Placebo Effect

A placebo (<a href="http://en.wikipedia.org/wiki/Help:IPA_for_English" title="Help:IPA for English" >/</a><a href="http://en.wikipedia.org/wiki/Help:IPA_for_English#Key" title="Help:IPA for English" >p</a><a href="http://en.wikipedia.org/wiki/Help:IPA_for_English#Key" title="Help:IPA for English" >l</a><a href="http://en.wikipedia.org/wiki/Help:IPA_for_English#Key" title="Help:IPA for English" >ə</a><a href="http://en.wikipedia.org/wiki/Help:IPA_for_English#Key" title="Help:IPA for English" >ˈ</a><a href="http://en.wikipedia.org/wiki/Help:IPA_for_English#Key" title="Help:IPA for English" >s</a><a href="http://en.wikipedia.org/wiki/Help:IPA_for_English#Key" title="Help:IPA for English" >i</a><a href="http://en.wikipedia.org/wiki/Help:IPA_for_English#Key" title="Help:IPA for English" >b</a><a href="http://en.wikipedia.org/wiki/Help:IPA_for_English#Key" title="Help:IPA for English" >oʊ</a><a href="http://en.wikipedia.org/wiki/Help:IPA_for_English" title="Help:IPA for English" >/</a> <a href="http://en.wikipedia.org/wiki/Wikipedia:Pronunciation_respelling_key" title="Wikipedia:Pronunciation respelling key" >plə-see-boh</a>; <a href="http://en.wikipedia.org/wiki/Latin_language" title="Latin language" class="mw-redirect" >Latin</a> <a href="http://en.wiktionary.org/wiki/en:placebo#Latin" class="extiw" title="wikt:en:placebo" >placēbō</a>, "I shall please"<a href="http://en.wikipedia.org/wiki/Placebo#cite_note-2" >[2]</a> from <a href="http://en.wiktionary.org/wiki/en:placeo#Latin" class="extiw" title="wikt:en:placeo" >placeō</a>, "I please")<a href="http://en.wikipedia.org/wiki/Placebo#cite_note-3" >[3]</a><a href="http://en.wikipedia.org/wiki/Placebo#cite_note-4" >[4]</a> is a simulated or otherwise medically ineffectual treatment for a disease or other medical condition intended to deceive the recipient. Sometimes patients given a placebo treatment will have a perceived or actual improvement in a medical condition, a phenomenon commonly called the placebo effect. The placebo effect consists of several different effects woven together, and the methods of placebo administration may be as important as the administration itself.<a href="http://en.wikipedia.org/wiki/Placebo#cite_note-Wechsler2011-5" >[5]</a>

In medical research, placebos are given as <a href="http://en.wikipedia.org/wiki/Scientific_control" title="Scientific control" >control</a> treatments and depend on the use of measured suggestion. Common placebos include inert tablets, vehicle infusions, <a href="http://en.wikipedia.org/wiki/Sham_surgery" title="Sham surgery" >sham surgery</a>,<a href="http://en.wikipedia.org/wiki/Placebo#cite_note-6" >[6]</a> and other procedures based on false information.<a href="http://en.wikipedia.org/wiki/Placebo#cite_note-Lanotte-1" >[1]</a> However, placebos may also have positive effect on the subjective experience of a patient who knows that the given treatment is without any active drug, as compared with a control group who knowingly didnot get a placebo.<a href="http://en.wikipedia.org/wiki/Placebo#cite_note-Kaptchuk_et_al-7" >[7]</a> It has also been shown that use of therapies about which patients are unaware is less effective than using ones that patients are informed about.<a href="http://en.wikipedia.org/wiki/Placebo#cite_note-8" >[8]</a>

Placebo effects are the subject of scientific research aiming to understand underlying neurobiological mechanisms of action in pain relief,<a href="http://en.wikipedia.org/wiki/Immunosuppression" title="Immunosuppression" >immunosuppression</a>, <a href="http://en.wikipedia.org/wiki/Parkinson%27s_disease" title="Parkinson's disease" >Parkinson's disease</a> and <a href="http://en.wikipedia.org/wiki/Depression_(mood)" title="Depression (mood)" >depression</a>.<a href="http://en.wikipedia.org/wiki/Placebo#cite_note-9" >[9]</a> Brain imaging techniques done by <a href="http://en.wikipedia.org/wiki/Emeran_Mayer" title="Emeran Mayer" >Emeran Mayer</a>, Johanna Jarco and Matt Lieberman showed that placebo can have real, measurable effects on physiological changes in the brain.<a href="http://en.wikipedia.org/wiki/Placebo#cite_note-10" >[10]</a> Some objective physiological changes have been reported, from changes in heart rate and blood pressure to chemical activity in the brain, in cases involving pain, depression, anxiety, fatigue, and some symptoms of Parkinson’s, but in other cases, like asthma, the effect is purely subjective, when the patient reports improvement despite no objective change in the underlying condition.<a href="http://en.wikipedia.org/wiki/Placebo#cite_note-11" >[11]</a>

Placebos are widely used in <a href="http://en.wikipedia.org/wiki/Medical_research" title="Medical research" >medical research</a> and <a href="http://en.wikipedia.org/wiki/Medicine" title="Medicine" >medicine</a>,<a href="http://en.wikipedia.org/wiki/Placebo#cite_note-H_Norup-12" >[12]</a> and the placebo effect is a pervasive phenomenon;<a href="http://en.wikipedia.org/wiki/Placebo#cite_note-H_Norup-12" >[12]</a> in fact, it is part of the response to any active medical intervention.<a href="http://en.wikipedia.org/wiki/Placebo#cite_note-eccles-13" >[13]</a>

The placebo effect points to the importance of perception and <a href="http://en.wikipedia.org/wiki/Neural_top_down_control_of_physiology" title="Neural top down control of physiology" >the brain's role in physical health</a>. However, 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.<a href="http://en.wikipedia.org/wiki/Placebo#cite_note-Newman-14" >[14]</a>The <a href="http://en.wikipedia.org/wiki/House_of_Commons_of_the_United_Kingdom" title="House of Commons of the United Kingdom" >United Kingdom Parliamentary Committee</a> 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."<a href="http://en.wikipedia.org/wiki/Placebo#cite_note-inquiry_cfm-15" >[15]</a>

Since the publication of <a href="http://en.wikipedia.org/wiki/Henry_K._Beecher" title="Henry K. Beecher" >Henry K. Beecher</a>'s The Powerful Placebo<a href="http://en.wikipedia.org/wiki/Placebo#cite_note-Beecher1995-16" >[16]</a> in 1955, the phenomenon has been considered to have clinically important effects.<a href="http://en.wikipedia.org/wiki/Placebo#cite_note-Hrob2001-17" >[17]</a> This view was notably challenged when, in 2001, a <a href="http://en.wikipedia.org/wiki/Systematic_review" title="Systematic review" >systematic review</a> of clinical trials concluded that there was no evidence of clinically important effects, except perhaps in the treatment of pain and continuous subjective outcomes.<a href="http://en.wikipedia.org/wiki/Placebo#cite_note-Hrob2001-17" >[17]</a> The article received a flurry of criticism,<a href="http://en.wikipedia.org/wiki/Placebo#cite_note-Moerman2002-18" >[18]</a> but the authors later published a <a href="http://en.wikipedia.org/wiki/Cochrane_Collaboration" title="Cochrane Collaboration" >Cochrane</a> review with similar conclusions (updated as of 2010).<a href="http://en.wikipedia.org/wiki/Placebo#cite_note-CochraneHrob2010-19" >[19]</a> 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.<a href="http://en.wikipedia.org/wiki/Placebo#cite_note-Hrob2001-17" >[17]</a>

Placebo Effect

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