To Use Or Not To Use The Term “Placebo,” That Is (Not) The Question
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About The Author

Sibylle Klosterhalfen is a researcher at the Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.

                       

To Use Or Not To Use The Term “Placebo,” That Is (Not) The Question

Placebos have been around forever, even if they were not named as such. Just think about the stone age, when healers operated with mostly, if not exclusively, placebos, but did not call them that. Today, the term is rather popular (even a pop band is named that way), but it has a negative taste as well - why? "Like the word dirge, placebo has its origin in the Office of the Dead, the cycle of prayers traditionally sung or recited...

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Science Without Giants: What Drives Placebo Research Since The 1990s?

In previous postings, we have pushed some giants of placebo research off their column, or rather, jumped off their shoulders (to refer to Robert Merton's allegory again), namely Henry K Beecher and Stewart Wolf. We have claimed that they cannot be made responsible for the surge of placebo research in the 1990s, as is made visible by the steady increase of the number of studies published every year, from around 50 per year in 1992 to more than 250 nowadays — a delayed...

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On The Shoulders Of Giants, Part 2: Stewart Wolf And The Pharmacology Of Placebos

In comparison to Henry Beecher's much-cited paper, "The Powerful placebo," of 1955 (1), Stewart Wolf's paper, "The pharmacology  of placebos," of 1959 (2) is today almost forgotten; it came along less spectacularly but more scientifically solid, hiding its implicit provocation (there is a biology underlying the placebo effects) behind a seemingly serious title and in an even more serious journal, the reputable Pharmacological Reviews. While Beecher assumed a specific personality of the placebo-reactor, Wolf's assumption was that the underlying mechanism of...

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On The Shoulders Of Giants, Part 1: Henry K. Beecher And The Placebo Effect

When Robert Merton (1910 - 2003) dissected the allegory that we all are "standing on the shoulders of giants" — based on a much older saying by Bernhard of Chartres, according to John of Salisbury in 1159, often falsely attributed to Isaac Newton (1643-1727) who popularized it — (On the shoulders of Giants, published 1965), what he meant was that much of what we (scientists) are taking for granted and as starting points for new explorations, discoveries, and interventions are...

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Placebo Personalities: Fact, Fake, Fiction, Or A Bit Of Everything?

"Do placebo responders exist?" This is a question raised by many and answered by few (1). Are those who respond with symptom improvement after placebo applications, e.g. in a randomized, placebo-controlled drug trial (RCT), people that always respond the same way and exhibit personality traits that allow for the prediction of their future behavior in drug or placebo application based on past behavior? Drug companies testing new compounds would love to know this in advance, as would doctors, pharmacists, and...

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Of Kids And Cats: Placebo By Proxy

Treatment responses in (small) children are difficult to assess since descriptions of symptoms and symptom changes are not easily available without the use of language, e.g. in the case of pain and emotions. The same holds true for therapies in animals, be it domestic animals or otherwise. In all these cases, the judgments rely on observation and interpretation of behaviors through proxies (parents, relatives, caregivers) on the one hand and animal owners on the other. And of course, drug trials...

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The Holy Grail Of Placebo Research: A Single Gene – Or Many – In Control ?

Whenever new research tools become available, scientists get excited about new options to explore, new inventions to make, paradigms to shift, and to kick scientific "saints" off their columns — despite knowing that we all stand on the shoulders of giants, as Robert Merton (1910-2003) has elucidated, and always will. Such was the case when the first brain imaging paper was published showing that there is a neurobiology to the placebo effect (1) — finally proving that it is not...

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The Dark Side Of The Moon: Nocebo Effects In Medicine

In randomized, placebo-controlled drug trials, reports of adverse events (AE) are common. 40% or more of patients report such side effects, and in both the drug and placebo arms of the study; serious adverse events often lead to trial discontinuation. But since neither the doctor nor the patient knows — at this stage — who receives the drug and who receives the placebo, why is it that these AE also can occur after taking placebos? In principle, this question is...

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Dodo Bird Meets Goldilocks: Psychotherapy And The Placebo Effect

In Alice in Wonderland (Chapter III, "A Caucus-Race and a Long Tale"), Alice viewed a race among all animals initiated by the Dodo bird. "… s they began running when they liked, and left off when they liked, so that it was not easy to know when the race was over. However, when they had been running half an hour or so ... the Dodo suddenly called out 'The race is over!' and they all crowded round it, panting, and...

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Sex And The Placebo Effect: Women Learn, And Men Just Listen!

The placebo effect describes the improvement of symptoms in a clinical trial of a new therapy, e.g. a new drug, where some patients receive an "inert" pill (tablet, infusion, or other medicines) that does not contain the pharmacological compounds to be investigated. As these studies usually are double-blinded, neither the patient nor the doctor knows who received the drug and who received the placebo. This is done to control for "unspecific" treatment effects: measurement errors and insecurities, a spontaneous variation...

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