17 Mar 11 The power of a simple sugar pill
Not so long ago, it wasn’t unusual for your friendly GP to have at hand a bottle of sugar pills for patients’ minor aches and pains. While sugar pills are no longer on offer, a report out recently revealed that half of all German doctors are prescribing placebos to their patients for ailments such as stomach upset and low mood.
The study, published by the German Medical Association, said that placebos – here defined as sham treatments without any active constituents – from vitamin pills to homeopathic remedies and even surgery, can prove effective as treatments for minor problems and are completely without side effects.
The power of the placebo first came to light during the Second World War. Morphine was in short supply in military field hospitals and an American anaesthetist called Henry Beecher, who was preparing to treat a soldier with terrible injuries, feared that without the drug the operation could induce a fatal heart attack.
In desperation, one of the nurses injected the man with a harmless solution of saline. To Beecher’s surprise the patient settled down as if he had been given morphine and felt little pain during the operation. Dr Beecher had witnessed the placebo effect.
Wind forward 70-odd years and the story of the placebo continues to fascinate, even though in the UK placebo treatments are usually confined to clinical trials, as a comparison with “real” treatments. Recent research suggests the placebo effect is not confined to subjective areas such as pain but may bring about physical changes. In one (albeit small) trial, published in the journal Science, people with Parkinson’s disease given placebo injections showed significantly higher dopamine levels in the brain, similar to the effects of medication.
Interestingly, the German study found that the efficacy of a placebo can depend on the size and colour of a pill and on its cost (with more expensive placebos being more effective) and that injections work better as placebos than tablets.
What causes the placebo effect? No one really knows; but the idea of the healing power of the mind is nothing new. The discovery in the 1980s of the rich supply of nerves linking the brain with the immune system, which led to a new branch of medical research known as psychoneuroimmunology, clearly goes some way to explain it.
Nor does the placebo have to be a pill or injection: just seeing your doctor can work wonders. Edzard Ernst, professor of complementary medicine at the University of Exeter, believes that the key is the relationship between the patient and the doctor or therapist….