10 Interesting Facts About the Placebo Effect

by Johan Tobias

The placebo effect happens when someone is given a pill, a shot, or some other form of treatment, and are told it will help with their ailments. They feel better, but it’s just their mind and body healing itself because the treatment is essentially fake. Researchers are very interested as to why it works, because understanding it will help with patient care and decrease the amount of drugs that need to be prescribed.

10. It Was Discovered to Protect Consumers

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The first test for the placebo effect took place in the late 18th century after a Connecticut doctor named Elisha Perkins was granted a patent for medical devices he called “tractors.” Perkins’ tractors were wand-like pieces of metal about three inches long. He claimed that they were made of special materials, but they were really just steel and brass. Perkins said that his tractors could help with sore joint and other aches and pains — he charged an enormous amount of money to run his tractors over the sore spot for about 20 minutes, and people claimed they felt better afterwards.

Other physicians were dubious about the powers of tractors, so a British doctor named John Haygarth performed tests with different materials like bone, a slate pencil and a tobacco pipe. He found that he could get similar results, and he concluded that any improvement the patient felt was just in the patient’s head.

9. It Has Physical and Psychological Responses

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The placebo effect may seem like something that’s solely psychological, but there’s strong evidence that your body physically reacts to it. In 2005, researchers at the University of Michigan performed PET scans on 14 healthy young men. Their jaws were injected with a saltwater solution to cause pain. A short time later, they were given a placebo and told that medicine was on its way. On the scans, researchers saw that the area of the brain that releases endorphins was active after the placebo was given. The participants also claimed they felt less pain, and their tolerance for pain went up.

A study published in 2001 gave participants a placebo mixed with drugs that blocked endorphins. The result was no placebo effect. While research is still being conducted, these two studies show that endorphins may have a big role to play in making placebos effective.

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8. The Bigger the Production, the Bigger the Effect

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If someone is sick and needs treatment, one of the quickest and most effective ways to treat them is through an injection. That made researchers wonder — if pills gave a placebo effect, would a placebo injection be even more effective? Between 1956 and 1965, and then again in 2000 and 2006, there were tests that compared people who received placebo shots and people who were given sugar pills. In all of the studies, they found that when using a medical device such as a needle to give injections the subjects had greater improvements than the people who took the placebo orally. It speaks to the power of the placebo effect that symbols like needles, which are tied to treatment and cures for diseases, play such an important role.

7. Fertility Can Be Affected

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Even fertility can be affected by the placebo effect. In one study, a group of 55 women that had polycystic ovarian syndrome were trying to get pregnant. Over the course of six months, 33 of the participants were given a placebo and 32 were given fertility drugs. Out of the placebo group, five of the 33 women got pregnant, while seven of the 32 women receiving the drugs were able to get pregnant, making the difference statistically insignificant. In other tests, the pregnancy rate is as high as 40% while taking a placebo. Researchers believe that the women in these tests were less stressed, making them more likely to get pregnant.

6. Placebos Can Negate the Effect of Drugs

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In most placebo tests, they look to see if a fake drug or treatment can help someone. However, it can also have the opposite effect and suppress the ability of actual drugs if the person isn’t expecting them to do anything. Researchers in Germany and the United Kingdom looked at brain scans of people who were given painkillers — half the group was told they’d be given strong painkillers, while others were just told they’d be given a placebo. They found that people who were told they’d be given the painkillers had signs of relief, while those who thought they were taking a placebo had the effectiveness of the drugs completely eliminated. Positive thinking helps, but expectations are important as well.

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5. Price of Treatment Affects Results

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Researchers at the University of Cincinnati performed a test on 12 people with moderately advanced Parkinson’s. They gave each of them a placebo and told them that they were effective for the treatment of Parkinson’s, but some were told their pills were 15 times more expensive to make than the alternative. Those who received the “expensive” placebo showed a greater improvement than people who took the “cheaper” placebo. In another test, 67% of the participants had improvement from the expensive placebo, while 58% said they felt better after taking the cheap placebo. These tests show how much our expectations play into medical treatment. If someone’s medication costs more, they have higher expectations for it to work.

4. Brand Names Affect Results

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The perceived cost isn’t the only thing that changes how well a placebo works. Studies have shown that people believe brand name drugs are more effective than generic drugs, even though both drugs are identical in every aspect except for name, color, shape and size.

Brand name drugs are much more expensive because pharmaceutical companies put a lot of money into research, development and marketing. A generic drug is released after the patent runs out, which is 15 years after regulators approve it. So while prescribing brand names after that period is an incredible waste of money for insurance companies and patients alike, they’re more effective simply because people think they’ll be. They’re not inherently superior, but we have a tendency to connect brand names to quality.

3. Placebos Work Better Than Ever Before

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Researchers have found that the placebo effect is getting more powerful, especially in studies that involve antidepressants, anti-anxiety agents and pain relievers. This strange phenomenon has been a problem for pharmaceutical firms, because it makes it more difficult to get drugs approved by the FDA. One theory is that people now have more faith in doctors and pharmaceuticals. During studies for drugs, participants get one-on-one attention from the doctors who prescribe them medication. Just visiting a doctor has therapeutic powers, and then they prescribe drugs that the participants expect to work. Our expectations have been raised, making placebos more effective in an almost cyclical relationship.

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2. It Can Still Work Even If You Know

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Even when people know they’re taking a placebo, the treatment can still be effective if they expect it to be. Researchers at Harvard performed a study on 80 patients who suffered from irritable bowel syndrome (IBS). Half of them didn’t take anything, and the other half took placebo pills. They were plainly told that they were “placebo pills made of an inert substance, like sugar pills, that have been shown in clinical studies to produce significant improvement in IBS-symptoms through mind-body self-healing processes” (note the difference from entry six, where patients were explicitly told that the placebos didn’t work). They even printed Placebo on the bottle.

By the end of the test, about twice as many people in the placebo group felt better than the control group. Amazingly, the known placebos worked as well as some of the strongest IBS medication.

1. Placebo Surgery is Effective

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It’s one thing to take a pill or receive a shot as a placebo, but surgery is another matter. A surgery physically changes someone, but crazily enough a number of different studies have shown that people feel better and start to heal after placebo surgeries. In Finland, surgeons had patients come in to have surgery to repair torn cartilage. Half the patients received the surgery. The other half were anesthetized, then the doctors cut them open and pretended to perform the surgery, going through all the same motions but not actually operating. Amazingly, both groups improved.

Another study found this worked on people with broken vertebrae. Half of the test subjects would go in for vertebroplasty, which would reconstruct the vertebrae, while the other half was given a placebo surgery. In two different trials, they found the placebo surgery worked just as well as the real surgery. There are still a lot of questions about how placebo surgeries work, but the implications are staggering.

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