Placebo Effects

[CMdeux]

This is a thread topic that I've been mentally flossing for quite a while. 


It's just that this week in particular, a few things have popped up in press releases that caught my attention on the subject.  Interesting stuff.

More expensive "drugs" work better than cheap ones.]http://www.fiercebiotech.com/story/one-big-reason-why-cns-drug-development-has-foundered/2015-01-29]More expensive "drugs" work better than cheap ones.


In other news-- homeopathy, much? 

"gluten sensitivity" might be placebo effect

In related news, apparently the placebo effect is "dose" dependent after all.  {snicker}


Okay-- seriously, though.

I think this combination of things is a HUGE reason why some people can-- with complete seriousness and seeming to have anecdotal evidence backing that claim-- to have been "cured" of food allergy via means which seem to lack any and all scientific or medical validity.  (NAET, homeopathy, wackadoo Woo of all flavors). 

 The point is-- as long as the original claim (food sensitivity/allergy) is equally equivocal (or at least cannot be backed by a monitored blind challenge), their BELIEF that they would be cured is all that apparently matters.  Well, and the size of the payments for treatment.

I wonder, also, how this plays into reaction severity even for those who ARE legitimately allergic, however.  I know that this is something that we've discussed in this community a lot over the years-- and concluded that there is probably a small subset of people who are geniunely "that sensitive" in terms of aerosol reactivity-- on the basis of the fact that so many of them can be triggered with exposures that they are not aware of a source for.  We've seen that far too many times to discount it in my own DD, for example-- she can react to an exposure that she has no idea is occurring, or one that she FIRMLY believes will be "fine" and turns out not to be. 

For many people, though-- and I am thinking specifically of an anecdote from Denver, in which during a challenge a child mounted a rather convincing "reaction" which was to the placebo. 

Belief isn't everything of course. 

But it makes me ponder whether or not belief in rescue meds is also a factor in some reaction outcomes.  Does BELIEVING that benadryl (or epi) will work to stop a reaction play some role in doing so?  I wonder.  Now that, clearly, is not a study which can be conducted in human subjects.  Because, ethics.  (And really, good thing, right?)  But I wonder.



Also-- please feel free to dig up or link to the original research articles-- I'm too lazy to do so after trolling PMC and PubMed for a living much of each week.  I was kicking back with the news this morning when my brain ran into this pair.

[LinksEtc]

I put a link to this thread in my research thread.   

[LinksEtc]

RT by @ckeet


"Can placebo pills help cancer survivors manage fatigue?"
http://www.cbsnews.com/news/can-placebo-pills-help-cancer-survivors-manage-pain/

We've known that placebos can produce benefits for over 50 years, but Ted has shown that you don't have to deceive patients by making them think they are taking a real drug

Even when they know it's a placebo, many still report reduced symptoms and some even manifest physiological changes as if they had taken a real drug.

[lakeswimr]

There are limits to placebo.  Where is the limit WRT FAs, I don't know but I would guess that it ain't going to do much for anaphylaxis.

[SilverLining]

The one comment on CM's first link raises some interesting points.

Do the results of this study suggest that Parkinson's symptoms are exacerbated by depression, or low levels of dopamine transmission ? The "placebo effect" here seems to be a short term boost in mood and morale. Presumably, the improvements in motor skills were achieved as a result of improved focus and determination on the part of those patients who believed that they had received a powerful drug. Can researchers find ways to manage patient mood to help patients experience improved function despite their neurodegenerative disease symptoms ?

[SilverLining]

I wonder, also, how this plays into reaction severity even for those who ARE legitimately allergic, however.  I know that this is something that we've discussed in this community a lot over the years-- and concluded that there is probably a small subset of people who are geniunely "that sensitive" in terms of aerosol reactivity-- on the basis of the fact that so many of them can be triggered with exposures that they are not aware of a source for.  We've seen that far too many times to discount it in my own DD, for example-- she can react to an exposure that she has no idea is occurring, or one that she FIRMLY believes will be "fine" and turns out not to be. 

For many people, though-- and I am thinking specifically of an anecdote from Denver, in which during a challenge a child mounted a rather convincing "reaction" which was to the placebo. 

I have admitted when I first had an anaphylactic reaction it was followed by some anxiety attacks that did a really good job of pretending to be anaphylaxis. (These were not biphasic reactions. I do not mean only hours or days after anaphylaxis.)

[ninjaroll]

DH and I were talking on the subject of data gathering, tool sets, skill sets and interpretation.  Part of it will be the patient, but the majority rests upon the caliber and context of the evaluator who presents his or her interpretation.

[LinksEtc]

Tweeted by @eliza68


Placebo Effects in Medicine
Ted J. Kaptchuk, and Franklin G. Miller, Ph.D.
N Engl J Med 2015; 373:8-9July 2, 2015DOI: 10.1056/NEJMp1504023

http://www.nejm.org/doi/full/10.1056/NEJMp1504023?query=TOC#.VZSJDtvOMAE.twitter

Placebo effects are often considered the effects of an “inert substance,” but that characterization is misleading. In a broad sense, placebo effects are improvements in patients' symptoms that are attributable to their participation in the therapeutic encounter, with its rituals, symbols, and interactions.

[CMdeux]

Exactly-- the magic of "holistic" care may be in the placebo effect, all right-- but that doesn't make it "ineffectual" by any stretch of the imagination.

http://www.nejm.org/doi/full/10.1056/NEJMp1504023

 

[Josh]

Look up the plastic rose effect. A woman claiming to be serlverely allergic to roses was presented with a plastic rose. When she smelled it she had a reaction despite it being fake. They call it a "nocebo" effect.

I wonder if I suffer from a "nocebo" effect. After all I am a huge hypochondriac. I'm also suspecting EE because I can swear to you, things I'm not allergic to make my chest so tight. I've had the epi pen in my hand debating rather the reaction is real or no. So far I guess it hasn't.

My mom had a severe reaction to an allergy test for dogs and cats. If she knows I was at a friends house with animals shell say she can't breathe. If I lie about where i was and wear my dog hair contaminated cloths she does just fine.