Tuesday, October 16, 2007

How powerful placebos could save the NHS millions - AND still cure illnesses | the Daily Mail

How powerful placebos could save the NHS millions - AND still cure illnesses | the Daily Mail

Sticking needles randomly into your body is almost as good as real acupuncture when it comes to back pain, according to a new study published last month.

Random needles are also just as good at improving the quality of life for Crohn's disease patients, another study found.

Why is this so? Sceptics say it's because complementary medicine is nothing more than a placebo.

A placebo is a treatment that has no active ingredient but makes the patient feel better simply because they trust the person administering it and believe the treatment will help.

The placebo effect has long been used by conventional doctors as a label to discredit alternative treatments.

However, in the past few years there has been a revolution in scientists' understanding of placebos - indeed, some experts now believe they could even replace treatments such as anti-depressants.

"The placebo effect tells us that we have a powerful natural ability to control pain and produce other beneficial effects," says Professor Irvine Kirsch, psychologist and expert on placebos at the University of Hull.

"We should be using this to boost the response to drugs and other treatments."

The medical interest in placebos has been stirred partly by brain scanning technology which has meant scientists can see what happens when you take a placebo.

Furthermore, there is increasing evidence that placebos can bring about genuine physiological changes in people suffering from pain, depression and even Parkinson's disease.

But the medical speciality that benefits the most from the placebo effect is pain treatment.

It seems that believing you are getting pain relief when you aren't really can make a big difference to how it feels - researchers have found that a specific region in the brain responds to a placebo by releasing natural morphine-like painkillers.

Besides pain, depression has also long been known to respond well to placebos.

Using brain scans neuroscientists have found that both placebos and antidepressants increased activity in the frontal cortex - the thinking and planning part of the brain - and reduced activity in areas linked with emotions, and therefore reducing depression.

According to Dr George Lewith, head of the Complementary Medicine Research Group at the University of Southampton, the placebo effect counts for about 70per cent of the benefit of therapies for pain and depression.

It's not just pills and needles that provide a placebo effect. In a study of a group of Parkinson's patients, half had stem cells implanted in their brain to boost their low levels of the brain chemical dopamine, the other half had 'sham' surgery, undergoing an operation but having nothing implanted.

A year later those who wrongly believed they had received the stem cells showed as much improvement as those who had received them. Some forms of placebo work better than others.

[...]

And some people respond better than others to placebos.

These are those people who are optimistic, especially when it comes to winning money.

Dr Jon-Kar Zubieta, a neuroscientist at the University of Michigan, found that people who expected to win in a gambling game also responded better to a placebo painkiller.

Brain scans revealed in a separate pain study that the area of their brain associated with expecting a reward produced more of a feel-good chemical called dopamine just before they got the fake treatment and that led to a better result.

Low dopamine again being associated with ADD. Low dopamine inhibits the "optimism" effect. Could lead to original, unconventional thinking, because part of the placebo effect is going along with what others believe.They have found that people with low dopamine in their brain are more immune to the placebo affect. Perhaps the benefit to low dopamine is the unconventional behavior that accrues? Because it does seem as if the ADD gene is positively selected.

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