From Jo Marchant in Nature:
Study suggests how dummy pills might reduce drug doses in routine care.
For some conditions — such as pain and immune disorders — trials have shown2 that it is possible to train people to respond to placebos, although this practice hasn’t made its way into clinical care. Benedetti and his colleagues wondered whether the same effect might be possible for neurological disorders.
They studied 42 people with advanced Parkinson’s disease who were having electrodes implanted into their brains for a therapy called deep brain stimulation, which eases symptoms by stimulating affected brain areas directly. That surgery gave Benedetti’s team a rare opportunity to measure the activity of individual neurons in the thalamus, a brain region known to be inhibited by lack of dopamine in people with Parkinson’s.
During surgery, participants were given a saline injection that they were told was apomorphine. It produced no response — unless the patients had been ‘pre-conditioned’ by having already received 1–4 daily injections of the real drug in the days before surgery. Those patients did respond to the saline: after the injection, their neurons showed increased activity, and their muscle rigidity dropped (as assessed by a neurologist who was not told the purpose of the study or which treatment the patients had received). Measuring the response of individual brain cells, Benedetti says, proves that changes in clinical outcome aren’t explained by any bias from patient or experimenter. More.
The placebo effect is short-lived but real, and clinically important. Finding a way to extend it would reduce the need for drugs, thus reduce side-effects and growing tolerance.
After all this time, such findings shouldn’t be surprising. The placebo effect is one of the best-attested facts of medicine. Drugs are not tested against placebo because placebo is “0%” of the effect but because it could be 50% of the effect. A drug should perform 5% better than placebo to be considered to have any effect at all.
In other words, a drug should work a bit better than your own mind’s desire to feel better.
See also: New Scientist’s about face on the placebo effect
Neuroscience tried wholly embracing naturalism, but then the brain got away
Would we give up naturalism to solve the hard problem of consciousness?
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