Absurd Placebo effect: the more expensive the pill, the better the effect

The Placebo effect is half of the success of therapy. Physicians would use him selectively, may be some patients recover faster, others would have to take less medication.

Winfried is not Called, a Professor of Clinical psychology and psychotherapy, University of Marburg, holds much of the theory of homeopathy. He holds, however, it from the medical supply to exclude or banish their funding from pharmacies, as it is always required. “From a scientific point of view homeopathy is nonsense, of course. It acts almost exclusively as a Placebo,“ says Rief. “But if patients with Globuli feel better than with a drug, why should we not make use of this effect?”

The Placebo effect can increase treatment success

The Professor of the University of Marburg belongs to the German research network “Placebo Competence” that explores the positive and negative effects of bogus drugs and treatments. Placebo and Nocebo effects are known for a long time. The first medical mention of a placebo comes from 1772, when a doctor prescribed a patient aware of ineffective sugar pills.

The scientists have set themselves the goal of helping the Placebo effect in modern medicine. The neurologists and psychologists are convinced that the targeted use of the placebo effect of any therapeutic effect and especially the effect of a drug treatment can be maximized.

There is no therapy without placebo effect

Called says: “I used to think that the placebo effect plays in some diseases and treatments, no matter. Today, I would exclude him never. There is no medical Intervention, in the case of the placebo effect plays no role.“

So far, Placebos, thus pharmacologically ineffective substances are used primarily as a control when testing new drugs. The difference between drug and placebo group defines the effect of the drug. “But this model is wrong. The actual effect is a Combination of different mechanisms,“ says researcher Called. “It is never alone at the tested substance.”

Expensive pills work better – especially as a placebo

A certain effect can be achieved to the Setting of the study, the contribution of the maintainer, the information on the drug (“expensive to manufacture”, “promising”, “occasionally severe side effects” …) “It makes a difference, what is the Placebo-proportion is called the subject. At 30 percent, the effect is better than 50 percent, because the Chance is higher to have the real medication.“

The placebo effect is based on the expectation of the patient to a effect, which is due to good previous experience, or by the positive relationship between the therapist and the Patient. In recent times, but also discovered more and more biological mechanisms of the placebo effect. Overall, it is a complex psycho-logical and biological patterns of response in the patient, which accounts for the Placebo proportion in a therapy.

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Placebos activate the same brain areas as real drugs

With modern imaging techniques, such as magnetic resonance imaging, for example, show that in the experiments with sham drugs, the same brain areas are active as in the case of real drugs. Called says: “You see but also other measurements that Placebos alter biological processes.” This relates to the immune response, neural transmission processes or of hormones.

Studies of the neurologist Ulrike Bingel from the University hospital Essen (it is also part of the Placebo competence network) have shown, for example, that a pain reliever works twice as well if patients have a positive expectation. Painkillers have a stronger effect if it had taken the subjects previously, and the positive effect remember.

Reaction to medications such as the Pavlovian dog

The Placebo researcher Fabrizio Benedetti of the University of Turin could prove in a trial with Parkinson’s patients, that the expectation of an effect, plus the previous experience with a real medicine can be a Placebo effect: The putative dopamine-injection only showed in patients an increased brain activity and less muscle rigid, which helped to bring the right drug ever for relief. The other did not react to the dummy drug.

Paradoxically, act as Placebos, even then, often, if the Patient knows that he gets a dummy medicine. Called explained: “It is not so much the pill itself but what it triggers in the patient. Our previous experiences to cause a reaction in the brain.“ In other words, We react to medication or a therapy situation, like a Pavlovian dog. In this famous Experiment, the experimental animals feed, after a bell rang got. They responded to the seizure with increased flow of saliva. Later, she slavers already at the sound of the bell, without the food came.

Expectation makes pain pills work

In headache patients, this conditioning, for example, looks like this: Who has made tablets a positive experience, respond later with less pain before the active ingredient reaches the nerve cells. The positive benefits: Has learned the body of the response pattern, from come chronic head pain patients with less active ingredient, even a dummy treatment can bring improvement.

The targeted use of Placebo mechanisms has been proven in a study with patients around your heart SURGERY at the University hospital Marburg. A controlled change in the attitude of expectation meant that it was these patients six months after cardiac surgery better than the control group. The Trick was: The patient should not remain in fear of the OP caught, but positive ideas of the time after the SURGERY. This meant that you doubted yourself after the procedure, earlier and faster on the legs.

“Antidepressants are Placebos with side effects”

The proportion of placebo effects is the greatest when it comes to the patients subjective Feelings: pain, depression, Fatigue, irritable bowel, and other psychosomatic complaints. A called admits: “We actually know how strong the placebo effect is involved. But some of the drug needs only a good placebo proportion, in order to act.“

For example, antidepressants: “The meta-analysis of various studies showed until recently a extremely low benefit in comparison to Placebo medication. You can say: Often, antidepressants are Placebos with side effects.“ For the Placebo-researchers and psychologists Called this means that you could achieve with sham drugs possibly more – without side effects.

Placebos do not work for everyone equally well

However, you don’t know that Placebo treatments work for all people equally well. Whether this has to do with an optimistic or pessimistic personality, genetic factors or of individual brain structures is unclear.

Called calls for a broader understanding of medicine. “Today, biochemical and biomechanical processes are overrated. In the study of medicine, the Placebo aspect in the clinical routine, important, plays no role.“ A medicine of the future should rely on all of the factors involved in the therapy. You should not leave the Placebo – and Nocebo-effects of the homeopathy or other holistic alternative methods, to the Benefit of patients.