Placebo

A placebo is a preparation which is pharmacologically inert but which may have a medical effect based solely on the power of suggestion, a response known as the placebo effect or placebo response. It may be administered through ingestion, injection, inhalation, insertion into a body cavity, or applied topically.

Sometimes known as non-specific effects or subject-expectancy effects, a so-called placebo effect occurs when a patient's symptoms are altered in some way (i.e., alleviated or exacerbated) by an otherwise inert treatment, due to the individual expecting or believing that it will work. Some people consider this to be a remarkable aspect of human physiology; others consider it to be an illusion arising from the way medical experiments are conducted.

However, some recent research indicates that the placebo effect may not be real. In May 2001 the New England Journal of Medicine published a study by researchers from the University of Copenhagen and the Nordic Cochrane Center, Rigshopitalet, in Denmark. They were trying to measure the strength of the placebo effect. From 727 studies they focused on 114 to test pharmacological, physical, and psychological placebos involving 7,500 patients. These studies tested medicine, placebo, and no treatment (that is, they merely monitored the patient). Doctors know that about 35% of patients given a placebo will be cured. The conventional wisdom was that the placebo "helps the patient cure himself". However, these researchers found that those not given any treatment were cured at about the same rate as the placebo groups, and that this was statistically significant. (They found that placebos DID have a somewhat beneficial effect, but only for pain control.) The authors wrote "We found little evidence in general that placebos had powerful clinical effects." If the results of this study gain wide acceptance it would indicate that placebos are generally ineffective as a medical treatment, and the study recommended that placebos not be prescribed as treatment. Conventional medicine has apparently still not responded to the results of this research as yet.

A review article on 'The Placebo Effect' by Dr Sundararajan Rajagopal, Consultant Psychiatrist at St. Thomas' Hospital in London, in the Journal 'Psychiatric Bulletin' () looks at the background of the placebo effect, defines the common terms used, describes the various hypotheses that have been put forward to explain this seemingly inexplicable phenomenon and also covers the issue of using placebos in research trials, highlighting the important ethical dilemmas involved.

A placebo is sometimes called a "sugar pill" in informal writings for the general public to quickly say that it has no useful medicinal content.

The word "placebo" has been used in many somewhat varying meanings; see below.

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