Healthbeat Report: Power of Placebos

March 18, 2010

Late at night, Jonathan Overman's life changed forever. A car careened into his lane.

After 13 surgeries and hundreds of medications, he was back on his feet, and Jonathan says placebos helped him get there. When his body could no longer handle the real medication he says his doctor gave him sugar pills.

"It's completely all belief. Belief changes and heals," said Overman.

A report out of the National Institutes of Health claims half of doctors prescribe placebos. For the purpose of the survey the definition of placebo went beyond sugar pills. The most commonly prescribed are painkillers followed by vitamins, antibiotics and sedatives.

"Somehow this thought process, this cognitive process of anticipation actually does something in the brain that's similar to what happens when you get an active treatment," said Dr. Walter Brown, psychiatrist, Brown University, Tufts University School of Medicine.

"There are serious ethical issues that surround giving someone a treatment that they believe is real when it's not," said Tor Wager, Ph.D., psychologist, Columbia University.

The American Medical Association recommends doctors only use placebos if the patient is informed and consents. But can a placebo work if the patient knows it's no more than this? Some doctors say yes.

"A lot of people with your kind of high blood pressure get better by just taking pills like this. These pills don't have any active medicine in them, but they do get certain people better. We don't know how they work," said Wager.

At the Northwestern University Feinberg School of Medicine researchers are trying to figure out how and why placebos work in pain relief. They have seen it happen. In a recent study, 30 patients with lower back pain received either a patch with pain medication or a patch with nothing.

"They all feel better but there is no difference between the drug vs. just the cloth by itself," said Vania Apkarian, Ph.D., neuroscientist, Northwestern University.

Both groups reported more than 50 percent less pain. But Dr. Apkarian says a fake treatment, even if it results in a real response, is not a cure. His goal is to understand why the brain reacts to placebos the way it does so real treatments can then be developed.

"Our main drive in our research is to be able to distinguish them from each other to be able, to identify specific networks, mechanisms, chemicals in the brain from which we can develop new drugs," said Dr. Apkarian.

Jonathan doesn't understand how he got better and back on his feet but he gives a lot of credit to the power of his mind.

"The human body is something that scientists will never figure out," said Jonathan.

Researchers say people who are most optimistic tend to respond to placebos and that's often women. In the future, doctors hope to harness how placebos work and stimulate the brain to enhance treatment or the production of pain relief.

Vania Apkarian, Ph.D.
Neurophysiologist, Northwestern University Feinberg School of Medicine
apkarianlab.northwestern.edu
Office: 312-503-0404
Email: a-apkarian@northwestern.edu

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