Placebo Effect

Jeremy & Jokie

Jeremy is a researcher at the University of Gotham. He has designed a new serum, jokie, and he wants to test whether this serum makes people funnier. He designs an experiment where he randomly assigns $100$ Gotham citizens into one of two groups. One group gets the serum, jokie. The other group does not get the serum. By having one group get the serum, while the other one doesn't, he is able to determine whether the serum actually works by making people funnier.

However - Jeremy doesn't tell the participants whether they got the serum or not. The participants who do not get the serum get saline, which is just salty water. All $100$ participants are injected with a liquid, but the participants don't know whether they're injected with the serum or saline.

Let's think about why Jeremy does that. We will first consider the placebo.

Placebo

A placebo is a substance, treatment, or injection that has no therapeutic value. That means that the chemical or treatment doesn't do anything. A placebo has no direct effect on the body or the brain.

We see placebos in our everyday life. If you take a birth control pill everyday, chances are you take a "sugar pill" for a few days per month. This "sugar pill" is a placebo - because it doesn't contain any active hormones in it. The crosswalk button is another example of a placebo. Pressing the crosswalk button used to change the light, but nowadays, most crosswalk buttons do not do that. So, when you press a crosswalk button, you are just pressing the button, without the light changing in your favor.

The Placebo Effect

Let's consider why we use placebos in research. Placebos can tell us whether a drug or intervention actually works or not. Oftentimes, even just a suggestion or something can change behavior. We want to determine whether a change in behavior or feeling is due to an active drug or intervention, or whether it's just the suggestion.

The mind is a powerful muscle - it is able to convince itself of a lot of different things. It's important to figure out whether it's the brain or the drug causing a change in behavior!

Let's go back to Jeremy's example. Jeremy wants to know whether his serum, jokie, actually works. Maybe the participants injected with the saline solution, or placebo, think they were injected with jokie, and so they feel funnier, even though they were not injected with the jokie serum. Participants who were not injected with jokie but still became funnier are feeling the placebo effect because they are feeling the effects of a drug they did not get, but think they did.

The placebo effect is when someone feels the effect of a treatment, drug, or intervention that they did not receive the active ingredient for. Because the participant thinks they received the drug or intervention, they unconsciously begin to act differently.

According to WebMD, there are a lot of medical conditions that are proven to show improvements due to the placebo effect, including:

• Depression

• Pain

• Sleep disorders

Back to Jeremy & Jokie

Let's circle back to Jeremy's research on jokie. His research sample has $100$ participants. Of those, half received jokie and half received a placebo.

Let's look closer at the $50$ who received the saline solution, or placebo. Of these $50$, $15$ said that they felt funnier. These $15$ did not receive jokie, but they still felt funnier. These $15$ participants are feeling the placebo effect because they're feeling the effects of an active ingredient that they did not get.

(Video) The Placebo Effect

by TED-Ed

The video by TED-Ed explains the placebo effect.

Summary

Placebo Effect: an unexplained phenomenon where drugs, treatments, and therapies that aren't supposed to have an effect, do have an effect.

Placebos have been used for centuries by physicians, especially in times when drugs weren't available, as physicians recognized the power of the placebo in treating and curing illnesses. Placebo means "I shall please" in Latin, indicating the use of placating patients.

An extension of healthcare treatment, placebos are now often used in clinical trials to understand the total effect of a drug. Placebos show up as sugar pills, injection of water/saline, and even fake surgeries. Participants in the research studies do not know whether they received the drug or the placebo, so if there was an effect in the participant, the researcher could determine that it was the drug that caused an effect.

We don't know why the placebo effect works, but there are a couple of theories out there. For one, patients may report a decrease in symptoms in an effort to appease their doctor. Another reason could be the power of belief, where if you believe strongly enough that something will happen, you can manifest that change.

There are some issues with the placebo effect. For one, if the patient believes that the placebo was effective, they may not use a drug or intervention that has been proven to be effective. It is also important to recognize that the placebo effect can degrade over time, so a patient or participant may feel the effects of a drug in the beginning, but over time the placebo effect of that drug may not work so well anymore.

The Placebo Effect

The placebo effect is the phenomenon where a patient experiences a perceived improvement in their condition after receiving a treatment that has no therapeutic effect. This improvement is not due to the treatment itself but rather to the patient's belief in the treatment's effectiveness.

Placebo responses refer to the positive changes in a patient's condition that occur as a result of receiving a placebo treatment.

We often see the placebo effect in clinical trial research. When participants in a clinical trial are assigned to the placebo group, they receive a placebo treatment instead of the active treatment being studied. A sugar pill is a common type of placebo treatment that looks like a medication but contains no active ingredients. It is often used in clinical trials as a control against which the effects of an active treatment can be compared.

A labeled placebo is a placebo treatment that is explicitly identified as such to the patient or participant. This can sometimes reduce the effectiveness of the placebo effect compared to an unlabeled placebo.

We see this effect in a wide array of studies, including those looking at chronic pain and blood pressure.

The opposite is the nocebo effect, where patients experience negative effects (or worse) due to their belief in the potential harm of treatment, even if the treatment itself is harmless.