Products
Placebo tablets are available, for example, in Germany (P-Tabletten Lichtenstein) or from Dynapharm. The term comes from Latin and literally means “I will please”.
Structure and properties
In pharmacotherapy, placebos are drugs that do not contain active pharmaceutical ingredients but only excipients such as lactose (milk sugar), starches, celluloses, or a physiological saline solution for appropriate injection and infusion solutions. Not all placebo drugs are completely inactive. For example, creams and ointments without active ingredients nevertheless have a skin-caring and hydrating effect. Drugs with active ingredients intended for a different field of application can also be considered placebos. So, for example, vitamin C tablets given for pain management.
Effects
Placebos (ATC V03AX10) can produce effects similar to those of real drugs. The placebo effect accounts for a substantial portion of the drug effect. Surprisingly, placebo can be effective even when the patient knows that he or she is not receiving active therapy. Thus, deception is not essential, especially since it is ethically sensitive (see below). It does, however, enhance the effect. Among other things, conditioning and expectation play a role as mechanisms of action. However, placebos are not only effective on the mental level. They trigger a biological response in the organism via the central nervous system (neurobiological effect). For example, the body’s own endorphins can be released, which have pain-relieving properties. An effect on hormones, neurotransmitters and mediators has also been documented.
Areas of application
Numerous diseases and symptoms respond to placebos. These include, for example, pain, nausea, motion sickness, hot flashes, sleep disorders, depression, Parkinson’s disease, irritable bowel syndrome, anxiety disorders, and ADHD. Placebos are also used as controls in double-blind randomized clinical trials (RCTs).
Contraindications
Administration without patient knowledge and consent is delicate and usually unacceptable. It is a deception that contradicts free will and shared decision making and damages the relationship between the professional and the patient.
Adverse effects
Like normal medications, placebos can produce not only desirable effects but also undesirable effects, such as headache, fatigue, and nausea. This is referred to as the nocebo effect. The term is derived from Latin (harm).
