Placebo

A placebo (pləˈsiːboʊ ; Latin placēbō, I shall please from placeō, I please) is a substance or treatment with no active therapeutic effect. A placebo may be given to a person in order to deceive the recipient into thinking that it is an active treatment. In drug testing and medical research, a placebo can be made to resemble an active medication or therapy so that it functions as a control; this is to prevent the recipient(s) and/or others from knowing (with their consent) whether a treatment is active or inactive, as expectations about efficacy can influence results. This psychological phenomenon, in which the recipient perceives an improvement in condition due to personal expectations, rather than the treatment itself, is known as the placebo effect or placebo response. Research about the effect is ongoing.Placebos are an important methodological tool in medical research. Common placebos include inert tablets (like sugar pills), vehicle infusions, sham surgery, and other procedures based on false information. There is also some evidence that patients who know they are receiving a placebo still report subjective improvement in their condition if they are told that the placebo can make them feel better. It has further been observed that use of therapies about which patients are unaware may generally be less effective than using ones that patients are informed about, regardless of whether or not a placebo is involved.Placebo effects are the subject of scientific research aiming to understand underlying neurobiological mechanisms of action in pain relief, immunosuppression, Parkinsons disease and depression. Brain imaging techniques done by Emeran Mayer, Johanna Jarco and Matt Lieberman showed that placebo can have real, measurable effects on physiological changes in the brain. Placebos can produce some objective physiological changes, such as changes in heart rate, blood pressure, and chemical activity in the brain, in cases involving pain, depression, anxiety, fatigue, and some symptoms of Parkinson’s. In other cases, like asthma, the effect is purely subjective, when the patient reports improvement despite no objective change in the underlying condition.The placebo effect is a pervasive phenomenon; in fact, it is part of the response to any active medical intervention. The placebo effect points to the importance of perception and the brains role in physical health. The use of placebos as treatment in clinical medicine (as opposed to laboratory research) is ethically problematic as it introduces deception and dishonesty into the doctor-patient relationship. The United Kingdom Parliamentary Committee on Science and Technology has stated that: ...prescribing placebos... usually relies on some degree of patient deception and prescribing pure placebos is bad medicine. Their effect is unreliable and unpredictable and cannot form the sole basis of any treatment on the NHS.In 1955, Henry K. Beecher proposed that placebos could have clinically important effects. This view was notably challenged when, in 2001, a systematic review of clinical trials concluded that there was no evidence of clinically important effects, except perhaps in the treatment of pain and continuous subjective outcomes. The article received a flurry of criticism, but the authors later published a Cochrane review with similar conclusions (updated ). Most studies have attributed the difference from baseline until the end of the trial to a placebo effect, but the reviewers examined studies which had both placebo and untreated groups in order to distinguish the placebo effect from the natural progression of the disease.

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