What does the placebo effect mean. What is the placebo effect? Placebo effect in psychology

Pharmaceutical companies spend a lot of money on the discovery of new drugs every day, and yet some people carry the drug in their head without knowing it. A placebo is a substance that can play a huge role in the treatment of a person, while not having any obvious medicinal properties. To put it simply, the placebo effect lies in a person's faith. Let's find out the principle of placebo effect on the human body.

The mysterious word placebo - a cure or not

Definition of placebo in psychology

How the placebo works

Interesting. One study that was conducted on subjects with an anxiety disorder showed that this method could work even when patients were told that they were taking a pacifier.

Placebo power - for whom the effect will be stronger

Advice. If you recognize yourself in this description, then you should think about it. Of course faith is a great feeling. But blind faith in a dummy can also have a negative effect on your health.

What are the types of placebos? List of drugs

• Tablets
• syrups
• lasers
• Injections

• Validol. Medicine that supposedly helps with pain in the heart. Has a calming, minty effect, but is unlikely to help with a heart attack
• Erespal - is available both in the form of tablets and syrup. Indicated for use in SARS. The effectiveness of this remedy has not been proven.
• Novo-passit is more of a homeopathic remedy than a real cure
• Wobenzym - is available in the form of tablets. According to the assurances of the manufacturers, it has a miraculous remedy for the entire body. Efficacy in vitro has not been studied
• Most drugs for the treatment of colds are placebo and the maximum effect that they can have is to bring down the temperature. Some of these: Imunomax, Engystol, Imudon, etc.
• Hilak-Forte, Bifiform and many other probiotics. Doctors in Russia love to prescribe them. In other countries, probiotics are extremely wary.

When is a placebo appropriate?

Important! Unfortunately, the world is designed in such a way that there will always be people who use placebos in bad faith. Under the guise of drugs, the substance is often sold to patients with oncology. Passing it off as "the same" remedy that will help to heal. Do not fall for such tricks and always consult a doctor.

Placebo therapy: video

In medicine, cases have been recorded when patients recovered due to taking drugs whose effectiveness has not been proven. Moreover, clinical studies confirm that the medicinal value is approaching zero. In this case, there is a placebo effect - curing yourself with almost the power of thought.

Placebo: what is it

Almost two hundred and fifty years ago, physicians described the facts of the recovery of patients after taking substances that are not drugs, but passed off as such.

In simple words, we can say that the patient receives a "dummy" that imitates a tablet, capsule, injection. There are no medicinal components in its composition and, logically, it should not “work”. But in reality, it turns out that the patient receives “treatment” and recovers.

The phenomenon was called "placebo" and was subjected to repeated study by psychologists and physicians.

For the purity of the experiment, double-blind studies are often carried out. In the experimental group, the experiment is controlled by neutral scientists. At the same time, neither the patients nor the doctors treating them know which of the patients receives drugs, and which - their imitation.

Example 1 Psychiatry

A doctor in a psychiatric clinic located in one of the cities of the United States treated patients suffering from violent attacks. Their behavior was aggressive, threatening the life and health of others.

At the initial stages, most patients of the clinic were kept in conditions of deprivation of activity - in straitjackets.

The management of the clinic went on an experiment in which, by prior arrangement, Dr. Medel's patients began to receive a new, hitherto unknown, but very effective medicine. This medicine allowed to stabilize and socialize violent crazy and mentally deranged patients.

Even the doctor himself didn't know who was getting the pills and who was getting the placebo. After some time, the doctor began to notice that the patients became calmer. They show adequate behavior, make contact and violent attacks become rare.

Patients talked, smiled, and the doctor was able to abandon the guard, which he had not parted with before.

Imagine his surprise when he learned the results of the test treatment. None of the insane asylum patients received medication, all took a placebo.

The therapy paid off because neither side of the experiment (neither the doctor nor the patients) knew who was receiving the medicine. Patients believed that a drug had been found that would help overcome their problems. And so it happened.

The doctor wanted with all his might to see the results, changes in the behavior and consciousness of his wards. He really "saw" them, thereby unwittingly influencing the sick.

A drug reserpine entered the history of psychiatry as the most effective placebo capable of treating people with mental disorders.

Example 2 Tuberculosis

At the turn of the 19th and 20th centuries, patients with pulmonary tuberculosis were observed in one of the German clinics. Scientists have not yet invented a medicine capable of defeating the disease, and mortality was extremely high.

Taking a risk, the medical staff informed the patients about the admission to the hospital of a rare, very effective and equally expensive drug that could overcome the disease within a month. The mentioned characteristics of the drug were important: new, effective, expensive.

Under the guise of know-how, patients received acetylsalicylic acid. But the belief in the effectiveness of a new drug delivered to the hospital specifically for them, potential suicide bombers, made it possible to cure 80% of patients.

Example 3 Pediatrics

In the United States, placebo drugs are widely used in pediatrics. American doctors are deeply and unshakably convinced that children should not be stuffed with medicines unless absolutely necessary.

Not only children, but also their parents often need a "magic" pill. Therefore, drugs of this kind are sold in pharmacies and consist of safe components that are allowed even for small children.

Pills "from laziness", "from fear", from diseases developing against a background of uncertainty, phobias are very popular. What is most surprising is that they bear fruit.

List of drugs considered placebo

The list of drugs marked as "dummy" is quite large. According to the Russian Academy of Medical Sciences, about a third of drugs on the modern pharmacological market are “dummy”. Many of them have a high cost and are popular with both doctors and patients.

1. Medicines to improve blood circulation, microcirculation - actovegin, cerebrolysin, solcoseryl;
2. Immunomodulatory drugs;
3. "Heart" drugs - ATP, cocarboxylase, riboxin;
4. and (linex, bifidumbacterin, bifidoc, hilak forte and others);
5. Means for improving cerebral circulation - piracetam, nootropil, tenoten, phenibut, pantogam, aminalon, tanakan, preductal;
6. Mildronate, mexidol;
7. Bioparox;
8. Polyoxidonium, grippol, gromecin;
9. Chondroprotectors - chondrosamine, glucosamine, chondroitin;
10. Valocordin, valoserdin, novopassitis;
11. Antithrombotic drug thrombovazim;
12. Essentiale N, mezim forte.

What enhances the placebo effect

Pharmaceutical companies that produce certain groups of drugs know the marketing moves. These methods increase not only the popularity (and hence the level of sales) of dummy drugs. They also help patients, despite the absence of the active substance in the composition of the drug:

• Patients like large, brightly colored tablets more than small, faded, colorless ones. Patients subconsciously develop confidence in outwardly visible drugs;
• A pronounced therapeutic effect is manifested in patients after taking drugs from well-known manufacturers compared to modest competitors, even if the composition contains the same active substance;
• Expensive medicines “treat” faster, more efficiently, and there is more confidence in them than in cheap analogues;
• After the end or interruption of the placebo "treatment" course, 5% of patients experience a withdrawal syndrome with pronounced symptoms;
• From 5 to 10% of patients experience the claimed side effects, although there are no substances that can cause them in the medicine;

Placebo has a better effect on people with a labile psyche, anxious, gullible. They consider the doctor to be the last resort and trust him. Such people, extroverts, are easily suggestible. Low self-esteem and secret readiness for a miracle allow the placebo to "work" in full force.

Patients who are suspicious, suspicious, checking any information “by the tooth”, are less amenable to the influence of a placebo. They do not trust miracles and the charlatans who propagate them. After all, it is the subconscious and the willingness to believe that play a key role in the treatment with pacifiers.

Types of placebo

Placebo treatment is not limited to banal pills with a magical effect. There are several types of placebo:

Preparations

The most popular and extensive group. Under the influence of "powerful" pacifiers, migraines disappear, blood pressure normalizes, bleeding stops, even tumors, including malignant ones, dissolve.

There are many such examples described in the medical literature. In each case, the effectiveness is recorded and cannot be explained only by the impact on the consciousness and subconsciousness.

Imaginary surgical interventions

Surgeons use the placebo effect, replacing the real operation with a sham one, and achieve the same result as with a real intervention.

Surgeon David Callmes has been practicing spinal surgery for many years after severe injuries and fractures. He decided on an experiment, during which some of the patients were actually operated on. The other part was informed about the operation, although in fact there was none.

But what really happened was the reliable preparatory work with patients, the identical surroundings in the operating room.

As a result of a well-played performance, the well-being of patients improved. At the same time, pain disappeared and functions were restored. This means that somewhat different regeneration mechanisms come into play.

Placebo - acupuncture and homeopathy

Instilling faith in the patient in the possibility of getting rid of a serious illness by inserting needles into the skin and taking homeopathic medicines makes it possible to achieve tremendous success in the treatment of mental and somatic diseases.

And yet, how does it work?

In psychology, the placebo effect is used not only to correct personal qualities, but also for training and education, development, and stabilization at any age. Placebo is based on suggestion. Properly executed suggestion triggers hidden mechanisms in the human body. This allows you to mobilize your own resources and defeat the disease.

Every doctor knows that there are patients for whom the attention of a medical worker is already a treatment. Suspicious, suggestible people, ready to believe in a magic pill, a unique procedure, rejuvenating apples and living-dead water, easily succumb to the temptation to be cured with the help of a miracle remedy.

Their body produces substances necessary for treatment, rejects pathological cells, promotes tissue regeneration, because the brain, confident in the effectiveness of treatment, gives the necessary commands.

For this category of patients, a good doctor is the one who prescribes drugs, will treat, and will not explain how to do without them. Just in such cases, the placebo contributes to the treatment, does not harm the body, causing, most likely, damage only to the wallet.

It has long been known that faith works miracles. Placebo - belief in the possibility of becoming healthy again despite predictions and possible negative options.

The phrase “placebo effect” is perhaps familiar to everyone. It is used in relation to medicines, healers and fortune-tellers, hypnotists, traditional medicine, the interpretation of dreams, sects, and even in relation to some everyday issues. But what is it? How exactly does it affect a person? Where and when is it used, and how justified is this remedy? To answer these questions, I recommend reading this article.

So, the placebo effect: deception or real help, illusion or reality? I invite you, dear readers, to look into this issue together. Of course, if you are not afraid to learn too much and get "immunity" to the placebo effect (the situation is somewhat reminiscent of a story with tricks and their disclosure). Do you want to see reality without embellishment? Then let's go!

Description of the phenomenon, examples

I propose to jump right off the bat and go to direct examples of the phenomenon under consideration. But first, a little historical background. The theory belongs to the American psychologist and physiologist Alvin Jellinek. The placebo effect was first described in 1920 and was originally only related to medicine.

Placebo literally translates as "I like it, I like it." In the classical medical sense, the placebo effect means an improvement in the patient's condition when taking supposedly drugs. In fact, he is given completely safe chalk, but in the form of a pill or injected with a physical solution intravenously. Healing is due to the person's conviction that he was given a medicine, which means that he should feel better.

Thus, a placebo is an abstract thing or phenomenon, that is, roughly speaking, a “dummy”, but due to self-hypnosis it has great power. And then the question is: is it a dummy then? Oh, those eternal "to be or not to be."

Currently, in addition to medicine, there are many more placebo options, that is, aspects of suggestion and self-hypnosis:

1. Folk healers douse a person with allegedly magical water, and he is miraculously healed.
2. The fortune-teller gives, for example, a bump, having previously said “terrible” things to it and reports that now it is a human talisman and only with him everything will be fine in life. For example, now this person will get a promotion. And indeed, this often happens, but in fact the person himself achieves this, and not the talisman. It's simple: being convinced that he has support and he cannot but get what he wants, a person without any fears and fears tries, takes on work, takes risks.
3. I do not want to offend anyone, I respect the faith and beliefs of everyone, but in my opinion, as a man of science, religion is no exception. Prayers, confessions, douches, all sorts of rituals - the placebo effect. A person has always needed and will need support under his feet, the conviction that there is an unchanging point of support, to which he can always come in a difficult situation. If it's a religion, great. The main thing is that it does not come to fanaticism and does not threaten the life of the person himself and other people.
4. The placebo effect occurs at every turn. Another example is clothing called by a well-known brand or country, which costs three times as much, but is essentially the same as a cheap analogue. With food, cafes, restaurants, this principle often works. After recognizing a popular brand, people automatically consider its products to be better. Or they just see the difference between two similar products. The most popular example is Pepsi and Coca-Cola. If you have not heard about the experiment, then I will tell you. Blindfolded people were given the same drink, but called it differently. What is the result? Of course, most of the participants noted certain “notes” of difference.
5. When choosing clinics, we often prefer expensive or high-demand institutions, although in practice they are not always better than budget ones, often the same.
6. In medicine, the “dummy” effect is most common. Doctors themselves admit that they often prescribe imaginary medicines. Alcohol coding (even the most serious, as it is considered, "stitching") is a placebo. A person, of course, will not die if he takes alcohol. In some cases, placebo is used even in the treatment of burns.
7. In general, in medicine, placebo is most often used to treat intestinal disorders, some of its pathologies, asthma, pain, and heart disease. For example, the whole direction of homeopathy is based on the placebo effect. However, it should be understood that if we are talking about serious diseases such as oncology, then despite the real improvement in the patient's well-being, the disease itself (pathological deformities) does not regress.
8. The placebo effect is useful in correcting the condition of hypochondriacs (people who constantly think of illnesses for themselves; this is a psychological disorder). Any empty pill will calm a person in a state of such a neurosis, which will create fertile ground for psychological correction. And also the far-fetched symptoms will immediately disappear.

These are just the most striking examples of placebos in real life. So, the placebo effect is suggestion, hypnosis, a kind of manipulation. But why do some people not succumb to magic, “magic” waving of the hands that relieve pain, and so on, while others easily believe everything? The most susceptible to the placebo effect are:

• insecure people with low self-esteem and expectations;
• unstable, "weak" people without personal convictions and "core";
• neurotic personalities;
• desperate people (often associated with some kind of disease);
• people with a weak or fragile psyche (children, the elderly).

For example, some individuals are so suggestible that they can immediately begin to actually feel any side effect of a drug read in the instructions. Theoretically, of course, everyone is subject to this effect. We are a chemical vessel with many ongoing processes. Every feeling and emotion is a chemical reaction. While waiting for the effect of the "dummy", the systems themselves are activated and produce the necessary substances.

The placebo effect can work both ways: to improve or worsen the individual's well-being. The most banal example is curses, evil eye. In this case, it is called a nocebo. Or a more classic example. So, because of one indigestion, you can “google” yourself a whole series of symptoms characteristic of an extremely dangerous disease. Admit it happened?

The effect of suggestion is the stronger, the more favorable the situation for this is created. In addition to the characteristics of the personality itself, several other factors are important:

1. The belief of the experimenter (doctor, fortune-teller) in the effectiveness of placebo.
2. Positive attitude, kindness. For example, it can be created by a pronounced involvement in a person’s life, “entering” into a position, personal appeal.
3. The more placebo, the more effective. For example, if we are talking about tablets, then a larger tablet is more easily perceived by the patient.
4. Colors. It is important to be aware of the effect of shades on the body. This applies to the color of the pills, lighting, clothing tones. For example, a happy blue blouse, which has contributed to so many transactions, actually affects the psyche as a tranquilizer (such is the property of blue).
5. Individual irritants that create a feeling of psychological comfort and safety for a person (favorite movie, music, a cat nearby).

Almost all of our lives are permeated with elements of suggestion. Promotions in stores are also often a placebo effect. Consumption and advertising are also often built on this principle (“With this chewing gum, all the girls will be yours”). That is, a placebo is a belief in something, often material.

If you do not want to become a random target, then train rational thinking, willpower, self-confidence. Build your own position on each issue. What else can be done? Can you use the placebo effect to your advantage? Read on.

What happens in the brain and how to use placebo in life

What is the real internal process of placebo action? Such systems, reactions and receptors as endocannabinoid, dopamines and endorphins are included in the work. That is, all possible natural foundations begin to interact with each other, creating a state of happiness and euphoria for a person. Sports are said to relieve stress. In general, yes, since hormones of happiness are produced during classes.

When absorbed (literally or figuratively), a placebo activates the pleasure center in the brain, the reward system, the prefrontal cortex (responsible for planning actions). Along with this, immunity increases, the body becomes “open” to positive changes. The exact mechanism of the "power of thought" has not yet been established. Research on the placebo phenomenon continues regularly.

How can you use the body's ability to deceive in your favor:

1. Are you in a bad mood? Smile! Seriously! Go to the mirror and smile. In just a few minutes you will feel a real uplift. Here's one psychological placebo effect for you in real life.
2. You quarreled with someone - hug. Whether you want it or not. A very useful "trick" for relationships. Make it a rule to always hug and go to bed together. You yourself will not notice how chemical reactions will do their job, and resentment will pass. The joking “I will kiss and everything will pass” is also a placebo. But, you see, it passes, doesn't it?
3. Are you going to the exam, but are afraid, despite the fact that you studied the material? Take a cheat sheet. You probably won’t get it, but this awareness (there is a safety net) will just help you.
4. Are you stressed and think you need to drink/smoke? No need! All you need is a surge of endorphins (they are produced under the influence of nicotine or alcohol). Offer yourself an alternative (walking, sports, reading, attractions). As a last resort, for example, instead of alcoholic beer, take non-alcoholic beer. By the way! Electronic cigarettes are also placebo.
5. Have you had a fight with someone, but want to make up? Or do you see that someone is sad? Bake a cookie, bring it to that person, and say something like, “I enchanted them. You need to bite off a piece, and all sorrows will immediately pass. Believe me, no matter how old a person is, it will give its effect. Endorphins will go through the roof.

Tell me, have you ever said the phrase “now I will rest for 10 minutes and do everything”? And after all, they really rested, and then calmly did it. It was? Here's a placebo. You set the brain that in 10 minutes the body will recover, and then whether it wants it or not, you need to do the task.

conclusions

Thus, the placebo effect cannot be unambiguously characterized. This is both salvation and a weapon. If it is used by honest and knowledgeable people, specialists in the field of medicine and psychology, then this is a brilliant invention. But if we are talking about scammers who profit from the naivety or grief of people, then this is evil. However, on the other hand, if any amulet (by the way, you can invent it yourself) really helps a person, is it really such an evil?

Is it possible to somehow use the placebo effect in everyday life for the benefit of oneself? Of course! We are talking about positive attitudes or the materialization of desires and aspirations (in this case, these are synonyms). For example, if we are talking about your qualities that you lack, then write them and read them regularly, “try on” for yourself, imagine situations where you are exactly like that.

The same principle applies to your environment. If you want to see a caring husband nearby, call him such at every opportunity. By the way, this is also true in the direction of the nocebo (“if a person is called a pig, he will grunt”).

But first of all, it is important to sincerely believe in the positive effect of suggestion. By the way, as experts note, the effect works even if the person is aware of the placebo. However, you must always adequately assess your strengths and circumstances. Still, no one canceled the financial, physical and other factors (if your dreams are material in nature). Well, for the correction of behavior and personality, of course, there are no boundaries.

In general, dear readers, I shared with you my thoughts about the essence of the placebo phenomenon and how to apply it in life, and the choice is yours. The best option for a person, of course, is a rational belief in one's own strengths. Although, to be honest, I probably experienced the “dummy” effect on myself (who will tell me if we are talking about, for example, medicines).

Thank you for reading this article! I'm glad it was interesting and useful for you!

This effect has been established by physicians. It is based on a deliberate or unconscious suggestion by a doctor or experimenter that a certain factor (drug, course of action) should lead to the desired result. The faith of the subjects or patients can really work wonders, although the factor itself does not play any effect. If patients expect that the drug should improve their condition, then they really experience changes for the better. In medicine, placebo (Latin placere - like) means a drug that has no medicinal properties ("fake drugs"). The term "placebo effect" was introduced into scientific circulation by the American physician Henry Beecher in 1955, who found that about a third of patients recover from "dummy" pills that do not contain active ingredients. Serious study of the placebo effect began during World War II. When there was a shortage of painkillers in the frontline hospital, Henry Beecher, an anesthesiologist, became convinced that in some cases an injection of saline had almost the same effect as real medicine. After returning from the war, a doctor with a group of colleagues from Harvard University began to study this phenomenon. He summarized the results of his research in 1955 in the article "Strong placebos." The strongest factor in placebo effects is the belief of the doctors themselves and staff in the power of drugs. A lot of double-blind experiments have been conducted in which a placebo effect has been demonstrated. One of them is a textbook case of studying the effectiveness of reserpine. In 1953, psychiatrist E. Mendel worked at the St. Elizabeth Psychiatric Hospital near Washington in the department that treated people from Puerto Rico and the Virgin Islands. Most of the patients were hospitalized due to bouts of hostile and aggressive behavior. Some of them were so dangerous that they were kept in special shirts, and Mendel was accompanied in the hospital by two guards. Communication was also difficult because the patients did not know English, and Mendel did not know Spanish. At that time, a new tranquilizer, reserpine, became popular, which gave good results precisely for such patients. Hospital leaders decided to test these drugs, and with the help of a special double-blind method. Patients were not informed that some received real medicines, while others - the so-called "pacifier" (simply sweet pills). Doctors did not know which of the patients received the drug, and which only thought they were receiving it. Mendel told patients about the new drug, its effectiveness, speed and lack of side effects. The patients knew the participants in the study. The experiment lasted several months. However, very soon Mendel came to the conclusion that the drug has a very positive effect on patients. The patients became calmer, communicated more affably with the doctor, and soon he allowed the straitjackets to be abandoned. Mendel himself experienced a spiritual upsurge, he believed that reserpine would revolutionize psychiatry, especially with regard to aggressive patients. However, he was shocked when he found out that his patients received exactly a “dummy.” After analyzing all the events, Mendel realized that positive changes had occurred precisely because of his behavior and kind attitude towards patients. The doctor believed that his patients receive reserpine and therefore become calmer, they have friendly looks, smiles, gestures. Mendel everywhere saw signs of an improvement in the mental state of patients. The doctor realized that the patients simply began to react to his calm attitude, which was the result of the doctor's confidence that reserpine was working. He simply began to treat his patients better, and they responded with friendly behavior, they were pleased that they were treated as full-fledged people. Manifestations of the placebo effect are associated with the patient's unconscious expectation, his ability to be influenced, and the degree of trust in the psychologist. This effect is used to study the role of suggestion under the influence of drugs, when one group of subjects is given a real drug, the effect of which is being tested, and the other is given a placebo. If the drug really has a positive effect, then it should be more than from the use of a placebo. The typical rate of positive placebo effect in clinical trials is 5-10%. In studies, it is also easy to cause a negative nocebo effect, when 1-5% of the subjects experience discomfort from taking a “dummy” (allergies, nausea, impaired cardiac activity). Clinical observations indicate that nervous personnel cause nocebo effects, and the administration of anxiety-reducing drugs to patients significantly reduces anxiety among doctors themselves. This phenomenon has been called "placebo rebound." For especially emotional patients who are prone to self-hypnosis, doctors attribute neutral drugs that will help improve the person's condition and avoid taking unnecessary drugs. The positive effect of homeopathic medicines is partly explained by the placebo effect. It works not only in an experiment, but also when imitating a certain medical procedure, under the influence of a conversation, when a person’s psychological reserves are mobilized. Even when using perfectly studied drugs, they try to trigger the placebo effect. Bright and large pills work better than vague and small ones, and drugs (“bioequivalents”) of well-known companies give a greater effect than drugs from modest manufacturers with the same composition. The basis of the placebo effect is the suggestion that the drug has a certain effect, and the expected effect appears because the brain begins to stimulate the production of endorphins, which partially replace the effect of the drug, and the "mobilization effect" also works - increased immunity, mobilization of the body's defenses. Manifestations of the placebo effect depend on the level of self-hypnosis and the physiological ability to form the necessary chemicals. Doctors have long used the placebo effect. Famous therapist of the XIX century. M. Ya. Mudrov treated patients with special powders with the names "golden", "silver", "simple". These names corresponded to the color of the paper in which the medicines were wrapped. Mudrov's powders cured many diseases, had a real miraculous effect. After the death of the doctor, it turned out that it was just ground chalk. Therefore, it is clear that psychological perception, emotions, trust in the doctor had a healing effect. The doctor himself, a practitioner of placebo therapy, wrote: “The art of the doctor lies in creating “medicines for the soul” that would console the angry, calm the impatient, stop the violent, frighten the impudent, make the shy bold, frank - unsociable, reliable - desperate. The effect of the placebo effect enhances the authority of the doctor, so any medicine from the hands of a famous luminary has a much more effective effect on patients than those prescribed by a local doctor from a local clinic. According to studies, placebo affects all people, but most of all - on extroverts who are anxious, labile, flexible and trust their doctors. Placebo non-responders are more likely to be introverted, distrustful, and suspicious. More exposed to the placebo effect are neurotic people with low self-esteem, insecure, who tend to believe in miracles. In medical practice, it has been confirmed that placebo works better for people with mild psychosomatic disorders, such as mild insomnia or minor depression. It has been established that the placebo effect can occur even if patients know that they are simply receiving neutral pills. In a study conducted at Johns Hopkins Medical School, 15 people were treated for anxiety and received a sweet pill once a week. They were frankly explained that these were “dummy”, however, they noted that they help some patients. After completion of treatment, 14 patients reported that their anxiety significantly decreased, of which 9 believed that the improvement was due to the action of the pill, 6 suspected that the pills contained active substances, 3 complained of side effects (impaired vision, dry mouth ). Such complaints are typical when taking certain psychotropic drugs. Since 1970, placebo and double-blind testing have been mandatory for evaluating the effectiveness of new drugs and comparing similar ones. Over the past 10-20 years, the interest of both psychologists and physicians in placebo has grown significantly and its study continues.

Cardiologist Yaroslav Ashikhmin talks about drugs without proven efficacy, their mechanisms of action and clinical studies of the placebo effect on the body.

A placebo is a substance with no apparent medicinal properties that can be used as a drug or mask the drug. The phenomenon of improvement due to the use of such a drug is called the placebo effect. This effect can be traced in a number of mental illnesses, pain syndrome, bronchial asthma, Parkinson's disease, irritable bowel syndrome, coronary heart disease and arterial hypertension.

The effect of using a placebo is not as reliable as the effect of using real drugs. Placebo due to the placebo effect can lead to some subjective improvement in the condition, but it rarely cures the disease. A person may feel an improvement in the condition, which is not due to the fact that the disease has “receded”. For example, a patient may feel better on the background of the use of homeopathy, which acts precisely due to the placebo effect.

The history of the use of placebo in clinical medicine began a long time ago. For example, the famous doctor Matvey Mudrov, who lived in the 18th-19th centuries, used simple, gold and silver powders that eased the pain of patients. Only after the doctor's death did it become clear that ground chalk served as the main component of these powders.

Placebo today

Firstly, placebo is used to relieve the patient's pain when effective drugs are not available.

Secondly, it is prescribed for the possible improvement of a condition when there is no certainty about the effectiveness of an existing drug.

Thirdly, it is being used unknowingly- for example, when a doctor prescribes a drug, being sure of its effectiveness, but the drug does not work. The third situation is the most dangerous, because drugs that seem safe at first glance may have hidden side effects that are observed after a long time.

A large number of different neurophysiological mechanisms are involved in the implementation of the placebo effect: the endocannabinoid system, dopaminergic, endorphin systems. When using a placebo, certain areas of the brain are activated: the prefrontal cortex, the anterior cingulate gyrus (previously referred to as the "pleasure center"), the nucleus presenting. A combination of mental and neurological mechanisms is involved. In this case, suggestion plays an important role.

placebo experiment

For example, in one study, patients with migraine were divided into two groups. One group was given a placebo, but it was said to be a powerful migraine drug, Rizatriptan.

The other group was given Rizatriptan, a real headache remedy, but was told it was a placebo. There was no difference in efficiency.

That is, the words of the doctor that the patient is receiving a strong medicine acted as effectively as the medicine "Rizatriptan" itself, when they did not know about it.

But when patients were given "Rizatriptan" and told that it was "Rizatriptan", the effectiveness of the drug in terms of relieving headaches increased by 50%.

Interestingly, the placebo appears to be more effective when administered via droppers. If the administration of the drug is sensitive to patients, then its effect is higher.

The analgesic effect of a placebo in the same migraine is higher by 7% if the doctor gives an injection, and does not offer the drug in tablets.

And the price of the drug also plays a role: if you tell the patient that the drug, which is actually a placebo, is more expensive, then it turns out to be more effective.

Persuasion plays a very important role. In addition, even the presence of the psyche is not necessary for the placebo effect to work - there are a number of studies that have shown the effectiveness of placebos in animals.

A placebo can be comparable in efficacy to a drug in diseases in which a decrease in the quality of life is primarily due to mental disorders and pain. But we must remember that such an improvement in physical condition is not always translated into an improvement in physiological parameters.

For example, the placebo effect appeared during World War II. When the medicines ran out, the shell-shocked soldiers were injected with saline under the guise of morphine, and this reduced the pain. But not always the mechanism of action of a conditioned saline solution has a purely psychological basis. For example, in a number of studies, scientists, in order to relieve pain, also brought to the nerve fibers not analgesics, but saline. It turned out that saline can somehow act on nerve fibers and also relieve pain.

If the main purpose of the drug is to relieve pain, a placebo may work and achieve the desired effect. But this effect will be less long-lasting than the real drug. A placebo can be used to relieve pain, but a placebo is highly unlikely to cure diseases.

Homeopathy, which works only due to the placebo effect, helps to improve the psychological picture of the perception of the disease, but at the same time it does not, under any circumstances, eliminate the disease itself.

The use of homeopathy (by the way, read the text on Zozhnik - ““) is a gross violation of bioethics in situations where there is a real medicine or when it is known for sure that the placebo is ineffective.

In addition, it is forbidden to use homeopathy in the treatment of bacterial infections, heart diseases, rheumatological diseases, for which drugs are already known that work accurately. In other words, if there are drugs with proven effectiveness, the use of homeopathy is criminal. But if there are no drugs with proven efficacy, as in the treatment of SARS, the use of a placebo is acceptable.

In a recent study of the work of British medical practitioners, it was noted that an implicit placebo, that is, a placebo that is prescribed when doctors doubt the effectiveness of the drug, was prescribed by about 97% of doctors, and pure placebo, that is, the same conditional saline solution, was prescribed by 12% of British doctors . Among Russian doctors, pure placebo is even more popular. This is due to the fact that people in Russia often believe that observation in the clinic must necessarily be associated with parenteral administration of drugs. Therefore, in the Russian tradition, many patients are given droppers with saline, that is, with a pure placebo. When evaluating the ethics of this event, one must take into account the cultural factor, because many of them really “help” a lot.