Evidence-based Ayurveda by C. P. Khare;

Author:C. P. Khare;
Language: eng
Format: epub
Publisher: Taylor & Francis (CAM)
Published: 2019-10-10T16:00:00+00:00

The impact of placebo

Now, we will elaborate on the impact of placebo in the treatments which survived for centuries.

Placebos have been shown to produce measurable physiological changes and exert therapeutic response in chronic pains, headache, depression, anxiety disorders, cough, erectile dysfunction, insomnia, dysmenorrhea, irritable bowel syndrome, Parkinson’s disease, epilepsy, benign prostatic hyperplasia symptoms and psycho-neurosis.

Brain imaging studies have found measurable changes in the neural activity of people experiencing placebo analgesia. Areas that have been implicated include parts of the brain stem, spinal cord, nucleus accumbens and amygdala.1 Strong placebo responses have also been linked to increases in dopamine and opioid receptor activity. Both of these chemicals are involved in reward and motivation pathways in the brain.

Conversely, nocebos have been found to reduce dopamine and opioid receptor activity.

Some of these neurological changes occur in areas of the brain that are often targeted by antidepressant drugs. This might account for the 50% to 75% placebo response rate in antidepressant trials.

The following conditions have demonstrated positive responses to the placebo effect:1

Pain: A placebo’s ability to reduce pain is referred to as placebo analgesia. Either the placebo initiates the release of natural painkillers and endorphins or they change the individual’s perception of the pain.

Additionally, genuine analgesics have been found to be more effective if a person knows they are being given the drug, rather than the drug being given without the person’s knowledge. In this case, the placebo effect can be viewed as assisting a genuine intervention.

Depression: The effect of antidepressants is believed to be largely reliant on the placebo effect. One overview of eight studies found that over a 12-week period, placebo antidepressants were effective, demonstrating the potentially long-lasting impact of placebos.

Anxiety disorders: The placebo effect is particularly prevalent in trials for anti-anxiety drugs and significantly interrupts the discovery and trials of new forms of medication.

Coughs: A review of cough medication trials found that “85 percent of the reduction in cough is related to treatment with placebo, and only 15 percent attributable to the active ingredient.”

Erectile dysfunction: In one study, participants were split into three groups. The first group was told they would receive treatment for erectile dysfunction, the second group was told they would receive either a placebo or an actual treatment, and the third group was told they would receive a placebo.

All three groups were, in fact, given placebo starch tablets, but the erectile dysfunction in all three groups improved significantly without any differences between the three groups.

Irritable Bowel Syndrome: A meta-analysis found that the placebo response rate in people with Irritable Bowel Syndrome (IBS) ranged from 16.0% to 71.4%. It was also noted that the placebo effect is greater in trials where the participants are required to take medication less frequently, and individuals with lower anxiety levels appear to be more susceptible to the placebo effect. In a trial, even when the participants were aware they were taking a placebo, their IBS symptoms improved.

Parkinson’s disease: A review of 11 clinical trials found that 16% of participants with Parkinson’s disease in the placebo groups showed significant improvements, sometimes lasting for 6 months.

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