“Our mission is to promote communication and cooperation between research centers and scholars in order to facilitate rapid dissemination of research results and theoretical ideas concerning placebo studies. Our goals are to use multidisciplinary tools (neuroscience, psychology, cognitive science, history, anthropology, and philosophy) to examine the physiological and psychological mechanisms underlying placebo effects, and to develop ethically acceptable methods to harness the placebo effect to improve treatment outcomes.”
Our experience in the commercial arena, which incidentally keeps us abreast of developments in understandings of the placebo effect. has seen a shift from ‘crackpot fringe’ to ‘scholastic fringe’ in the direction, we hope, of acceptance of placebo studies as a legitimate field of research, grounded in a real phenomenon
The Australian researchers measured brainstem activity with high-resolution functional MRI (fMRI) in participants as they rated the pain of a hot stimulus applied to their arm.
From this article: “Over two successive days, through blinded application of altered thermal stimuli, participants were deceptively conditioned to believe that two inert creams labeled ‘lidocaine’ (placebo) and ‘capsaicin’ (nocebo) were acting to modulate their pain relative to a third ‘Vaseline’ (control) cream.”
Placebo and nocebo effects influenced activity in the same brainstem circuit but in opposite ways. The strength of the placebo effect was linked to increased activity in an area called the rostral ventromedial medulla and decreased activity in a nucleus called the periaqueductal gray; the nocebo effect induced the opposite change. These results reveal the role of the brainstem in pain modulation and may offer a route for future treatments of chronic pain.
“Placebo and nocebo effects influenced activity in the same brainstem circuit but in opposite ways. The strength of the placebo effect was linked to increased activity in an area called the rostral ventromedial medulla and decreased activity in a nucleus called the periaqueductal gray; the nocebo effect induced the opposite change. These results reveal the role of the brainstem in pain modulation and may offer a route for future treatments of chronic pain.”
Micro-dosing psychedelics as a therapy and productivity booster is all the rage in some quarters (like Silicon Valley). But is that a placebo effect?
People may not have to microdose psychedelics to feel their wellbeing benefits, according to a new study – they just have to believe (our italics) they’ve microdosed them.
Published in eLife, the new study found that participants who took placebos often reported the same beneficial effects as those that actually microdosed psychedelic substances. Likewise, those who believed they had taken a placebo, even when they had actually taken a psychedelic drug, experienced fewer improvements to their wellbeing.
Given these findings, the researchers suggest that the anecdotal benefits of microdosing can be explained by the placebo effect.
We all ‘handle’ pain in unique ways, and indeed it can be said that pain ‘is all in your head’. Ongoing studies into the impact of the placebo effect is uncovering more of the ways in which we understand and physically process pain. This study reinforces the concept that “pain is not ‘all in your head,’ but in some cases, changing how you think about pain can help you manage it.
The placebo effect will have to be taken into account in the development of vaccines and treatments, according to this opinion in Stat News.
“The placebo response is a complex psychobiological phenomenon that describes the clinical improvement seen in patients taking dummy or sham medicines. It can also comprise some proportion of the measured effect among patients receiving active drugs. Multiple behavioral, psychophysiological, and neuroimaging studies have shown that the placebo response is a real, multifactorial effect associated with changes in biochemical pathways in the brain. The effect is patient specific and is influenced by patient expectations and certain well-defined personality traits.
While drug developers are attuned to considering the placebo response in areas like pain and depression, it may not be immediately apparent why it is so critical for the development of Covid-19 therapies and vaccines. What set the stage was the FDA’s regulatory guidance, released in May, directing how the biopharma industry should evaluate drugs and vaccines being developed to fight the pandemic.”
In this article the author argues strongly against using the ‘double blind placebo controlled’ methodology in testing the effectiveness of the numerous vaccines now in the works.
” … the use of a placebo in a challenge trial for a Covid-19 vaccine is both pointless and ethically questionable.
We’ll use a deliberately simplistic analogy to help explain why. Suppose we need to test a new type of parachute during wartime, when a better parachute happens to be urgently needed. Sooner or later it will have to be tried in a real jump. But we won’t let that happen until we are already quite sure it is going to work. And we are certainly not going to give dummy parachutes to a control group, randomly selected from a group of volunteers. We already know what will happen to them.”
While this logic may hold, as far as testing vaccines go, but we wonder if there’s space to think that, at least for symptoms if not the condition itself, placebos might have a place? After all, nobody yet understands how an intangible input like a placebo actually seems to cause real effects in the material world …
We have posted for a while now on so-called ‘open label’ placebos, and the placebo effect engaged when someone actually knows they’re taking a sugar pill (or any other placebo treatment such as a saline injection).
This report, in Science Alert, claims that “across two experiments (…) during a highly arousing negative picture viewing task, non-deceptive placebos reduce both a self-report and neural measure of emotional distress.”
It seems that ‘open label’ placebos can also be described as ‘non-deceptive placebos’. This designation is of importance where researchers try to tackle the ethical issues involved in ‘lying’ to people about the test drug (or non-drug) being administered.
“What if someone took a side-effect free sugar pill twice a day after going through a short convincing video on the power of placebos and experienced reduced stress as a result?” says lead researcher and psychologist Darwin Guevarra from Michigan State University (MSU).
“The pancebo effect is when a person begins to worry that the worst is about to happen without valid evidence. It’s panic over logic.”
This article at Huffpost was written by a Canadian in the early days of the virus (where were you on the 2nd of March?). Of course it reads as naive and uninformed right now, in August, but we include it because it’s the first time we’ve come across the term ‘pancebo’, which remains topical. This was not, perhaps, the author’s intent, since he was referring to a kind of fear-panic (a ‘nocebo’) inspired by the emergence of Covid-19. Instead, these days, it might better refer to the rash of crazy conspiracy theories that crowd our newsfeeds. It’s still about fear, but the ‘pancebo effect’ of fear of the virus seems to have been translated into a generalised fear of authority figures, health officials, government and anyone who can be vaguely associated with the panglobal lizard people who are ‘really’ in control.
Our placebos make an appearance, and our motto NOTHING WORKS BETTER, is featured in the article What is the Value of Placebo Pills? which includes links to further placebo-related sites. Well worth checking out.
It’s a small sample, but a provocative one. What if the placebo effect extends to diet? What if just imagining/imaging that a particular diet leads to weight loss actually has an effect on weight loss?
What’s the readership for a new book on ‘Imaginary Low-Calorie Diets’?
