How is the placebo effect explained?
It is not known exactly how the placebo effect comes about. It is presumably due to the body’s self-healing powers, which in turn are triggered by the belief in the medication.
The patient’s expectations can therefore influence the effectiveness of a treatment. In the case of the placebo effect, this would be a positive influence – the patient believes in the preparation, expects and hopes for a cure and this often occurs as a result.
However, the influence can also be negative. Anyone who is absolutely convinced that a treatment will not help them will probably be right.
The influence of the patient’s expectations can also affect the effectiveness of real medication.
Interestingly, it has been repeatedly confirmed that placebos cause actual reactions in the body, such as the release of messenger substances or pain-relieving substances. It is also known that some diseases respond better to placebos than others.
Ointments and creams without active ingredients occupy a certain special position, as the base – even without an active ingredient – has a caring and moisturizing effect.
How are placebos used in medicine?
Clinical studies
In the course of this, one group of patients is administered the real drug, while the other group is given the placebo, which must resemble the real drug in terms of shape, color and taste (e.g. placebo tablets, placebo capsules). A new medication is only classified as effective if it is clearly more effective than the placebo.
Therapy
However, the doctor can also use placebos to treat mild or non-life-threatening complaints. This can be useful, for example, if the cause is most likely psychological or if a “real” medication is not suitable for medical reasons.
One example is sleep problems in the elderly. On the one hand, this patient group processes medication differently than younger people, meaning that more risks and side effects are possible. On the other hand, elderly patients often have to take many medications that can interact negatively with sleeping pills.
In this case, a placebo can be a good alternative that helps those affected to get a good night’s sleep without any risks.
Administering placebos without first informing the patient is ethically unacceptable. For this reason, a treatment trial with a placebo must be clarified with those affected.
Facts that reinforce the placebo effect
Influence
The placebo effect can also occur with real medication and can be reinforced by various, sometimes strange-sounding factors.
It is now known that very small and very large tablets work better for patients than medium-sized ones. Red tablets help better than white ones. Injections work better than tablets. If the injections are given by doctors, they are also more effective than those given by nurses.
The placebo effect can also be influenced in drug tests. If the doctors know which patients receive the placebo, it is less effective in this group. For this reason, trials are usually designed as “double-blind studies”. Here, neither patients nor doctors know who is receiving the real drug and who is receiving the placebo.
Examination interviews can also reinforce the placebo effect. The more often patients are examined in the placebo group, the greater the measurable effect. Even the name of the medicine or how it is taken plays a role:
What other circumstances contribute to the placebo effect?
Studies carried out in various countries also show that the placebo effect is influenced by the cultural environment. In Germany, for example, around 60 percent of all stomach ulcers can be cured with a placebo. In Brazil, on the other hand, this only works for very few patients.
Conversely, high blood pressure patients in this country hardly respond to placebo preparations, while in other countries high blood pressure levels can be reduced with placebo medication.
The gender of both the patients and the doctors treating them also has an influence on the placebo effect. Placebo drugs tend to work better for women than for men. In addition, both male and female patients seem to trust female doctors more than male doctors. So if patients are given a placebo by a female doctor, it usually works better than one from a male doctor.
