When a patient knows that it's a placebo

[bibblebub]

http://www.guardian.c...ct-patients-sham-drug

In a trial of 80 patients with IBS, half the people were given a placebo and "Not only did we make it absolutely clear that these pills had no active ingredient and were made from inert substances, but we actually had 'placebo' printed on the bottle." said the professor in charge of the test.

"By the end of the trial, almost twice as many patients treated with placebo showed adequate relief of symptoms compared with the control group. Patients taking the placebo also doubled their average rate of improvement to that achieved with the most powerful IBS medications."

In other words just giving the patents something to take, even though they knew that it should be ineffective, gave positive results.

Is this just a statistical anomaly because of the sample size? Have there been any previous studies of a similar nature where the patients know that they are getting the placebos? (did a quick search but couldn't see anything)

[mollykins]

Giving placebos is all about the psycology of the illness, is it possible they could have been real but wanted to see if they still worked even if they patient didn't think they would? or would that be illegal, as there are some medicines you can't take at the same time and if you thought you were only having a placebo you wouldn't say 'oh no I can't have that aswell' that's the only thing i can think of.

[bibblebub]

From that report, both the doctors and patients knew that the pills were completely inert placebos so there was no mixing of drugs or any subterfuge that could be deemed illegal.

[LazyGun]

Its only one trial, and does have limited numbers, so conclusions drawn from such a trial should be regarded as tentative at best.

There is at least one other trial I have read about that suggested that, even when the patient knew they were receiving an inert medication, there was still a self-reported benefit. This trial was from the 60s, and again a small sample size.

The placebo effect is fascinating, but care needs to be taken when interpreting its effectiveness and power. What evidence there objectively is for the positive effects of placebo is slight ,bordering on none when you perform a thorough look back through the clinical literature. There have been several systemic reviews of all the clinical literature,including at least one recent cochrane review ,which show no real benefit of placebo.
Those papers most positive tend to be related to self -limiting conditions or the treatment of pain relief, and of course such reporting is hugely subjective and therefore open to bias.

[237SJ]

Maybe a placebo drug works well on a patient with IBS because (maybe) IBS is a psychosomatic illness?

[craft1948]

Is it 237.......I've suffered from IBS for about 10 years now, and I don't think a placebo will do me much good.

[Buenchico]

Perhaps drug companies should start advertising the benefits of placebos?

http://www.youtube.com/watch?v=Mc9Q2vlZH44

[woofgang]

I have been involved in work improving the "circumstances of care" of some people within the NHS. This involves nicer waiting rooms, improved customer service including communication, providing papers and magazines (new ones) and coffee in the clinics, and cutting down delays on seeing the person at their appointment. There was very strong evidence that such niceties make people feel better even without any change to the clinical treatment. I would suggest that in this case, simply taking the person's condition seriously and paying attention to them by involving them in a clinical trial made them feel better NOT because IBS is "all in the mind" but because that's the way people in general are made. The people I was involved with needed hip replacements, which is deffo NOT psychosomatic!!