13 March 2009

You may ever go to the doctor office and he gave you some pill you should take. Do you wonder what are those pills? Analgesic? Antipyretic ? Antidepressant? Don't be surprise, those pills could be a fake medications! Those are placebo! So, Is it danger?

Giving powerful drugs to vulnerable patients who likely don't know what they're taking for unproven reasons is obviously problematic. A survey found that nearly 45% doctors had given a placebo to a patient at some point in their career. Only 3% of these placebos were actual sugar pills or other inert tablets. Most were treatments, such as antibiotics, herbal supplements, or vitamins, that had no proven health benefit for the patients’ conditions.

The oddly thing is, about 4% of them actually told the patients it was a placebo, which presumably means they believed those patients had no idea what a placebo was. More than a quarter of the placebo-using docs told patients it was a medicine or medication; a third told patients they were providing a substance that "may help" but wouldn't hurt them.

For better or worse, a pill is often a powerful symbol of healing in Western medical culture. It can be a very humanistic and empowering thing. It's less about a sugar pill and more about channeling this power of positive thinking or symbols of healing for patients.

A study in Italy suggested that the use of placebos as a painkiller could lead to the production of endogenous opiates—naturally occurring painkillers in the body. And if doctors ask patients at their first visit if it is OK at some point in their doctor-patient relationship to receive a placebo.

The placebo effect is powerful and well documented; it makes some sense that doctors would exploit it in cases where other meds don’t work or aren’t appropriate. Some analyzes, for example, suggest that the response to antidepressant drugs in patients with mild and short-term depression are indistinguishable from the response to placebos (though the drugs are clearly beneficial for more severe depression).

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