known osteoarthritis specialist at Rush University, speaking at the American College of Rheumatology’s 2018 State of the Art Symposium.

But the thrust of Block’s 30-minute talk can be summed up in two words: So what?

The placebo effect is still an effect and a very important one, he argued repeatedly in addressing current knowledge about therapies, largely unregulated, now marketed nationwide in newspapers and online as “disease-modifying.”

It’s “extraordinarily strong” in osteoarthritis, Block said, for reasons that aren’t entirely clear. The experience from randomized trials is that one normally expects a 40% response rate with placebo with large effect sizes. Moreover, the improvements in patient-reported pain do not quickly disappear: the trial data indicates that placebo responses last beyond a year, he said.

“Placebo is active treatment,” Block said.

Want to think outside of the box? Try sniffing a placebo

We usually think of placebos as tools for therapy, or perhaps as marketing strategies, but here’s an idea about the placebo effect and creative thinking.

“The placebo effect is best known in medicine for making people feel better when they are given sham treatments. Now there is growing interest in using placebos to boost athletic and cognitive abilities.

Previous studies have found that people lift more weight and cycle harder when they take medicines with no active ingredients that are falsely labelled as performance-enhancing substances. Placebo pills have also been shown to improve scores in memory tests.

These findings prompted Lior Noy and Liron Rozenkrantz at the Weizmann Institute of Science in Israel to test whether the placebo effect can stimulate creativity too.

They asked 90 university students to sniff a substance that smelled of cinnamon. Half the students were informed that the substance had been designed to enhance creativity.

The participants then completed a series of tasks designed to test their creativity. One involved rearranging squares on a computer screen into different shapes. Another required them to think up new uses for everyday items like shoes, pins and buttons.

Those who were told the smelly substance increased creativity scored higher on measures of originality. For example, they came up with more unusual shape configurations and novel applications for the everyday items. “The improvements weren’t enough to turn you into the next Picasso, but they were significant,” says Noy.”

Read the full article here.

Placebos and acupuncture

Here’s a link to a fascinating meta-analysis of the effectiveness of acupuncture in the treatment of chronic pain, controlling for some of the dodgy and unscientific ‘studies’ out there.

In this article, the outcomes of the study are listed and discussed, and it’s good news for acupuncturists.

‘When comparing legit acupuncture to standard care, there was a statistically significant benefit to acupuncture … “We saw a measurable effect there,” he explains. “If acupuncture were a drug, we’d say the drug works.”’

…and later, in relation to the placebo effect:

‘Many people equate placebo effects with scams. “The term placebo has always had this very negative connotation,” says Vitaly Napadow, director of the Center for Integrative Pain Neuroimaging at Harvard Medical School. But Napadow says our poor opinion of placebo needs revising. The human body has built-in systems for stoking or calming pain and other subjective sensations. “If a placebo can target and modulate these endogenous systems, that’s a good and a real thing,” he says.’

Meanwhile, in two comprehensive studies into the value of acupuncture treatment in treating women’s health issues, we see mixed results.

‘These studies shed new light on when and when not to consider using acupuncture,” Dr. Josephine Briggs and David Shurtleff, of the U.S. National Center for Complementary and Integrative Health, wrote in an editorial to accompany the studies.

The research done to date on acupuncture has shown that, generally, its benefits are limited to outcomes that are subjective, such as pain, Briggs and Shurtleff wrote. People’s positive expectations and the reassurance they feel from the procedure likely contribute to the benefits. “Clearly these ancient practices are helping reveal the complexity of the links between the mind and the body,” the editorial said.’