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Lecture 10 - Placebo and Expectancy

Lecture 10 - Placebo and Expectancy - Mind Over Matter...

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Mind Over Matter: Placebos and Expectancies
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Quiz! 1. T/F:’Placebos’make’pa3ents’ feel be7er;’they’don ` t’actually’ get be7er’ 2. T/F:’There’are’no’nega3ve’e±ects’ of’placebos’ ². T/F:’Placebos’can’reduce’asthma’ and’make’wounds’heal’faster’ 4. T/F:’Placebo’therapy’could’be’the’ end’of’biomedicine’as’we’know’it’ 5. T/F:’Doctors’can’lie’to’pa3ents’if’it’ is’in’the’pa3ent ` s’best’interest.’
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Placebo • From’La3n’placere’-’ l to’please z ’or’ l I’will’please z • Placebo’ l an’innocuous’ substance ’without’a’specifc’physiological’e±ect z • Clearly’ac3ve’and’not’innocuous;’ • has’physiological’e±ects’ – any’ treatment ’devoid’o²’specifc’ac3ons’on’the’pa3ent ` s’ symptoms’or’diseases’that,’ somehow ,’can’cause’an’e±ect’upon’ the’pa3ent.’ • Obviously’have’specifc’ac3ons’but’true’that’we’don ` t’know’ precisely’how’
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Examples of Placebos • Inert’pills,’drugs,’or’ injec3ons’ • Sham’surgeries’ • Inac3ve’medical’ devices’ • Efec3ve/non-efec3ve’ acupuncture’
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The’Placebo’Efect • Based’on’ expectancies "an3cipa3on’oF’a’systema3c’iF/then’rela3onship’between’events’and’ objects."’(Tolman,’19±2)’ • A²ic3ons’that’have’strong’psychological’component’ (pain,’anxiety,’and’depression)’tend’to’show’high’rates’oF’ placebo’efects’ – ~’65%’oF’pa3ents’in’an3depressant’trials’get’be7er’with’drug’ – ~’±5%’oF’pa3ents’in’an3depressant’trials’get’be7er’with’placebo’ – Many’3mes’these’rates’don ` t’difer’sta3s3cally’(±0%’rule)’ • A’meta-analysis’showed’that’an3depressants’relied’on’ the’placebo’efect’For’³5%’oF’their’efec3veness’ • The’remaining’25%’ l real z ’drug’efect’may’be’a’disguised’ placebo’efect’
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The’Placebo’Efect’(cont) • Produces’real’physical’diferences’(UCLA,’2002’study)’ • Blocked’by’real’drugs,’e.g.,’opioid’antagonists’ • Placebos’have’side’efects’(nocebo)’ • Placebo’efects’can’last’For’a’long’3me:’over’8’weeks’For’ panic’disorder,’6’months’For’angina’pectoris,’and’2.5’ years’For’rheumatoid’arthri3s.’ • Depressed’pa3ents’who’respond’to’placebos’difer’ biochemically’From’those’who’don ` t’(suscep3bility’might’ be’gene3c)’ – Short-term’depression’(<’±’months)’more’responsive’ – Long-term’depression’(>’1year)’not’responsive’
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