Sarah’s Health Notes: Decoding the placebo effect
Here’s a paradox.
According to the US National Institute on Ageing, ‘the “gold standard” for testing interventions in people is the “randomised, placebo-controlled” clinical trial. That means volunteers are randomly assigned - that is, selected by chance - to either a test group receiving the experimental intervention or a control group receiving a placebo or standard care.’
As NHS pharmacist Ranjeev Sidhu from Derby points out, ‘pharmaceutical companies spend billions every year in trials where the drugs effectively try to “beat” the placebo. Sometimes they do, sometimes they don’t. But the placebo – or dummy drug – always has an effect. In fact, placebo is the most researched phenomenon in medicine.’ Despite this clear evidence that it works - and the window between placebo and drug benefit sometimes being small - giving a placebo in medical practice is seen as unethical, due to the perceived deception and lack of transparency.
In his new paperback, Our Secret Super Power, Sidhu argues that patients would be better served if the medical profession acknowledged the value of the placebo effect and utilised it. ‘The placebo effect is definitive proof that the body has the capacity to heal itself. We need to educate clinicians and patients to harness this power,’ he says.
Asked to define the placebo effect, he explains it is ‘a psychological response to any therapeutic encounter that causes an improvement in a patient’s condition. This psychological response creates a psychological reset stimulating a shift in mind set – a change of consciousness – that can influence various clinical and physiological outcomes relation to health and allow the body to achieve a state of homoeostasis.’
As with everything, the placebo response will vary with individuals, Sidhu adds. ‘It is mediated by diverse factors including the relationship between health professional and patient, learning/education and expectations. In fact, the benevolent placebo effect has an evil twin called the nocebo effect where a patient experiences side effects when they are expecting a negative experience.’
Among the many factors that can enhance or decrease the placebo effect is the colour of pills. According to a survey in the International Journal of Biotechnology, researchers found that yellow pills ‘work’ better for depression, red for alertness and green to soothe anxiety symptoms. Pills with a brand stamped on them have a better effect than plain pills.
The placebo effect can also work in surgery. Researchers found that going through the process of surgery without actually doing it – so-called ‘sham’ surgery - showed improved health in some cases. And with animals: pharmaceutical companies now employ the same double blind procedures on dogs when testing canine medication as they do for human medications. It was originally expected that the placebo effect was a human phenomenon that would not work in animals. But it seems that non-human sentient beings also respond well to a caring and empathetic approach since placebo groups have reacted positively to dummy drugs.
Curiously perhaps, the placebo effect even works when patients know they are taking a placebo. Previously it was thought that the placebo effect only worked unconsciously but it has now been established there can be an effect even when a patient knows they are taking a dummy pill.
College of Medicine Chair Dr. Michael Dixon, who wrote a Foreword for this book, calls placebo ‘the most comprehensive, powerful effect we have in medicine’. He believes it is a huge part of everyday medical practice but that it is underestimated, underused and under-researched.
Sidhu says: ‘By using the placebo effect consciously in practice and educating people about what they can do for themselves, I believe many people could be helped to prepare better for their healing journey and help the process of healing.’
This is, of course, not to deny the usefulness and necessity of pharmaceutical drugs but to suggest adding in the power of the placebo effect.
Our Secret Super Power by Ranjeev Singh Sidhu/£9.99 - buy here
