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• Placebo Effect
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Alternative medicine - Placebo effect
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Use of placebos in order to achieve a
placebo effect in integrative medicine
has been criticized as “diverting
research time, money, and other
resources from more fruitful lines of
investigation in order to pursue a
theory that has no basis in biology”.
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Alternative medicine - Placebo effect
Another critic has argued that academic
proponents of integrative medicine
sometimes recommend misleading patients
by using known placebo treatments in order
to achieve a placebo effect. However, a 2010
survey of family physicians found that 56% of
respondents said they had used a placebo in
clinical practice as well. Eighty-five percent of
respondents believed placebos can have
both psychological and physical benefits.
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Placebo - Placebo effect and the brain
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These changes can act upon the brain's
early stages of information processing:
Research using Event-related
potential|evoked brain potentials upon
painful laser pulses, for example, finds
placebo effects upon the N2–P2, a
biphasic negative–positive complex
response, the N2 peak of which is at about
230 ms, and the P2 one at about 380 ms
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Placebo - Placebo effect and the brain
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The brain is also involved in less-studied ways upon
nonanalgesic placebo effects:
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Placebo effect
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Placebo effect consists of several different
effects woven together, and the methods
of placebo administration may be as
important as the administration itself.
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Placebo effect
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Placebo effects are subject of recent
scientific research aiming to
understand underlying
neurobiological mechanisms of action
in pain relief, immunosupression,
Parkinson disease and Depression
(mood)|depression.Neurobiological
Mechanisms of the Placebo Effect,
Fabrizio Benedetti, Helen S. Mayberg,
Tor D. Wager, Christian S. Stohler, and
Jon-Kar Zubieta,
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Placebo effect
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The Journal of Neuroscience, 9 November
2005, 25(45)
[http://www.jneurosci.org/content/25/45/1039
0.full] Brain imaging techniques done by
Emeran Mayer, Johanna Jarco and Matt
Lieberman showed that placebo can have
real, measurable effect on physiological
changes in the brain.The neural correlates of
placebo effects: a disruption account,
Matthew D. Lieberman, Johanna M. Jarcho,
Steve Berman, Bruce D. Naliboff,
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Placebo effect
Placebos are widely used in medical
research and medicine, and the placebo
effect is a pervasive phenomenon; in fact,
it is part of the response to any active
medical intervention.
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Placebo effect
The placebo effect points to the
importance of perception and Neural top
down control of physiology|the brain's role
in physical health
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Placebo effect
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Most studies have attributed the difference
from baseline until the end of the trial to a
placebo effect, but the reviewers
examined studies which had both placebo
and untreated groups in order to
distinguish the placebo effect from the
natural progression of the disease.
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Placebo effect - History
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John Haygarth was the first to investigate the
efficacy of the placebo effect in the 18th-century
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Placebo effect - History
Émile Coué, a France|French
pharmacist, working as an apothecary at
Troyes between 1882 and 1910, also
discovered the potency of the Placebo
Effect. He became known for reassuring
his clients by praising each remedy's
efficiency and leaving a small positive
notice with each given medication. His
book Self-Mastery Through Conscious
Autosuggestion was published in
England (1920) and in the United States
(1922).
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Placebo effect - History
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Beginning in the 1960s, the placebo
effect became widely recognized and
placebo controlled trials became the
norm in the approval of new
medications.
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Placebo effect - Mechanism of the effect
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A 2001 meta-analysis of clinical trials with
placebo groups and no-treatment groups
found no evidence for a placebo effect on
objectively measured outcomes and
possible small benefits in studies with
continuous subjective outcomes
(particularly pain). A 2004 follow-up
analysis found similar results and
increased evidence of bias in smaller trials
that calls into question the apparent
placebo effect on subjective outcomes.
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Placebo effect - Mechanism of the effect
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Because the placebo response is simply
the patient response that cannot be
attributed to an investigational
intervention, there are multiple possible
components of a measured placebo effect
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Placebo effect - Brain and body
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Recent reviews have argued the placebo
effect is due to top-down control by the
brain for immunity and pain
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Placebo effect - Brain and body
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A recent fMRI study has shown that a
placebo can reduce pain-related neural
activity in the spinal cord, indicating that
placebo effects can extend beyond the
brain.
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Placebo effect - Clinical significance
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Another group of researchers noted the
dramatically different conclusions between
these two sets of authors despite nearly
identical meta-analytic results, and
suggested that placebo effects are indeed
significant but small in magnitude.
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Placebo effect - Clinical significance
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Other writers have argued that the placebo
effect can be reliably demonstrated under
appropriate conditions.
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Placebo effect - Clinical significance
Several clinical (physical placebos,
patient-involved outcomes, falsely
informing patients there was no placebo)
and methodological (small sample size,
explicit aim of studying the placebo effect)
factors were associated with higher effects
of placebo
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Placebo effect - Clinical significance
In 2013 Jeremy Howick et al. used
Hróbjartsson Gøtzsche's data to compare
the magnitude of placebo effects with the
magnitude of treatment effects. They
found a statistically significant difference
between placebo and treatment effect
sizes in trials with binary outcomes but not
in trials with subjective outcomes.
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Placebo effect - Doctor-patient relationship
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* Roughly only 30% of the population
seems susceptible to placebo effects,
and it is not possible to determine
ahead of time whether a placebo will
work or not. (However the placebo
effect is zero in studies of blood
poisoning and up to 80% in studies of
wound on the duodenum).
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Placebo effect - Genes
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In social anxiety disorder (SAD) an inherited
allele|variant of the gene for tryptophan
hydroxylase 2 (enzyme that synthesizes the
neurotransmitter serotonin) is linked to
reduced amygdala activity and greater
susceptibility to the placebo
effect.[http://sciencenow.sciencemag.org/cg
i/content/full/2008/1202/1 The Placebo
Effect: Not All in Your Head], ScienceNOW
Daily News, 2 December
2008[http://www.newscientist.com/article/
mg20026854.900-first-placebo-genediscovered.html?DCMP=OTCrssnsref=online-news First 'placebo gene'
discovered], New https://store.theartofservice.com/the-placebo-effect-toolkit.html
Scientist, 03 December
2008
Placebo effect - Genes
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In a 2012 study, variations on the COMT
(catechol-O-methyltransferase) gene
related to dopamine release are found to
be critical in the placebo effect among the
patients with irritable bowel syndrome
participating in the trial, a research group
in Harvard Medical School reported
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Placebo effect - Symptoms and conditions
The placebo effect occurs more
strongly in some conditions than
others. Dylan Evans has suggested
that placebos work most strongly upon
conditions such as pain, swelling,
stomach ulcers, depression, and
anxiety that have been linked with
activation of the Acute-phase
reaction|acute-phase response.
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Placebo effect - Pain
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The placebo effect is believed to reduce
pain in two different ways. One way is by
the placebo initiating the release of
endorphins, which are natural pain
killers produced by the brain. The other
way is the placebo changing the patient's
perception of pain. A person might
reinterpret a sharp pain as
uncomfortable
tingling.[http://www.cancer.org/treatm
ent/treatmentsandsideeffects/treatment
types/placebo-effect Placebo Effect].
Cancer.org. Retrieved on 2013-08-25.
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Placebo effect - Depression
In 1998, a meta-analysis of published
antidepressant trials found that 75% of the
effectiveness of anti-depressant
medication is due to the placebo effect
and other non-specific effects, rather than
the treatment itself.Kirsch, I
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Placebo effect - Gastric and duodenal ulcers
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Moreover, in many of these trials the gap
between the active drugs and the placebo
controls was not because [the trials'
constituents] had high drug effectiveness,
but because they had low placebo
effectiveness.
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Placebo effect - List of medical conditions
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The effect of placebo treatments (an
inert pill unless otherwise noted) has
been studied for the following medical
conditions. Many of these citations
concern research showing that active
treatments are effective, but that
placebo effects exist as well.
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Placebo effect - Placebo-controlled studies
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The placebo effect makes it more difficult
to evaluate new treatments. The placebo
effect in such clinical trials is weaker than
in normal therapy since the subjects are
not sure whether the treatment they are
receiving is active.
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Placebo effect - Placebo-controlled studies
This is particularly likely, given that new
therapies seem to have greater placebo effects
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Placebo effect - Placebo-controlled studies
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Clinical trials are often double-blinded so
that the researchers also do not know
which test subjects are receiving the active
or placebo treatment. The placebo effect in
such clinical trials is weaker than in normal
therapy since the subjects are not sure
whether the treatment they are receiving is
active.
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Placebo effect - Nocebo
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The recipients of the inert substance
may nullify the placebo effect intended
by simply having a negative attitude
towards the effectiveness of the
substance prescribed, which often
leads to a nocebo effect, which is not
caused by the substance, but due to
other factors, such as the patient's
mentality towards his or her ability to
get well, or even purely coincidental
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Placebo in history - Placebo effect
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The first to recognize and demonstrate
the placebo effect was English
physician John Haygarth in 1799
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Placebo in history - Placebo effect
The wooden pointers were just as
useful as the expensive metal ones,
showing to a degree which has never
been suspected, what powerful
influence upon diseases is produced
by mere imagination.Wootton, David.
Bad medicine: Doctors doing harm
since Hippocrates. Oxford University
Press, 2006. While the word placebo
had been used since 1772, this is the
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Placebo in history - Placebo effect
In modern times the first to define and
discuss the placebo effect was T.C
Graves, in a published paper in The
Lancet in 1920. He spoke of the placebo
effects of drugs being manifested in those
cases where a real psychotherapeutic
effect appears to have been produced.
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Placebo in history - Placebo effect
In 1946, the Yale biostatistician and
physiologist E. Morton Jellinek described
the placebo reaction or response. He
probably used the terms placebo response
and placebo reaction as
interchangeable.Jellinek, E. M. Clinical
Tests on Comparative Effectiveness of
Analgesic Drugs, Biometrics Bulletin,
Vol.2, No.5, (October 1946), pp. 87–91.
Henry K. Beecher's 1955 paper The
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Placebo in history - Placebo effect
It has been suggested that a
distinction exists between the placebo
effect (which applies to a group) and
the placebo response (which is
individual).
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Alternative health - Placebo effect
1
Use of placebos in order to achieve a
placebo effect in integrative medicine
has been criticized as diverting
research time, money, and other
resources from more fruitful lines of
investigation in order to pursue a
theory that has no basis in biology.
https://store.theartofservice.com/the-placebo-effect-toolkit.html
Placebo effect (disambiguation)
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* Placebo effect, the tendency of any
medication or treatment, even an
inert or ineffective one, to exhibit
results simply because the recipient
believes that it will work
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Placebo effect (disambiguation)
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* Placebo Effect (Doctor Who)|Placebo
Effect (Doctor Who), an original novel
written by Gary Russell and based on the
long-running British science fiction
television series Doctor Who
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Placebo effect (disambiguation)
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* Placebo Effect, a song by English postpunk band Siouxsie and the Banshees on
the 1979 album Join Hands
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Henry K. Beecher - Beecher and the Placebo effect
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His 1955 paper constantly and correctly
speaks of placebo reactors and placebo
non-reactors; furthermore, Beecher
(1952), Beecher, Keats, Mosteller, and
Lasagna (1953), Beecher (1959),
consistently and correctly speak of
placebo reactors and placebo nonreactors; they never speak of any placebo
effect; and, finally, in his Research and the
Individual: Human Studies (1970),
Beecher simply speaks of placebos.
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