Open Label Placebos: How Starting a Treatment Can Still Produce Pain Relief

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In summary: Kaptchuk, an interesting article. In summary, Ted Kaptchuk describes how starting a treatment (say, opiates for pain) and then substituting placebo afterward (with the patient knowing) can still produce a pain relieving effect. He also talks about how placebo is a tricky matter to study, especially since the expected effect has no lower limit: thus many other causes can compete for anything observable. Finally, he discusses how the body-brain connections and how conscious and subconscious expectations alone actually determines physiological reactions.
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brainpushups
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TL;DR Summary
Placebo doesn't need to be kept secret to have an effect on subjective symptoms
An interesting news article.

Part of it describes how starting a treatment (say, opiates for pain) and then substituting placebo afterward (with the patient knowing) can still produce a pain relieving effect. This aligns with an interesting thing I learned from a neuroscientist several years ago which I guess is a well known 'trick.' Goes something like this: Look at your hand and say "turn red" then place your hand in a bath of warm water for several minutes. Take your hand out and it will be red. Repeat about 28 times. Then do it again without the water and your hand will turn red. Apparently doing things like this in sequence connects neurons in a way that the intermediate step can be bypassed with the same result.

Unfortunately I don't remember the proper name of this type of thing. All I can find when I search is the other trick about putting someone else's hand in warm water (still amusing, but not very nice).
 
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Placebo is a tricky matter to study, especially since the expected effect has no lower limit: thus many other causes can compete for anything observable.
For example, in many cases simple personal interaction (!) can be a help. Or even a laugh.

Nonetheless it's kind of an interesting idea to study placebo-placebo ( o_O ).

The original source (Ted Kaptchuk) definitely does not looks like a crackpot, but that 'Vox' thing has very limited scientific value and this makes interpretations based on them really vulnerable. Be extremely careful.
 
  • #3
brainpushups said:
This aligns with an interesting thing I learned from a neuroscientist several years ago which I guess is a well known 'trick.' Goes something like this: Look at your hand and say "turn red" then place your hand in a bath of warm water for several minutes. Take your hand out and it will be red. Repeat about 28 times. Then do it again without the water and your hand will turn red. Apparently doing things like this in sequence connects neurons in a way that the intermediate step can be bypassed with the same result.
Another robust result that I've seen myself and on myself many times is how not only pain, but the expectation or just "thinking of it", can induce the same symphatetic activation. It is easily measured by skin condutance response. Symphatetic activation of the sweat capillary channels in the skin are under direct symphatetic control and 1-4 seconds after a pain/shock or just "thinking about pain", it is robustly measurable in peripheral skin conductance as a transient and you can't miss it.

The test is, to pinch yourself, or someone else, note the reaction. The try it again and just THINK you should pinch yourself, but you stop and don¨t do it. You get a similar reaction as the real stimuli.

It shows clear how the body-brain connections and how conscious and subconscious expectations alone actually determines physiological reactions.

/Fredrik
 

1. What are open label placebos?

Open label placebos are inert substances or treatments that are openly given to patients with the intention of producing a placebo effect. Unlike traditional placebos, which are given without the patient's knowledge, open label placebos are openly discussed and acknowledged as placebos.

2. How do open label placebos work?

Open label placebos work by harnessing the power of the mind and the placebo effect. When a patient is aware that they are receiving a placebo, they may still experience a reduction in pain or symptoms due to their belief that the treatment will help them. This belief triggers the release of natural pain-relieving chemicals in the brain.

3. Are open label placebos effective?

Yes, open label placebos have been shown to be effective in reducing pain and symptoms in various conditions, including chronic pain, irritable bowel syndrome, and depression. However, the effectiveness may vary from person to person, and more research is needed to fully understand their potential benefits.

4. Are open label placebos ethical?

The use of open label placebos is a topic of ethical debate. Some argue that it is deceptive to give patients a placebo without their knowledge, while others believe that the potential benefits outweigh any ethical concerns. Ultimately, it is up to individual healthcare providers and patients to decide if open label placebos are an appropriate treatment option.

5. How can open label placebos be used in healthcare?

Open label placebos can be used in various healthcare settings, such as in clinical trials, as a complementary treatment alongside traditional medicine, or as a standalone treatment for conditions where traditional treatments have been ineffective. They can also be used to study the placebo effect and its impact on patient outcomes.

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