happy woman with glass of water takes pill
Medical Research

Can "Fake" Medicine Help You?

Linda Buonanno dealt with Irritable Bowel Syndrome (IBS) for years, suffering serious pain and stomach issues. She got involved with a study for a new IBS treatment. The doctor gave her this new medication: sugar pills with no active ingredients. She took the pills

When new medicines are developed, they have to go and started feeling better within days, even knowing that they weren’t actual medicine, through rigorous testing processes. Scientists need to know if the new drug works, so they treat one half of the study participants with the drug and a placebo to the rest of the subjects. Placebos are basically sugar pills—there’s nothing to the “medicine” patients are taking, but they don’t know that.

There’s an interesting twist to placebos, something that is only recently being studied. Very often, patients respond to placebo treatment—even though there isn’t a pharmaceutical reason for it. This “placebo effect” doesn’t mean that new drugs aren’t effective or that people are faking illness. Instead, the interaction between brain and body is hugely complex and still not fully understood.

In a 2016 CBS News segment, Ted Kaptchuk, a professor at Harvard Medical School, explained, “Placebo effect is everything that surrounds that pill — the interaction between patient, doctor or nurse. It’s the symbols, it’s the rituals. These are powerful forces.”

group of blue, labeled placebo pills

When we feel like we are doing something about pain or illness, our body responds. That includes making a doctor appointment or taking a pill. And these effects can be seen on brain scans.

The interaction between brain and body is hugely complex and is still not fully understood.

Placebos seem to be most effective on medical conditions where we don’t have a lot of good treatment options. Think of chronic pain or irritable bowel syndrome. “Any symptom the brain can modulate itself” is where the placebo effect can be seen, says Kaptchuk. Illnesses such as cancer aren’t open to the effect because it doesn’t involve the brain, but cancer-related depression qualifies.

The Program in Placebo Studies and Therapeutic Encounter (PiPS) is run through Harvard University and Beth Israel Deaconess Medical Center in Boston. This is where current research on placebos is centered. There’s a molecule, called COMT, that seems to be involved, though the scientists don’t fully understand yet what its role is.

Writer Robert Anthony Siegel worked with PiPS deputy director John Kelley to see how he’d react to a placebo. His goal for the non-drug pill? “Getting rid of my chronic writer’s block and the panic attacks and insomnia that have always come along with it,” Siegel writes in Smithsonian.

Siegel and Kelley worked together to design a pill and dosage instructions, then had a lab create them.  For the first two weeks, Siegel actually felt like his anxiety increased. But then something shifted—he was writing and not erasing. The treatment was “working.”

The good news for those suffering who haven’t been able to find treatment, is that placebos may be a new avenue to pursue. BMJ, a medical journal, recently published results from several Kaptchuk trials. “Placebo treatments in randomized controlled trials produce significant improvement in many subjective symptoms,” Kaptchuk wrote in the journal.

Your general practitioner might not be comfortable prescribing a placebo quite yet, but the body of evidence continues to grow. It might be time to start a conversation about how a capsule each day can improve your quality of life – even if it is made of starch or sugar.

 

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