Open-Label Placebos | Mind Over Matter?

As far as medicine goes, placebos are objectively the most useless prescriptions in regard to their active ingredients…being none whatsoever. Still, these “sugar pills” as they’re known somehow create noticeable, positive health effects in patients. Conventional perspectives would say it’s the thought of receiving treatment that actually makes the impact. Now, new research studies are showing how “open-label” placebos may actually yield similar results, throwing into question what exactly is at play here.

What Are Open-Label Placebos?

For most curious reasons, the psychology of humans lends itself to generating positive health effects through little more than becoming convinced said positive health effects are occurring. Simply put, sugar pills help some of us with the whole mind over matter thing.

The Placebo Effect as seen on The Andy Griffith Show:

Until recently, it has been agreed upon that placebos work based on the fact that patients are unaware that their medicine is chemically inert. Recently, clinical epidemiologist Dr. Jeremy Howick published a review addressing five previous research studies showing how open-label placebos — or those pills which patients are aware are inactive — may also be similarly effective to their normal placebo counterparts. So, if it’s not the fact that placebos are believed to be real drugs, how are such results possible?

Looking at Open-Label Placebo Studies

One study reviewed by Dr. Howick’s publication comes from a trial led by Professor Ted Kaptchuk of Harvard Medical School. Here, Kaptchuck treated irritable bowel syndrome (IBS) patients with either an open-label placebo or nothing at all. Much to the surprise of those reviewing the study, patients who took the placebos actually experienced a significant degree of relief from their symptoms, particularly less pain caused by IBS. Remarkably, one patient almost made a full recovery from the syndrome until the treatment stopped, becoming sick once more without access to the placebos.

The other studies in Dr. Howick’s review addressed the effectiveness of open-label placebos on patients being treated for depression, ADHD, and even lower back pain. Amazingly, similar results to the IBS study were reported, adding to the mysterious forces behind these so-called sugar pills.

How do Placebos Work?

Now, it’s safe to say that placebos don’t always work — even regardless of a patient’s awareness of their pseudo-prescriptions. Yet despite the subjective nature of this effect, previous research shows that placebos can cause real physiological changes. The main examples include increased levels of dopamine in the brain, as well as a higher level of endorphins circulating throughout the body, which results in lessened sensations of pain.

Other research has shown placebos being particularly effective for patients suffering from fatigue, itching, and pain — all things that the brain can modulate to be perceived in different ways. Additionally, an individual’s genetics can also play a part in the effectiveness of a placebo. Otherwise, several hypotheses attempt to explain why open-label placebos, in particular, seem to work as well as they do. One answer is that the act of seeing doctors and “receiving medical attention” releases a boost of neurotransmitters and endorphins to produce overall feelings of well-being.

It may even be as simple as patients believing that if others are experiencing positive health effects, then they should too. If there is one takeaway point let it be this: physicians can make a positive difference in a patient’s overall health just by providing quality attention. Obviously, the point is not to lie to your patients, but to realize that encouraging a positive outlook can be a subtle form of medicine in and of itself!

Author: Connor Smith

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