Does your head hurt? Take a placebo!
Placebo relieves headaches
Kirill Stasevich, And in one of the most recent articles in the journal Science Translational Medicine (Kam-Hansen et al., Altered Placebo and Drug Labeling Changes the Outcome of Episodic Migraine Attacks), a group of researchers from Harvard Medical School and Deaconess Beth Israel Medical Center (USA) reports another ability of this miracle-a remedy: it deals with migraines.
Perhaps it would not be so interesting if we were not talking about a placebo. The term "placebo" itself appeared at the beginning of the XVIII century, but the idea of a drug-free healing effect has existed for many centuries: doctors have long known that for more effective treatment in patients it is necessary to maintain high morale, optimism and expectation of a speedy recovery.
However, the use of placebo often met with objections from "medical ethicists": after all, whatever one may say, this is a deception of the patient. In addition, with all its advantages, this strange psychophysiological effect is not at all omnipotent: you should not expect a placebo to get rid of symptoms that can be called objective (like high blood pressure), and you should not expect that with the help of a placebo you can expel the infection from the body. But at the same time, placebo is able to effectively relieve various types of pain, which largely depends on a person's sense of self and can be called a subjective symptom – after all, it may really seem to us that something hurts more than it really does.
In other words, the placebo effect is related to our perception of our own body and state of health. At the same time, the effectiveness of the placebo obeys rather curious patterns. For example, when a placebo was passed off as a muscle relaxant or muscle stimulator, the placebo relaxant acted more effectively than the placebo stimulator. In another study, it was found out that red, yellow and orange "dummy" pills work better if they are given out as stimulants, and it is better to paint pseudo-sedatives in green and blue. Finally, the size of the pill itself can also affect its effectiveness: large placebo pills work better than small ones.
At the same time, the neurobiological mechanisms behind the placebo effect remain largely a mystery. Observations of brain activity, which accompanied the use of a pseudo-anesthetic, showed that in the cerebral cortex, different areas are triggered than when taking a normal analgesic. Moreover, the areas of the cortex that respond to placebo are related to higher cognitive functions, such as memory, attention, etc.
If we go back to the last work about placebo and migraine, the experiment in it was built like this: sixty-six volunteers suffering from regular migraines were given envelopes with certain pills that they had to take at the next attack. Some received envelopes on which it was written "maxalt" (the commercial name of risatriptan, a well-known headache remedy). Other envelopes had no designations – and in this case the expectations from the medicine were neutral. Finally, there were envelopes that honestly informed everyone around them that they contained a placebo. In this case, the person formed negative expectations – after all, he knew in advance that there was no medicine there.
But at the same time – regardless of the inscription – some envelopes contained a real cure for migraines, while others still had a placebo. That is, as a result, Rami Burstein and his colleagues could compare different combinations between subjective expectations (positive, neutral and negative) and the drug itself (real or dummy). Of course, scientists proceeded from the self-perception of patients, from how patients felt their pain when taking a particular substance from a particular envelope.
As mentioned above, the placebo proved its effectiveness once again: if a person drank it under the guise of a real analgesic, the result was the same as when taking a real analgesic under the guise of a placebo. If the analgesic was taken as is, then its effectiveness was only twice as high as in the case when it was passed off as a placebo.
That is, positive expectations are quite comparable in strength to the effect of a real medicine. Which, of course, should push doctors even more to use placebo in therapy, although it would seem to contradict medical ethics. It is simply not necessary, firstly, to overestimate the placebo: it, as it was said, does not work on "real", objective symptoms. And secondly, we should not forget about the nocebo – a negative analogue of placebo, which can lead to a deterioration of the patient's condition due to the expectation of side effects from the drug, including from the imaginary.
Prepared based on the materials of the Beth Israel Deaconess Medical Center:
Study Shows That Information Is as Important as Medication for Treatment of Migraine PainPortal "Eternal youth" http://vechnayamolodost.ru