Placebo treatment can outperform prescription drugs!

The Goodlife Letter 

 13th March 2011

  • Placebo treatments are given out by German GP's... and their patients get better!
  • Did you know that a placebo treatment could outperform prescription drugs?
  • Would YOU trust a placebo treatment? 

Imagine a world where all your ailments can be cured with no side-effects.

We all know that every drug has some risk attached to it. Common anti-inflammatories often cause stomach upsets, cold remedies make you drowsy and blood pressure pills risk kidney failure. But, there is a way that you can be prescribed an effective and proven treatment without any side effects at all.

I was leafing through The Guardian last week when an article caught my eye. It said that a report had shown that half of German doctors were giving their patients sham treatments.

Now in most circumstances this would be a worry as it implies that these GP's are taking a liberty - and could be putting lives at risk. However, the article was actually in support of this approach!

Let me explain.

On Friday I discussed the way that placebo treatments are considered to be inferior to a modern pharmaceutical option. But for many conditions the response to a 'sham' approach is as good, and sometimes better than for the more expensive alternative.

Well, these German doctors wanted to explore that further.  They actively gave out placebos for things like stomach upsets, colds and even depression. Remarkably, they found that the results helped at least 60% of their patients.

The results show that some areas of Germany use placebo interventions more than others, for instance 88% of Bavarian doctors use this approach successfully - and also save themselves huge amounts of budgetary cost into the bargain!

This is a spectacular success, and I particularly enjoyed a statement made by The German Medical Association who said "we don't fully understand how placebos work, but we know from this report that they have a stronger impact and are more complex than we realised".

Can you imagine our own BMA ever saying something like that?

The placebo effect is not good news for everyone

I can't. For a start they would have to admit that they don't know everything - and that would make them feel uncomfortable.

Many therapies and alternative practices hold at their core a belief in the body's ability to heal itself.

The founder of osteopathy, a man delightfully called Andrew Taylor Still, believed that given time and space the body held all it needed to sort out most problems.

It's true that he was talking about beliefs which were relevant at the time of the American Civil War, and he knew nothing of AIDS, cholera or cancer - however, the principle still has merit. My GP always say that a cold will be cured in a week if he gives medication or will resolve itself in 7 days if he doesn't!

Sometimes we only have to give the slightest of nudges to our body in order for it to be able to reset itself and restore us to good health. It should really be something that we talk about more, after all the impact of these simple interventions has been documented since 1955 - however you can understand that the drug companies don't want to make too much noise about this one.

In fact the placebo effect is often the cause of their drugs failing in development.

Part of the tests that are conducted before a new drug is approved are trials against a placebo. This is often their undoing.

For example, in 2002 the US giant Merck was desperate for a breakthrough drug and was delighted when early trials of MK-869 proved highly effective against depression and carried no side effects. It was only when the drug was tested against a look-a-like pill made of milk sugar that they discovered that the placebo was actually more effective. In the industry jargon the trials crossed the futility barrier... Game over!

The mystery of the placebo effect

So how does the placebo effect work? Well that's just the thing - no-one is absolutely sure.

Everyone agrees that there is a positive effect for most people, but without properly understanding it there is a reluctance to make more use of it.

Probably the best way theory proposed so far is:

  • The treatment causes a change in mental state. Negative states are replaced by positive ones. In most cases this is because the patient expects the drug to have an effect, in part due to our conditioning, but also because we believe that the doctor treating us has experience and expertise and we allow ourselves to be managed by them.
  • By feeling more positive we tend to focus on health more, so that we eat more good things, cut out the bad things and support our bodies in the best way we know e.g. exercise, stop smoking, cut out the booze. Our bodies react by improving our immune status and allowing us to relax more.
  • We recognise any improvement in symptoms and use this to re-enforce our belief that started in stage 1. If our pain level falls we immediately say it was because of the pill or the excellent doctor, rather than just the body sorting itself out anyway.

The end result of all this though, is that we return to good health and function, and that was what we wanted from the beginning.

It would be great for science to properly discover why the effect of placebos is so great, however, in some ways perhaps a little mystery and magic are vital ingredients in the healing process.

If nearly 90% of Bavarian doctors believe so strongly in the power of the body and spirit, for after all that's what I'm suggesting the Placebo effect is, why can't we take heart from this German study and make the most of building our own positive mental attitude to health.

Sugar pill anyone?

Yours, as always

 

 

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