Would you want to know if a medication you were taking was working as a placebo?

[emzie]

From wiki, so we're on the same page:

A placebo is a sham or simulated medical intervention. Sometimes patients given a placebo treatment will have a perceived or actual improvement in a medical condition, a phenomenon commonly called the placebo effect.

...

In one common placebo procedure, however, a patient is given an inert pill, told that it may improve his/her condition, but not told that it is in fact inert. Such an intervention may cause the patient to believe the treatment will change his/her condition; and this belief may produce a subjective perception of a therapeutic effect, causing the patient to feel their condition has improved — or an actual improvement in their condition.

So let's say you're suffering from a condition not very well understood, like fibromyalgia. Your doctor puts you on a real medication (so not an inert pill) and you experience an improvement. Later, further research on the medication shows that it is no more effective than a placebo. Would you want to be informed of this?

It should be noted that even patients who know they're taking a placebo often show improvement.

 

[Silurian]

They have done studies where people have been told they were taking a placebo and they still showed a positive effect.

Added did not read all of OP

From Guardian

Placebo effect works even if patients know they're getting a sham drug
...

....
To investigate the limits of placebo, Prof Ted Kaptchuk of Harvard Medical School's Osher Research Center divided 80 patients suffering from irritable bowel syndrome (IBS) into two groups: one received no treatment and the other was given dummy pills to take twice a day. The second group was told by the doctors that they would be taking "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".

"Not only did we make it absolutely clear that these pills had no active ingredient and were made from inert substances, but we actually had 'placebo' printed on the bottle," said Kaptchuk. "We told the patients that they didn't have to even believe in the placebo effect. Just take the pills."

http://www.guardian.co.uk/science/2010/dec/22/placebo-effect-patients-sham-drug

 

[Kyriakos]

Hm, any more info on your closing statement?

I would suspect that the reason placebo's are working with some patients is that illnesses are not a merely somatic phenomenon, but they are psychosomatic. So believing you will get better has very real effect on how your state develops, although it is not yet examined thoroughly just how much such an effect contributes to the development itself.

But i would be surprised if a patient who knows he is taking sugary water as medicine, improves while knowing he just had that soft drink.

 

[Tahuti]

Of course I want to be informed it is a placebo. Even though the medication may soothe the pain provided I'm uninformed, the reason I take medicine - when demanded - is to cure and not to hide illnesses.

And btw, I disapprove of alternative medicine and placebo therapies in general.

 

[emzie]

They have done studies where people have been told they were taking a placebo and they still showed a positive effect.

... and I stated this.

Hm, any more info on your closing statement?

I would suspect that the reason placebo's are working with some patients is that illnesses are not a merely somatic phenomenon, but they are psychosomatic. So believing you will get better has very real effect on how your state develops, although it is not yet examined thoroughly just how much such an effect contributes to the development itself.

But i would be surprised if a patient who knows he is taking sugary water as medicine, improves while knowing he just had that soft drink.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3008733/?tool=pmcentrez

Placebo treatment can significantly influence subjective symptoms. However, it is widely believed that response to placebo requires concealment or deception. We tested whether open-label placebo (non-deceptive and non-concealed administration) is superior to a no-treatment control with matched patient-provider interactions in the treatment of irritable bowel syndrome (IBS).

...

Open-label placebo produced significantly higher mean (±SD) global improvement scores (IBS-GIS) at both 11-day midpoint (5.2±1.0 vs. 4.0±1.1, p<.001) and at 21-day endpoint (5.0±1.5 vs. 3.9±1.3, p=.002). Significant results were also observed at both time points for reduced symptom severity (IBS-SSS, p=.008 and p=.03) and adequate relief (IBS-AR, p=.02 and p=.03); and a trend favoring open-label placebo was observed for quality of life (IBS-QoL) at the 21-day endpoint (p=.08).

Of course I want to be informed it is a placebo. Even though the medication may soothe the pain provided I'm uninformed, the reason I take medicine - when demanded - is to cure and not to hide illnesses.

And btw, I disapprove of alternative medicine and placebo therapies in general.

What if it's a poorly-understood condition that currently has no cure? You'd prefer the truth to alleviated suffering?

 

[Kyriakos]

Of course I want to be informed it is a placebo. Even though the medication may soothe the pain provided I'm uninformed, the reason I take medicine - when demanded - is to cure and not to hide illnesses.

And btw, I disapprove of alternative medicine and placebo therapies in general.

It is not exactly "alternative" medicine, since placebos and dynamic (psychosomatic) therapies existed since Hippocrates. So they are very much western, mainstream medicine, i bet even Galenos used them

 

[Kyriakos]

... and I stated this.



http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3008733/?tool=pmcentrez






What if it's a poorly-understood condition that currently has no cure? You'd prefer the truth to alleviated suffering?

Interesting. But keep in mind that if one is told he is taking a placebo, he may very well react by trying to get better, so as to prove something. This in effect ruins the normal psychosomatic balance the patient without the truth would have had

 

[emzie]

It is not exactly "alternative" medicine, since placebos and dynamic (psychosomatic) therapies existed since Hippocrates. So they are very much western, mainstream medicine, i bet even Galenos used them

Alternative medicine is medicine that has been shown to not work. Placebos are shown to improve conditions.

I generally cringe when I hear someone say, "holistic medicine" but there's a huge benefit when a patient feels they're being cared for beyond data sheets. Compare good doctors who listen, who humour, who show compassion to those who are of the mindset, "X is broken, Y fixes X. Here's Y, have a good day." It's one of the reasons CAM can be so effective. You have an "expert" paying a lot of attention to you and listening to your problems.

Interesting. But keep in mind that if one is told he is taking a placebo, he may very well react by trying to get better, so as to prove something. This in effect ruins the normal psychosomatic balance the patient without the truth would have had

Another example might be animals. If you associate a specific treat with a medication, if you continue to give the treat but stop giving the medication, the animal will continue to show improvement against a control of stopping treatment with no association.

 

[Kyriakos]

Seems logical to assume that when one is in need (eg when he is sick) he tends to feel weaker than normal, and so will concentrate his powers into defending against an environment he considers to be hostile. Those powers would be instead put to good use to help with his illness, if he is in a safe and friendly environment. I do not see anything spiritual or otherwise 'alternative' in it, it seems to be common sense.

 

[NickyJ]

Only if it the medication is very expensive. I mean, placebos have been known to work simply because people think it will work. I know, I know, placebo effect works even if patients know they're getting a fake drug, but still, I'd want to have full faith in it, which could help. If it's expensive though, I don't want to waste big money on something that isn't known to really be helping.

 

[say1988]

So let's say you're suffering from a condition not very well understood, like fibromyalgia. Your doctor puts you on a real medication (so not an inert pill) and you experience an improvement. Later, further research on the medication shows that it is no more effective than a placebo. Would you want to be informed of this?

I take it we are under the assumption that there is no alternative treatment for the cause? In which case I want symptom reduction, so nope. If it was dangerous then provide me a "new formulation" that is safer.

They have done studies where people have been told they were taking a placebo and they still showed a positive effect.

Added did not read all of OP

From Guardian




http://www.guardian.co.uk/science/2010/dec/22/placebo-effect-patients-sham-drug

Personally, if I were in that study, I would assume that the drugs weren't placebos and they were trying to make me think that.

Of course I want to be informed it is a placebo. Even though the medication may soothe the pain provided I'm uninformed, the reason I take medicine - when demanded - is to cure and not to hide illnesses.

Of course, there is also the possibility that the major problem is psychological as well.

 

[emzie]

I opened this thread because I had sprung upon me, rather unexpectedly, that a medication I take is no more effective than a placebo. I went through a day of being irrationally angry at the source, and a denial in which I thought the data must be wrong since I showed improvement. Then in a moment of humility, I realized that's the same reaction I've seen in believers of CAM. I had to concede (to myself) that my anecdote doesn't stand up to a meta review.

I think I'd prefer to have never known though. I'm not sure if knowing intellectually a medication is no more effective than a placebo will cause it to stop working, but I'd rather not be thinking about it in the first place.

I take it we are under the assumption that there is no alternative treatment for the cause? In which case I want symptom reduction, so nope. If it was dangerous then provide me a "new formulation" that is safer.

Yes. Either there's no good alternative or a proven effective alternative has very uncomfortable side effects (perhaps like first generation anti-psychotics).

 

[warpus]

It should be noted that even patients who know they're taking a placebo often show improvement.

Really? Source?

I read an article on placebos in Scientific American or some such magazine (Nature? Discover? I forget).. It was a while ago and very interesting.. At the time of reading, placebos were not really understood that well.. in terms of how and why they actually work.

So I'm not really sure what I'd do. I'd probably want to know.

 

[emzie]

Really? Source?

I read an article on placebos in Scientific American or some such magazine (Nature? Discover? I forget).. It was a while ago and very interesting.. At the time of reading, placebos were not really understood that well.. in terms of how and why they actually work.

So I'm not really sure what I'd do. I'd probably want to know.

http://forums.civfanatics.com/showpost.php?p=11053916&postcount=5

 

[say1988]

I agree that discovering it on your own would be awkward. But so long as it isn't very expensive and doesn't present a health risk I am perfetly happy to take what is effectively a placebo.

 

[warpus]

http://forums.civfanatics.com/showpost.php?p=11053916&postcount=5

Crazy! Have these results been reproduced by another study?

 

[emzie]

Crazy! Have these results been reproduced by another study?

Without access to a lot of journals, NIH gave me a few abstracts showing a similar result, but in very small trials.

 

[jtb1127]

I'd say yes. I always try to convince myself.

 

[Akkon888]

What does "working" mean?

If "working" means that the medicine relieves the ailment via some chemical, drug etc., then by definition it cannot be a placebo, which is supposed to be inert.

If, on the other hand, "working" means that the person psychologically feels as though he is receiving some benefit (without there begin a tangible benefit), then it would be in the best interest to NOT inquire whether the medicine is a placebo or not.

I am skeptical about the data stating that a placebo works even when the patient knows that it is a placebo. Oh well, it is what it is.

If the pill cost an astronomical amount of money, I would like to know. If the pill is relatively cheap, I would prefer not to know.

 

[GenjiKhan]

Absolutely,because I can create my own medication . I'd just need to throw away all the skepticism that I have about it .