The placebo effect

definition of the placebo

Origin
It appeared in the late 18th century from latin. It means
literally I shall be acceptable or pleasing

usually pharmacologically inert preparation prescribed

more for the mental relief of the patient than for its
actual effect on a disorder
substance that has no therapeutic effect, used as a
control in testing new drugs.
 What is a placebo
Placebos are dummy treatments. Doctors of old
prescribed them for demanding patients who wanted
some sort of pill or injection for their illnesses. A typical
placebo might be a pill containing only sugar or bread
or an injection containing only salt and water, and a
placebo "sham" operation was one in which the patient
was cut open and then sewn right back up. All of these
so-called dummies were given to placate the patient,
not to fix the illness-hence the Latin name placebo,
which means "I shall please
 Case 1
On the north African battlefield of world war ll, wounded
soldiers were plentiful but morphine was scares. Army
doctor henry breecher needed to operate on an injured
soldier but there was no drug to give him for the pain.
The nurse grabbed a bottle of saline and filled the
syringe with saline only ( no drug at all ) and she
injected the soldier. Surprisingly the soldiers pain went
away and the doctor began his operation.
Case 2
Mr. Wright was a patient of psychologist Bruno Klopfer in 1957, had large tumors, and
was expected to die from the disease. Mr. Wright gave a new drug called Krebiozen a
try. Heres how this sad but insightful case unfolded:
After receiving shots of Krebiozen over the course of several days, his tumors
disappear.
Several months later after hearing news reports that question the effectiveness of the
drug Mr. Wright has a relapse and is once again near death.
His doctor then tells him that the news reports were due to early shipments of the
drug deteriorating and that this problem has been fixed. The doctor then gives him
injections of water (a placebo). Mr. Wright becomes hopeful again and responds to the
treatment (of just water).
But once again, after reading more news reports that indicate the drug is ineffective,
Mr. Wright relapses again, is re-admitted to the hospital and in a couple of days, dies.
 The placebo effect
Two psychological mechanisms appear to contribute to the placebo
effect:expectancy(believing that a positive bodily change will occur)
andconditioning(being in circumstances that, in the past, produced a positive bodily
change).
Expectancy:
Say you are experiencing pain and spontaneously decide to eat a sugar pill chances are you
wont feel better. However, if you describe your symptoms to a physician, who then prescribes
you the same pill (unbeknownst to you, its just sugar), you expect that pill to have a
therapeutic benefit. This expectation activates reward pathways in the brain, in turn
stimulating the release of substances called endorphins, which are chemically similar to
opiates like morphine. Like morphine, these endorphins bind to opioid receptors and cause
pain relief. Therefore, in response to positive expectations of treatment, your brain becomes
flooded with its own supply of natural painkillers. In one study, when patients in pain following
surgery were given a visible injection of a narcotic painkiller into their intravenous tubing, they
experienced twice as much pain relief as when the same drug was given by hidden injection
 The opioid system is not the only pathway at play when
it comes to placebos. For example, placebos also
increase the release and uptake of dopamine, a
neurotransmitter involved in reward-motivated behavior
and decreased pain sensitivity. Specifically, in
anticipation of benefit when a placebo is administered,
dopamine receptors are activated in regions of the brain
associated with reward.
conditioning
Placebos can act similarly throughclassical conditioning
, wherein a placebo and an actual stimulus are used
simultaneously until the placebo is associated with the
effect from the actual stimulus.Both conditioning and
expectations play a role in placebo effect,and make
different kinds of contribution. Conditioning has a
longer-lasting effect,and can affect earlier stages of
information processing.Those that think that a
treatment will work display a stronger placebo effect
than those that do not, as evidenced by a study of
acupuncture.
 Different placebos have
different effect on expectations
and results
Placebos are all built on the expectations of the patient.
It all depends on the way the patient thinks of how
powerful the medicine is so,
a placebo pill < plain placebo capsule
Placebo capsule < a colored stamped capsule
A placebo colored capsule < a placebo syringe
A placebo syringe < a placebo surgery

The more complicated the medicine is, the more the rise
of expectations for the patient and so the better the
 The nocebo effect
(Latinnocebo "I shall harm").Anocebo effectoccurs
when the recipient of an inert substance reports a
negative effect and/or a worsening of symptoms, with the
outcome resulting not from the substance itself, but from
negative expectations about the treatment. A group with
administered with fake chemotherapy, surprisingly they
reported massive hair loss and fatigue.
Your doctor can either be a
placebo or a nocebo
Your doctors words can affect your treatment by either
being your placebo or your nacebo
A doctor who tells you that you will get better by time
and that your case is curable, will affect your minds
perception of your illness
On the other hand, a doctor who tells you that your
case is incurable and that you wont have a good
chance for a long life, will affect your body directly and
will cause a downcline in your overall health and illness
 Placebos and medical industry
placebodouble-blind studies are so important when
conducting clinical trials. Clinical trials are studies on
drugs not yet approved by the FDA. There are four
phases to clinical trials, and in phase 3, placebo
double-blind studies are conducted in various clinics
and hospitals. We are looking at the safety and efficacy
of the study drug. Do the drug's benefits outweigh its
side effects, and does it show effectiveness beyond that
of a placebo?
 Placebo effects and daily life
In conclusion to all of the placebo effect, we can see
that our psychological state will affect our bodies by all
means. For a longer and a better life with less illness
and medication we need to take care of
- healthy relation ships
Healthy sexual life
Healthy work environment with less stress
Healthy environment with less pollution
Thank you