Placebos Can Be Bona Fide Painkillers

Memories formed following previous intake of actual drugs are triggered by a placebo pill resulting in a real effect to fight pain and inflammation, according to a new Italian study. First thing, though, you better trust your doctor.

Is it real? (stephalicious)
Is it real? (stephalicious)
Marco Accossato

TURIN - Yes, placebos can truly kill the pain.

According to a new study by researchers at the University of Turin's neuroscience department, there are demonstrable physical benefits of taking a placebo for treating pain and inflammatory conditions. The study showed how painkillers and anti-inflammatory drugs in fact leave marks on our brains. These marks, in turn, help to recreate the same effects of an actual treatment in patients that are merely thinking of taking an active drug while actually taking a placebo, or an inert drug with no chemical activity.

According to the study, whether or not a patient believed in the treatment he was receiving and expected to improve played an important role with all factors associated with the ability of a patient's brain to produce endorphins (similar to morphine) to fight pain, and endocannabinoids (similar to cannabis found in marijuana) that is active against inflammation.

The research, whose findings were published this week in "Nature Medicine" journal, was coordinated by Fabrizio Benedetti, Professor of Physiology at the University of Turin, and consultant to the National Institute of Health and Harvard University's Mind-Brain-Behavior Research Initiative.

It is still not clear what the mark left in the brain actually is, or the precise location of the pharmacological memory switch in the central nervous system that occurs when taking a placebo. But the study did indicate that the anti-pain placebo and the anti-inflammatory placebo activate the same receptors that specific drugs activate, and initiate the same process on the molecular level of actual treatment. The substances in the patient that are released during the placebo effect (endorphins or endocannabinoids) vary, depending on the drugs the patient has previously taken, or the memory traces previously created.

In Doc We Trust

The study was carried out in volunteers who received real drugs initially. Most patients started to improve. When researchers then started to administer placebo substances without informing the patients, a conditioned response was seen. The mere association of the intake of a certain pill resulting in the disappearance of symptoms, led patients to learn that they would achieve the same benefit even if it was a placebo drug they took – a pill with identical look in terms of shape and color, but without possessing the active ingredient.

Previous studies have shown that the relationship the patient has with the doctor plays an important role in this memory effect. Only if the doctor is capable of assuring the patient that the real drug will help, will the placebo have the same effect as the actual treatment. In this case, the placebo will activate the endorphin pain receptors or the endocannabinoid receptors that reduce inflammation.

Professor Benedetti has extensive experience in placebo-related research. This recent discovery showed a benefit over a short period of time. It does not, however, automatically translate to a placebo effect benefiting patients with chronic illnesses over a long period of time.

"Currently, we can't tell doctors to replace drugs with inert substances and to start the placebo effect, because there is no scientific proof of this mechanism working over a period of years," said Benedetti. "On the other hand, we can say for sure that the use of drugs can be reduced by alternating drugs with placebo, especially when drugs carry serious side-effects."

For more from La Stampa in Italian

Photo - stephalicious

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