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by dr_dshiv 744 days ago
The placebo effect is not a single thing. That is, there are ways of amplifying the effect and minimizing the effect. For maximum effect, treatments ought to be designed to take advantage of the placebo effect to the extent possible. That’s because placebos have low side effects and are often very effective. However, this creates some challenges — how do you test which placebo effect works best? What do you use as a placebo? It’s not that hard, really — just use a placebo with less of a placebo effect.

Niacin was used as the placebo for Timothy Leary’s Good Friday experiment [1], where he randomly dosed catholic monks on psilocybin. Unlike a sugar pill, Niacin creates some facial flushing — so you do feel something. But it would be very clear eventually that you didn’t get the psilocybin. But that doesn’t negate the findings of the experiment.

[1] https://en.wikipedia.org/wiki/Marsh_Chapel_Experiment

1 comments

Sure, for those conditions that have subjective components (e.g. pain, mood) or where there is more or less direct conscious control of the condition (e.g. heart rate, BP), you can vary the strength of such effects.

But in many other conditions, you can't, because that kind of placebo effect is just noise. For example, you can't vary the effectiveness of placebo effects in antibiotics studies (though you may be able to reduce certain side effects like headache or nausea).

Well, you can if there is a mental connection to the immune system. E.g. attitudes toward life and toward disease seems to affect outcomes in cancer patients. And placebos can affect that.
That's true, but I'm not sure such a link has ever been established. Is there any study that has found measurable variance in cancer or infection outcomes based on differences in mental outlook?
Here’s an article that speaks to this: https://www.onclive.com/view/markman-column-optimism-plays-a...

In short, yes! Mental outlook has a big effect on outcomes. It won’t cure you, but it will improve your physical outcomes.

This is the meta analysis they refer to: Rozanski A, Bavishi C, Kubzansky LD, Cohen R. Association of optimism with cardiovascular events and all-cause mortality: a systematic review and meta-analysis. JAMA Netw Open. 2019;2(9):e1912200. doi:10.1001/jamanetworkopen.2019.12200

Fascinating, thank you for sharing this, I'll take a deeper look.