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Some Placebos Heal Better Than Others

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  • medit8ionsociety
    Here s an article that I found interesting that deals with the mind/body connection. I think is on-topic for our group and hope you enjoy it and that it gives
    Message 1 of 1 , Feb 6, 2006
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      Here's an article that I found interesting that
      deals with the mind/body connection. I think is on-topic
      for our group and hope you enjoy it and that it gives
      you a greater understanding of how belief works in and
      on us.
      Peace and blessings,
      Bob

      BOSTON, Feb. 2 - In a dual between two placebos for
      treating self-reported arm pain, the better placebo
      emerged victorious, Harvard researchers have found.
      They attributed it to the placebo effect.


      During the first two weeks of the comparative study,
      there was little difference between sham acupuncture
      and a sugar pill, investigators reported in today in
      BMJ Online First. However, differences began to emerge
      during the following weeks showing that sham acupuncture
      produced a more enhanced and surprisingly lasting placebo effect.


      A longitudinal regression analysis that followed patients
      through the study period showed that pain scores per week
      declined significantly more in the sham acupuncture group
      than in the sugar pill group (-0.33 [95% confidence
      interval -0.40 to -0.26] vs. -0.15 [95% CI -0.21 to -0.09];
      P<0.001).


      The same held true for symptom severity with scores
      dropping more among the patients who received the sham
      acupuncture compared with those who took a sugar pill
      (-0.07 [95% CI -0.09 to -0.05] vs. -0.05 [95% CI -0.06 to 0.03]),
      noted Ted Kaptchuk, a doctor of oriental medicine, of
      the division for research and education in complementary
      and integrative medical therapies at the Osher Institute
      at Harvard.


      The study by Dr. Kaptchuk and colleagues showed that the
      patients who reported improvements in symptoms were also
      those who believed they were getting an active treatment.
      At two weeks, 75% of the participants in the sham
      acupuncture group said they were receiving an active
      treatment compared with only 48% of the sugar pill group,
      indicating that believing may be key to feeling better.


      There were no significant differences between function and
      grip strength between the two groups. However, arm function
      improved more in the sugar pill group (2.0, 95% CI 0.06 to 3.92;
      P=0.04) during the initial two weeks.


      Not surprisingly, both groups reported the side effects that
      they had been warned about at baseline. "The types of side
      effects were totally different in the two study groups and
      clearly mimicked the information given at the informed consent,"
      Dr. Kaptchuk and colleagues wrote.


      Nevertheless, the authors said the results illuminate some
      interesting points regarding the ever-mysterious placebo effect.


      "These findings suggest that the medical ritual of a device
      can deliver an enhanced placebo effect beyond that of a
      placebo pill," Dr. Kaptchuk said. "There are many conditions
      in which ritual is irrelevant when compared with drugs, such
      as in treatment of a bacterial infection, but the other
      extreme may also be true. In some cases, the ritual may be
      the critical component."


      Dr. Kaptchuk's study had two parts. A total of 270 patients
      with upper arm pain from repetitive strain injury were
      randomly assigned to receive either the sham acupuncture
      treatment twice per week for two weeks or take a sugar pill
      every night for two weeks.


      Most patients were in their mid- to late-30s and were white.
      Approximately 20% of the group reported NSAID use. Both
      groups were explicitly informed about potential side effects.


      The needles used in the sham acupuncture treatment were
      identical to those used in active acupuncture. The patients
      saw and felt the needles. However, unlike true acupuncture
      needles, the sham needles had a blunt tip and retracted into
      a hollow shaft handle. At every treatment, a minimum of five
      needles was placed in the arm and one was always placed in the
      foot.


      In the second part of the study, the same patients were
      randomized again, but this time, half of the acupuncture
      patients either continued with their sham acupuncture or
      switched to real acupuncture whereas the other half either
      continued taking a placebo pill or switched to a pill
      containing 25 mg of amitriptyline. The acupuncture treatments
      lasted an additional four weeks (the time believed to achieve
      a clinical effect) and the pill treatment lasted an additional
      six weeks (the time believed to achieve optimal drug blood
      concentrations).


      "The results of our study provide evidence that a placebo effect
      exists over time, even when instructions are neutral," the
      researchers concluded.


      They noted that the findings were limited by the fact that
      there were no participants on a waiting list, a variable
      that could have affected the interpretation of the results
      as there was no true control group without any intervention.
      The study also did not examine whether a daily placebo
      compared with weekly placebo treatments made a difference or
      whether more frequent attention from a health care provider
      may have influenced the results.


      Primary source: British Medical Journal
      Source reference:
      Kaptchuk et al, "Sham device v. inert pill: randomized controlled
      trial of two placebo treatments," British Medical Journal Online
      First, Feb. 1, 2006;

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      http://www.medpagetoday.com/PrimaryCare/AlternativeMedicine/tb/2604
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