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Tuesday, June 9, 2009

Placebo effect

A placebo (Latin for "I shall please") is a pharmacologically inert substance (such as saline solution or a starch tablet) that produces an effect similar to what would be expected of a pharmacologically active substance (such as an antibiotic). By extension, "fake" surgery and "fake" therapies are considered placebos.

Maimonides recommended in his Treatment of Sexual Disorders urinating into a hollow carrot as a cure for impotence. Well into the 17th century, the London Pharmacopoeia (as much of an authority as existed then) listed among its medicinal agents such things as the saliva of a fasting man, lozenges of dried viper, fox lungs and shed snake's skin and sutures of the skull of an executed criminal among others.

In 1939, long before high-tech drugs came along to treat the chest pain known as angina, an Italian surgeon named Fieschi devised a simple technique. Reasoning that increased blood flow to the heart would ease his patients' pain, he made tiny incisions in their chests and tied knots in two arteries. The results were spectacular. Three quarters of all patients improved." One third were cured.

Forty years ago, a young Seattle cardiologist named Leonard Cobb conducted a unique trial of a procedure then commonly used for angina, in which doctors made small incisions in the chest and tied knots in two arteries to try to increase blood flow to the heart. It was a popular technique—90 percent of patients reported that it helped—but when Cobb compared it with placebo surgery in which he made incisions but did not tie off the arteries, the sham operations proved just as successful.

Some doctors belive that the placebo effect is mainly or purely physical and due to physical changes that promote healing or feeling better. So, what is the explanatory mechanism for the placebo effect? Some think it is the process of administering it. It is thought that the touching, the caring, the attention, and other interpersonal communication that is part of the controlled study process (or the therapeutic setting), along with the hopefulness and encouragement provided by the experimenter/healer, affect the mood, expectations, and beliefs of the subject, which in turn triggers physical changes such as release of endorphins, catecholamines, cortisol, or adrenaline. The process reduces stress by providing hope or reducing uncertainty about what treatment to take or what the outcome will be. The reduction in stress prevents or slows down further harmful physical changes from occurring. The healing situation provokes a conditioned response. The patient's been healed before by the doctor (or thinks she's been healed before by the doctor) and expects to be healed again.

57 comments:

the walking man said...

Back in the day I could always tell the difference between smoking oregano and something with an uhhh more active ingredient.

Mariana Soffer said...

TWM:I still get confuse every now and dthen between licking the superman ssticker and the LSD tablet

ines,gato@yahoo,com said...

I was thinking, since you brought up the subject that most of the nowaday illegal drugs where used a medicine, ahd they where supposed to be great for the problem at their time. Among the ones I can recall are heroine, cocaine,lsd and nowadays pot

Mariana Soffer said...

Ines: thank you very much for your collaboration. IT is true the fact that all those drugs have been used for curing illness, but I woudnt say that they where all preciselly placebos. For example cocaine was a marvelous antidepresant, but it stoppped being used due to the problems it brought the long term exposure to it. So it is not a placebo cause it work, the fact that it has been problematic afterwords is another issue,

Neil R Graf said...

i have been reading and thinking about iatrogenic disorders and nosocomial infections, in the context of oncology and psychology. placebo theory is certainly related. thanks!

Mariana Soffer said...

I am glad the information is somehow usefull. I find nosocyomial infections more related to placebos than iatrogenic disorders.
I did some research long time by applying datamining and multivariate statistics techniques to iatrogenic disorders, but the project ended before any conclusion could be reached

Rob Bryanton said...

Hi Mariana, another fascinating blog entry, thanks for sharing. My youngest son is a fourth year med student, and I'm increasingly fascinated by the new scientific studies indicating how much control we each have over own health. This gets very tricky: in a blog published today I talk about the "nocebo effect", where drug/placebo studies have shown that simply warning a patient about possible negative side effects might cause those symptoms to manifest in people who are taking the placebo!
http://imaginingthetenthdimension.blogspot.com/2009/06/placebos-and-nocebos.html

It does indeed seem like you and I are having a conversation outside of space-time, doesn't it? I love synchronicity. Keep up the great work!

Rob Bryanton

Mariana Soffer said...

Yes it is amazing the hability we have to control our body, wether release the tensions in the muscles, stop different
kind of aches, modify our emotional state. But beware because all this hability we have for healing ourselves we also
have for harming ourselves. This hability is very powerfull, but since it hasn't been payed much atention to, many people
have suffered from self inflicted afflictions without even knowing it.
Very intresting your post, it is amazing also that just with the mention of the postive and negative effects the person
is induced to experiment them.

We ll keep talking in the X demension for sure, I am not planing to change to another one. I wanted to congratulate you for
your great work in explaining this phenomenom, it is really clear and intresting to read.
Best Regards
Mariana

Uncle Tree said...

This is huge, Mariana! There have been tons of books written on the subject of the mind/body connection. They've known about this in the East for thousands of years. The ol' "mind over matter" is at it again.

Except for those Christian Scientists, who also refuse to do surgery when it is obviously required. There are other groups like that too. It's really all 'faith-based', this placebo stuff. They use this for the argument that one ought to pray like hell to stay well, and pray even harder, after confessing all your sins of course, pray even on your hands and knees if your lips hurt from kissing the feet of your healer, literally and/or figuratively.

There is no replacing psychoactive drugs, if you ask me. But, I do believe that one just might be able to induce flashbacks under certain kinds of stress.

Cocaine's for horses if you ask a Deadhead. The quicker-way-ker-upper is too damn good. There's just no faking it. I had a rich friend who blew it all away (a long time ago), that's why I can opine on this one.

Where were we...oh yes. I do believe in personal affirmations and their effectiveness over long periods of time. As in,"I make only healthy cells. Exactly the right amount, in exactly the right places, at exactly the right time, for exactly the right purpose." Some might call that a prayer. Whatever...I can't prove that it works for everyone, but I'm still here, ain't I?

That's enough comment for today. We could go on for days over this one. Do I have to be so explicitly specific next time? Hugz!

paulandrewrussell said...

I think, in a lot of cases, people just want to be listened to when they have certain problems that manifest in some physical way. Of course, physical ailments have to be cured physically for the most part, but many symptoms of an underlying physical problem can be dealt with in other ways, hence the placebo effect.

I found the heart surgery reference very interesting.

Paul

valbrussell said...

Thoughts are things and occasionally thoughts can fix things that aren't working correctly. Wonderful post mariana. :)

Mariana Soffer said...

Paul w: Yes people desperately need to be listened, they talk and tell their problems even when there's no other communication side (nobody paying attention).
Don't be so sure Paul that physical ailments require physical cures. The power of the mind is amazing.
I am glad you liked the weird surgery procedure.
Thank you very much for stepping by
M

Mariana Soffer said...

valbrusell: great phrase you said, thoughts are things, sure they are, it is like energy and matter, energy is matter and the same way around.
Nice to hear from you
M

Mariana Soffer said...

Mon Oncle:(A movie I like a lot):
I did not know about those christian scientist, they are quiet extremist, I bet that several people died without need of it.
One is able to induce lots of stuff under difference circumstances (I think), but there are times when either is too late, or the body needs an invasive procedure no Mather what.
I know about cocaine too, its pretty dangerous and pretty good, but you are destined to go down eventually.
Great one paragraph poem about the cells, great wish.
You can be as explicit as you want my uncle, either way is ok for me. I wrote this post cause both my parents where medical doctor, one on the lets do surgery or nothing side and the other on lets try this light cream. So I know pretty much what happens to people. I have my posture pretty clear.
Take care Tree and txs for comming

Uncle Tree said...

The latest news on that subject dealt with court ordered chemotherapy, and there was no precedent for that. Can you pray the cancer away once you've got it? Or does prayer work best as a preventive measure? I'll go with the latter conclusion. But I've heard chemo sucks bad! Personally, I hope never to find out.

Thanks for reminding me about your parents being doctors. I am a bit surprised they disagree a tad, but then again...they're married. You're posture looks good from here. Are you tall? Damn...

"txs for comming". You make me laugh at myself, girl! To comm-ment quickly as possible is my pleasure, don'tcha know?

Mariana Soffer said...

This is getting interesting. Whenever you have some time send me something about the story about this guy.
I DONT think that after cancer is pretty advanced anything can be done to keep the person alive, except for rays, medication, chimo, surgery for removing the cancerigenous cells. And probably something else.

I kind of agree that praying ( wont pray I would meditate dough) helps in the early stages, but only on some of them, my best friend died at 28 in a 1 month fulminate cancer attack. I do not think neither pray neither surgery could have helped him stay alive. What helped him was living life fully till the last minute.
What I do think is that leading a more equilibration life helps you avoid developing illness, such as comcerm that is the pretension I think we should take.

It s Great, you like quick comments, I loved them cause you do not repress yourself about what you are seeing, and interesting thing generally from them
Big hugh

Shubhajit said...

It is a good article and left with much brainstorming.

I think mind and body is dependent to each other. Though apparently it seems that mind is separate from body but it is not. Let’s talk in a simpler way. If we take our human body as a whole then there is a body, which consists of all organs including brain and the subtle part of the body is mind then there must be something that is beyond the mind and body. Suppose eye is the organ by which we can see the subject but actually it is just the instrument and behind that there are optical nerves. And again, the optical nerves etc is not the only source of vision, it is connected with certain portion of brain and brain by some peculiar process identify and instruct all other organs to operate. But this is not the end of whole chain, there is something beyond the brain and that we call buddhi (Sanskrit) or intellect. On that intellect plane we can identify, what vision is pleasant and not and so on. intellect gives us to interpret certain things. Now, where is this intellect come from? Every cause has its effect and vice versa. There must be something that beyond that intellect, which controls the intellect of ours. What is that? Is that the only thing? There metaphysics comes into existence. Because when we start to think from the root we are quite lost by the mystery of our body.

(Some texts from my previous article)

Some people think that there is not any existence of soul, and if there is any, it is not a separate entity from the body. They say, mind, consciousness etc are just conterminous with the brain functions. Moreover, they learn that every special form of thought is a result of the activity of a special portion of the brain. When we see things or think of the seen objects, the optical convolutions of our brain is active. Certain portions of the tympanal lobes are active when we hear, and so on. But they do not give any satisfy answers to how we see and interpret objects as nice or ugly or how we hear something that is pleasurable to our ears or not. If we analyze the complexities of our brain then we find that in a first place we cannot know matter by itself and also cannot know for by itself; that we know nothing but a mental change. When we say the matter exists, we are conscious of a peculiar mental change beyond which we cannot know. The mind cannot go beyond itself. Even our knowledge that the soul, is a function of the brain assumes the existence of another mind or knower. Whenever we say that consciousness or soul is the result of the combination of matter, that statement also requires another mind to be conscious of that idea.

Shubhajit said...

Scientific study says, every motion produces nothing but motion. As we all know that universe and life forms are created by vibration. Sub-atomic molecules vibrate to form atoms; atoms vibrate to forms molecules, molecules to form elements, elements to form matter and so on. Some sort of peculiar vibrations creates us all and it is an established fact that motion created by motion and nothing more. If this fact were true then how we can say that the molecular motion of brain-cells produces consciousness or intelligence, which is not the same as motion, but is a knower of motion? Therefore, we must admit that source of consciousness cannot be found in matter but an independent identity.

Now, come back to healing or placebo effect. Ancient times as you have mentioned here that there were queer process of treatment. In fact if you research on the eastern medicines of 5000 or 10000 years old, you will find that the whole process of healing was holistic. It was not just the body but the spiritual healing also. Without knowing the root, it wasn’t possible to cure the whole. Man is always moving against the nature and all the development comes because of this resistance. And because of that nature also has its own mechanism to perish the species by introducing different new germs and perils. As in earlier days people were more holistic and they realized the spirit also. but now days it is more of thinking and treatment based principally on gross matter. Without realizing the spirit, it is not possible to introduce a perfect healing therapy.

Shubhajit said...

Oh! I'm sorry I didn't see your blog approval thing. That's why same comment one after another.

Anyways, I also forgot to thank you for your patience.

Mariana Soffer said...

The way that conscious experience presents itself seems arbitrary and personal. Why is a particular wavelength of light seen as a particular color? Is my red your red? Qualia (properties of perceptions) are an aspect of
consciousness.

I was also thinking that Usually function is fairly obvious in our bodies but not with our consciousness, which makes it hard to see the evolutionary role consciousness plays.

here is an idea about the self: “Neurological conditions have shown that the self is not the monolithic entity it believes itself to be. It seems to consist of many components each of which can be studied individually, and the notion of one unitary self may well be an illusion … Consider the following disorders which illustrate different aspects of self.”

I agree that without addressing the spirit, and having a holistic approach it is impossible to really heal somebody, maybe medicine should be an art, the art of healing, not a hard science, which has all its sub-specialties in separate compartments
with isolated treatments for each one.

I have to thank you for taking all that time on commenting about some of my thoughts. It is a pleasure to reflect with you.
Take care, and I will probably go on tomorrow M

Uncle Tree said...

Interesting comments, Shubhajit. The individual self, (where do I end and where does another begin?) is a tricky, sticky, hindering question.

I'm thinking of the mold that grows under the ground and actually spreads itself over acres and acres of land. Each spore is separate, but not really. Distinguishing the queen bee from the rest of the hive can also present a problem in this respect.

Mariana, the art of healing is correct. That's why doctors call what they do a 'practice'.

In evolutionary terms, consciousness provides us with an ego. This ego assumes that history is a progress, when really it's only a process. Individuals do not evolve, only species can do that. There is no question of 'for better or worse', and Nature/Mind does not have a wish to survive. It can't help itself. We might also say that it not even aware of itself. If it was, it would show favoritism in one form or another.

Gotta go. Bye!

human being said...

another great subject containing interesting facts and contemplations...

and great comments too!

yes mind is very powerful...

all the world is energy and energy of our mind's thoughts can be materialized as disease or healing effects...

the best remedy and also placebo is love and care...

i've tried it lots of time... just a few positive words and gestures can change a person's state of mind in way s/he feels healthy enough to do lots of things...

of course when the illness is deep, there should be patience... and sometime the vital force is so impaired the process cannot be reversed...


i have never experimented on the other way round... but i have been subject to negative words and vibes that made me totally and physically ill for some time...

:)

oh just some babblings...

RDC said...

The placebo effect is kind weird. Actually, it could find diferents kind of placebo effects depending on the situations. I mean, it's possible placebo effects could work by means of diferent mechanisms.

See

Mariana Soffer said...

Uncle: According to Buddhist I underwerstand that the idea of us humans being completely separate, being another thing, than the world we live in is the cause of lots of suffering. I do not think they are clear strict boundaries that separe whatever kind of thing it is (even a thought) in real life.

I guess ego is the sense of self, or the self in itself. IT is fantastic what you say about history being a process not a progress (Maybe we have the need to feel we are going somewhere better). And yes the evolutionary process is a social process, not an individual one.
I have doubts with the point about the whish to survive, I think there is a parte of the mind that has the instinct of survival, which causes the urge to survive in the individual, but maybe this is not the same as a wish.
The mindis not aware of itself, guau, that is such an intresting idea, and I think I agree, You know that will make most of the current modern AI (artificial intelligence) community angry, cause one of their objectives is to make self-aware machines (cause they think we are).
Excelent reflection uncle

Mariana Soffer said...

Human being: I do think to that my readrs/friends comments are awesome, they help me understand things betters and open new doors for me.

Lovely words: "the best remedy is love and care", but remember that it also has to come from yourself, not only from others.

Completely agreewith what you said about how nice gesture can change people for good, and bad ones can really harm you.
Cute andi ntresting Bablings mr

Mariana Soffer said...

RDC: I think placebo effect can bethe same using different mechanisms, either pills, needls, reiky, and many other stuff.
You are right it also depends on how that particular placebo affects in that particular situation.
I think it is completely subjective the think that works for each person cause it depends a lot on the human perception and apreciation of both factors how the effect expresses itself.

Mr_Wrong said...

Interesting post of a complicated issue. My two cents: placebo and sham are rather different concepts. The first is an effect and the second a control procedure that is performed in order to reduce confounding factors due to the mechanics of a given intervention, such as stress. Secondly, the described surgical examples may not be considered within the placebo effects. In small trials (i.e. 90 subjects), dependent variables are likely to be trumped by confounding factors (age, gender, race, current and past conditions, etc) so the expected effect is not significant, statistically or otherwise.
Finally, most diseases are subclinical and most clinical conditions "cure" themselves regardless of treatment. I think the "power of the mind", a somehow new age concept, is highly overestimated and gives the illusion that external, medical, intervention or prevention is, for the most part, not required. A troubling example nowadays is the growing number of adults refusing to vaccinate their kids.
Saludos.

Mariana Soffer said...

Intresting viewpoint about placebos, completely agree that they are not the same than shams.

Regarding the small trial cases you might be right it's completelly true that in experiments with small populations results are easily biased by confounding factors, and that for the experiment to be statistically significant is needed an almost perfect accuracy, which can be easily aquired with this twisting factors.

About not vaccinating kids, I do not know, maybe parents are being quite extreme there, or exesively "new age" like, because this could bring serious concecuences.
On the other side I know that kids that are not given antibiotics when they get sick, develop by themselves antibodies,and on the long run,they prevent by themselves getting ill; while the ones that are medicated never develop their own protection agains the illness and always depend on medication.

Cheers to you and thank you very much.

Uncle Tree said...

Hey, Mariana, this has been fun. I may be guilty of trying to pull a fast one on you where concerns the Mind not being aware of itself. New Age folks like to capitalize a lot, and that was my imitation. Cosmic Mind vs. individual mind, with a little m.

Intelligent Design folk also go along with this idea, which is damn near the same as saying the GOD word. It is this Mind to which I was referring to as not being aware of itself. God doesn't know that He/She/It exists. The Omnipotent One has to answer this question: If God has Self awareness, and is all powerful, can He get rid of Himself? Can He make Himself disappear forever?

That's a philosophical quandary, and sort of a trick question. Nature is blind, it is said. But the patterns on animals and moths sure seem to know what they are doing when it comes to camouflage, and blending in to the surrounding scenery. It is almost as if the evolutionary force has eyes. But that cannot be. Can it? Therefore design...therefore Creator. That's how the story goes, like it or not. It was thrown out of court and the schools. It's not Science. It's only an interesting idea.

Orientals and the Hindus have no problem saying, "I am God." As opposed to being separated in the first place. Occidentals in the West see that idea as blasphemous, and how dare they say such a thing. In The Bible, God says (through an interpreter), "I am that I am, and besides me there is no other." The way I read that, Christians should not regard themselves as the other, or any other. There is no one else but God. There is no one else but Nature, and we are, each one of us, It. This is It, and It's all there is.

I may not have made myself clear, but I'm trying, sweet niece. None of this is new information. I love philosophising as much as the next person (that doesn't exist).

Mariana Soffer said...

Dear uncle I thought you could never be a capitalist even if you try very hard, at least I woudn't belive you.

In the same line that mind selfawareness comes the god one, which is also pretty intresting, but this ones has extra questions that question the almighty almightighness

The fact that nature is blind does not mean that beings
can not addapt to nature. Nature is blind and in a sense inherte, cause there is not such thing as a decision making nature, and even less a self-aware one.

Great forth paragraph, although the notion of god keeps making me uncomfortable.

I think I understood you pretty well this time, I have clear what you mean, which is not easy to explain, and i almost agree completely except for the god idea (I do not agree with any god theory or idea cause I do not agree about it with myselF)
Thankyou very much for your reflections with me, guess what I am trying to build a new artificial inteligence computational model and for example the idea that the brain is not self aware is going in it.
Send you a hugh.
Niece

theperceptionpoint said...

I really believe in the mind-body link, definitely: one is often a reflection of the other. I would even go as far as to say that most of all illnesses can be cured by our own minds.

Hope your well.

Mariana Soffer said...

Perception:There is a branch in artificial intelligence that sustains that you need a body to be able to emulate the brain, cause the body is fundamental for what the brain is and how it functions.
Txs for stepping by mr

Shubhajit said...

Regarding your confusion in my blog I posted a comment as well as I want to post it here.

****
(Whip me HARD and Laugh HARDER)

Philosophy must be realized rather than understanding.

It is all about life. the lashing of life comes with different forms but it is not about how hard we return back but how much we can take and drag ourselves forward. True springing back is hidden in the very secret that how much we can absorb.

And don't feel repentant about mistakes, just laugh. Repentance is for weak man. We are all strength. so, laugh at the child's prattle and believe that this mistake is Lord's will and it is just a process of walking on the burning path. Be divine, feel divine, make people divine. Have faith!
***

I agree with Human.
***
I disagree with you when you says Ego is self. Beyond ego there is self. Ego can only make us a species and that's why we are what we are.

Mariana Soffer said...

What you say about philosophy is true. I also think that the same fact applies to other disciplines, for example when I really get a math equation is when I can feel what it means.

Regarding lashing of life I think I understood what you mean (you tend to use quite difficult words for my english level, I am sure that causes us several misunderstandings), and agree too. The secret is in how much we can absorb because the more we can the less we return back.

I really apreciate your encouragment and advice about laughing at our mistakes, you are so right about it,

I got what you say about ego, it is true that ego is not the self, I checked the dictionary and this is the definition of it:
"the part of a person's self that is able to recognize that person as being distinct from other people and things"

Thank you very much for your comments, I am enjoying our thoughts exchanges a lot, and also learning from them.

Shubhajit said...

Dear Sister,

In a short span of time we have exchanged quite a heavy load. I've reading some of your write-ups and feeling you are a deep thinker.

It's absolutely true about mathematics thing.

I always try to use simple, nay, simplest language to express. It is just my thought,which is convoluted. I've been reading and find that you are much much learned person than me regarding use of a particular language.

I'm waning when you said, you were learning... I'm just an insignificant tiny dot, it is just the thought that are momentous. Remove the name from the writings then only form will remain. And with forms we can improve in a much better way.

maekitso said...

Hi Mariana. I'll take a stab and posit that the success or otherwise of placebos can be predicted by calculating the ratio of blue cheese to Cabernet Sauvignon present in the bloodstream at the time that one's other half admits a preference for cheetohs. Thanks for dropping by and asking after me. As you can see, nothing to worry about here.

Protervo said...

cual es el sentido de fumar orégano?

beso!

Mariana Soffer said...

Shubhajit, my friend:
Thanks for the thinker idea you have about me. I think it is
important to keep learning (specially if you get the trill of understanding new things) during all your life.

Despite I had not had enough time yet to check your blog enough, I seriously doubt I am a more learned person than you are. I think you know a lot about several issues I do not have a clue about, but anyway I do not think you can compare the degree of "learnerness" of one person to another one, humans are too complex
for humans to do that. Your humbleness is an excellent quality, unlike many people, you are one, which I consider a great quality to have, that shows wisdom, and
also gives you the possibility to keep learning new things, cause you do not think that you know it all.

Regarding the complex language, I don't know why is it that you chose the words you use, but sometimes there are beautiful words that need to be rescued.
Send you a Hugh

Mariana Soffer said...

Maekito: I think that is a new revolutionary theory, you should publish a paper about it before someone steals your idea

Protervo:
(((El mismo que planchar resortes))))
He asks what is the use of smoking organ?
and I say: the same as the use of smoking the metallic stuff inside your mattress

medicatedlady said...

There is definitely power in placebo. I think the feeling of "doing something" about a particular ailment makes us feel good. And there have certainly been times when I've said I don't care if it's placebo, I feel better.

I also think that mindset isn't all there is to illness, mental or otherwise. People die with hope all the time. People die with false hope all the time. But then, you know I'm morbid.

Mariana Soffer said...

MedicatedLady:
Same here, do not care whatever it is, just care about feeling better.

I know how you are, I do not know if morbid or more towards the sarcastic/darkish side. And its true that people die with false hopes. Like the saying
"Live in hope, die in dispair"
Thank you for stepping by, I always enjoy your comments

Lucy in the Sky said...

We still have so much to discover about the power of the mind...

Mariana Soffer said...

Lucy:Sure we do, I think we barely know anything. Thanks for stepping by,.

Harlequin said...

a great piece with history and mystery... I love the history of science stuff ... as if the body were an object like a rock or a phenomenon like a rainfall or an experiment with degrees of freedom that one can actually control...
but what I liked more were all the great comments that this entry spurred... and/or spawned...and I liked the Latin.. most of all.
looking forward to being a more frequent visitor... now that my well earned sabbatical is nye...

Mariana Soffer said...

Harlequin: I like how you describe the history of science (I like it too), because science can be kind of arrogant, it believes it can discover all the mysteries about about how things work, and even reproduce them by making models from the observations taken. But I guess there is more to life than that strict models and hard rules.
I love the people who comment on my blog too, there are extremely creative, nice and interested about learning new stuff.

Looking forward to see you often Harlequin (I have a painting with a violet one; one of these day I will send you a picture). I will also keep reading your alluring entries.
take care
M

Mariana Soffer said...

The latest research in the area:
"Our results are in agreement with those of other meta-analyses," Kirsch and Sapirstein explained, "revealing a substantial placebo effect in antidepressant medication." "They also indicate that the placebo component of the response to medication is considerably greater than the pharmacological effect."

daedalus2u said...

I have my own interpretation of the placebo effect.

http://daedalus2u.blogspot.com/2007/04/placebo-and-nocebo-effects.html

The placebo effect is particularly strong in conditions that are caused or exacerbated by low NO, (such as depression for example).

Mariana Soffer said...

daedalus2u:
first some definitions:
"The nocebo (I will harm) effect is similar, and is usually considered to be the opposite of the placebo effect, but actually is somewhat different.

Contrary to popular belief, both of these effects are misnamed, in that harmful effects can occur via placebos, and beneficial effects via nocebos."

How it works:
"I will consider two extreme metabolic states, the "fight or flight" state (FoF), and the resting and relaxed state (RnR). It is well known that organisms can invoke such states and FoF results in the characteristic physiological effects of "stress", and if prolonged can cause physical disorders associated with "stress". RnR reverses the effects of stress, but to do so, has to occur within a certain time period.

I suggest that placebos invoke the RnR response, and that nocebos invoke the FoF response."

And then he shows lots of examples that happen in real life, and tries to chain together the cause and the effects of them all.

I do recommend reading this article, seriously, cause I find it really interesting the different proposal it shows about how this mechanisms work.
If you have any trouble with the technical language please do not hesitate and ask me please.
Take you very much for your intresting approach to the causes and effects this complex mechanisms have, according to what it is proposed here.

J said...

So, according to daedalus2u, we have bacteria on our skin that produe NO, which makes its way into the body an provokes a relaxation response, and one pupose of our hair is to harbour these bugs and provide a means to transport the NO.
So if you are a hairy smelly hippy who never shaves her pits then you will be more relaxed?
I have that right?
And if that is so, what are the consequences of all that shaving, scrubbing, plucking, waxing?

Mariana Soffer said...

J

I do not think it works that way, if you check the deffinition of it in wikipedia there is part that says:

Exercise. From the authors' clinical experiences, sweating induces commonly observed effects of exercise on mental health. Sweat practices are similar to exercise as they cause the stimulation of the sympathetic nervous system, activation of the hypothalamus-pituitary-adrenal hormonal axis, and an increase in noradrenaline. The sweating experience appears to produce profound physiological changes and perceptions of physical symptoms. Unlike typical forms of exercise, sweat practices cause an increase in B-endorphins and do not increase the concentration of adrenaline in the blood stream. Sweat practices also contrast with the majority of exercise activities because they do not require muscle tension, the movement of large muscle groups, and attentional capacities to be focused on muscle coordination. Sweat practices are a unique form of exercise as they cause muscle relaxation and allow focal attention to be placed on another activity, such as group content and process.

So according to this I guess that given hairy people sweat more, that means you are right.
Well I guess it would cause to diminish the effects of sweating, you will be less relaxed, focal attention will become harder, and all the other benefits sweatting brings will also diminish with it.

J said...

Mariana, it seems my little ironic joke about hairy hippies didn't hit the target. Hmm, I'm not sure if you missed something or I did.

Part of his work seems to be about bacteria living on the skin that produce NO which is absorbed into the body which in turn affects the nervous system to relax. These bacteria thrive in hairy areas and he thinks that is one purpose of our hair.
A novel and intriguing idea and i haven't a clue if it is realistic or not.
So I was thinking if part of our bacterial fauna is helping us to stay relaxed and healthy, then maybe the much reviled and stereotyped hairy hippy should be a little less mocked and disdained by cleanly scrubbed and shaven square and uptight society.

That's me dicking about.

If you look at his profile on his 'Stranger Than You Can Imagine' blog he mentions his bacteria there.

Mariana Soffer said...

J
sorry man, my fault now that I read it, I think i was in a serious mood and did not get it (too much thinking about artificial intelligence stuff).
It is cool the new idea, at least it sure is really innovative.

Feel free to dick out as much as you want, I like that.

Take care and be well
M

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Anonymous
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