- What is the placebo effect?
- Can it really help conditions like migraines and depression?
- Placebo effect examples and case studies
Chances are, you’ve probably heard about sugar pills or plain saline syringe injections appearing to help people with everything from cancer and fatigue to chronic pain. In this blog post, you’re going to find out everything there is to know about the famous placebo effect.
What Is a Placebo Effect?
When a person’s physical or mental health appears to improve after receiving a placebo or ‘dummy’ treatment, this is referred to as the placebo effect.
The term ‘placebo’ refers to a treatment that appears to be effective but is actually ineffective. A placebo may take the form of a sugar pill, an injection of water or salt water (saline), or even a phoney surgical procedure.
The placebo effect is triggered by the individual’s belief in the treatment’s benefit and expectation of feeling better rather than by the placebo’s characteristics.
Placebos are frequently used in clinical trials to help determine the true effect of a new treatment – both the positive and negative effects.
Placebo vs. Placebo Effect
It is important to understand that a “placebo” and the “placebo effect” are different. The phrase placebo refers to the inert substance itself, but the term placebo effect refers to any medication side effects that cannot be linked to the treatment itself.1
Let’s look at a story, shall we? The Reddit user named NeoCoN7 experienced this very thing, although second-hand. In high school chemistry class, their teacher gave everyone a drop to taste (supposedly) pure alcohol. Ten minutes later, a large group of girls started to behave…, well, for lack of a better term, drunk. Giggly and swaying on their stools throughout the entire class. Just before the end of the lesson, their teacher revealed the truth, that the ‘alcohol’ was just pure water. Talk about second-hand embarrassment.
Intrigued? Here’s another one. Seventy-one-year-old Jim Pearce was in a wheelchair experiencing excruciating chronic back pain, for which he needed morphine for. Little did he know how much a little blue and white striped ‘pill’ would change his life. One tiny detail, though; the pill in question was nothing but ground rice—a placebo.
His response when asked about his pain? “I just woke up one morning, and I thought, hang about, I haven’t got a twinge in my back. And it’s been going from strength to strength.”
Studies and Research on the Placebo Effect
A 2014 study looked at how people thought about the world.
Researchers looked at 66 participants on how the labelling of drugs made them more likely to get migraines. How the study was set up:
During six different migraines, the people who took part were asked to take a pill to help. At these times, they were given something called Maxalt, which is used to treat migraines.
The labelling of the pills changed a lot during the study. They could be called a placebo, Maxalt, or any other type of medicine (neutral).
During a migraine, people were asked to rate how much pain they felt 30 minutes into the migraine, take their pill, and then rate how much pain they felt 2.5 hours later.
Placebo, Maxalt, or a neutral pill label affected how much pain people said they felt. The following are the results of the test:
As expected, Maxalt gave more relief than the placebo did. However, placebo pills were found to help more than a control group that didn’t get any treatment at all.
It turned out labelling was important! People who took Maxalt and a placebo were asked to rate how much relief they felt based on their labels. People in both groups who took Maxalt pills had higher scores than people who took placebo pills.
A placebo labelled as Maxalt gave the same amount of relief as one labelled as a placebo that was labelled as Maxalt.
A study published in 2015 examined the placebo effect in 35 individuals with depression. At the time of the study, participants were not taking any additional antidepressant medication. The study was designed as follows:
Each subject was given a placebo pill. However, some were labelled as an antidepressant with a rapid onset of action (the active placebo), while others were labelled as a placebo (the inactive placebo). Each group was assigned to take the pills for a week.
After the week was up, a PET scan was used to determine brain activity. The active placebo group received a placebo injection during the scan, explaining that it may improve their mood. No injections were given to the inactive placebo group.
For another week, the two groups switched pill types. A second PET scan will be performed at the end of the week.
Following that, all participants received ten weeks of antidepressant treatment.
The researchers discovered that some individuals experienced the placebo effect, which affected their brain activity and antidepressant response. The findings were as follows:
When people were given the active placebo, depression symptoms were reduced.
Taking the active placebo (including the placebo injection) increased brain activity in areas associated with emotion and stress regulation, as measured by PET scans.
Individuals who had increased brain activity in this area frequently responded better to the antidepressants used at the end of the research.
Fatigue As an After Effect from Cancer
Fatigue may persist as a symptom for some cancer survivors. In 74 cancer survivors with fatigue, a 2018 study tested the effects of a placebo versus standard treatment. The study was carried out in the following way:
Participants got either a tablet labelled as a placebo or their usual treatment for three weeks. After three weeks, those taking the placebo pills discontinued use. Meanwhile, patients getting standard care chose to take the placebo pills for three weeks.
Following the study’s conclusion, the researchers found that the placebo affected both groups of participants despite its labelling as a placebo. The following were the findings:
After three weeks, those getting a placebo reported improved symptoms compared to those receiving standard treatment. Additionally, they reported ongoing improvement in symptoms three weeks following discontinuance.
Individuals receiving standard treatment who chose to take the placebo tablet for three weeks likewise reported improved fatigue symptoms after three weeks.2
Factors That Increase the Likelihood of The Placebo Effect
Expectations And Attitude
Kind of like a self-fulfilling prophecy, expectations, or what we think will happen, have been found to play a key role in the placebo effect. People who are very excited about the treatment and think it will work may be more likely to have a placebo effect.
It can even affect how a patient responds to treatment if the prescribing doctor is psyched about it. Patients may be more likely to benefit from taking a drug if their doctor is sure that it will work. Verbal, behavioural, and social clues can help people think that the medication will work.
Genetics May Be at Play
Genes may also impact how people respond to placebos. Some people respond better to placebos than others. One study indicated that those with a high-dopamine gene variant are more susceptible to the placebo effect than those with a low-dopamine variant. The high-dopamine variant of this gene also increases pain perception and reward-seeking.
Hormones in Action
Taking the placebo may have caused endorphin release. Endorphins are produced naturally by the brain. Using brain scans, researchers showed that both the placebo and treatment groups stimulated areas that contain numerous opiate receptors.
The Polar Opposite of Placebo Effect
The “nocebo effect,” on the other hand, refers to the phenomenon in which people respond to a placebo by experiencing an increase in symptoms or adverse effects. A patient may complain of headaches, nausea, or dizziness after taking a placebo.3
Even though the placebo effect can significantly impact how you feel, it’s important to bear in mind that it isn’t a cure-all.
It is unethical for healthcare providers to use placebos in real life without telling their patients. This reduces or eliminates the placebo effect. However, scientists can better understand how medicines affect patients and if newer and more innovative medications and treatment approaches are safe and successful by using placebos in studies, during which they do not have to inform the subject.
We hope you enjoyed this blog post and found it informative. What’s your experience with placebo effects working? Share them down in the comments section below. Thank you!