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How many copies are broken about the placebo…
There is no miracle, just that psychic stimuli can sometimes replace pharmacological ones.
Let's not be trivial and go from the opposite. What is the placebo effect when there is a nocebo effect? A placebo is when something helps that shouldn't help. Nocebo — when what should have helped doesn't help. Interesting, isn't it?
There are many ways to explain where the placebo effect comes from: “positive thinking”, “self — healing”, “rebooting the biocomputer” – and all this will not be completely true. It's easy to talk about miracles. And it's easy to attribute something to the placebo miracle that isn't even a placebo.
It's much harder to talk about how what should help — and usually does-doesn't help. It seems wrong, it seems unnatural, it's something that I don't want to discuss. Still, it's understandable.
Under what circumstances is the nocebo effect most common?
Interestingly, the placebo effect is most often found in the same circumstances. Why? Because they have the same mechanism, which has nothing in common with “positive thinking”, “self-healing”, or “rebooting the biocomputer”.
Why does it stop hurting us at all?
The opioid system plays the role of an absolute painkiller in our body (at the same time being a conductor of drug addictions). I will make a lyrical digression: there are opioid analgesics that stimulate the opioid system, and there are their antagonists that interfere with their action. So: if you give a patient with pain a placebo under the guise of an opioid analgesic, and it helps him, and then give him an antagonist of opioid analgesics, without informing about it, the effect will reliably disappear. Think about it: the placebo really did work on the opioid system-otherwise, the hidden use of an opioid antagonist did not cancel the effect. Moreover, positron emission tomography scans of the brains of patients treated with real opioid analgesics and those treated with placebo show activity in the same areas associated with the opioid system. At the same time, of course, the activity from a real opioid was higher, but from a placebo, in turn, there was more activity than without anything at all. Think about it again: the placebo had a material effect that it shouldn't have.
The cholecystokinin system (CCCS) has the opposite effect to the opioid system. Activation of CCCS-suppression of the opioid system. It is noteworthy that the introduction of subjects into an anxious state had an effect similar to the effect of the CCCC activator — the nocebo effect, and the CCCC antagonist significantly removed the effect of CCCC on the opioid system. Think about it again: the nocebo really did work on the opioid system-otherwise, taking a CCX antagonist would not have had an effect.
In both cases, the real drug antagonists removed the effects of placebo and nocebo as if they had taken real drugs instead of placebo and anxiety.
The cannabinoid system (which is also responsible for other addictions) is also involved in the development of placebo and nocebo effects. Thus, replacing a real NSAID with a placebo provided the same pain relief as the real drug, and was not removed by opioid system antagonists, but was removed by cannabinoid system antagonists.
Placebo effects are also associated with the dopaminergic system, which explains their prevalence in patients with Parkinsonian disorders, which are characterized by an imbalance of dopamine in the body. While waiting for the effect (not only receiving, but still waiting) from taking placebo, the dopaminergic reward system was activated in patients, thereby determining the placebo effect. If the patient was skeptical, it was not activated, and even from taking a real drug, the effect was worse.�
Moreover, under the influence of the dopaminergic system, peripheral immunity is activated through stimulation of the lymph nodes and spleen
Two processes play a key role in the development of placebo and nocebo effects: learning and waiting. So, an extremely interesting study was conducted on two groups of climbers, in one of which there was a “decoy duck”.
The decoy duck in the first group constantly complained of headaches, thereby contributing to the development of headaches in the entire group. In the other group, the headache developed naturally as they ascended (this is a common phenomenon for climbing). In addition to the increased development of headache sensations in the first group, its members also had increased levels of prostaglandins, thromboxane and cortisol, which are responsible for pain and anxiety.
When both groups were at the top, each of them was divided into three subgroups within the groups. Then “a” is the decoy duck group, “b” is the control group.
a1 and b1 — people with headaches received real aspirin.
a2 and b2 — people with headaches received a pacifier.
a3 and b3-people were forced to endure headaches.
In group b, aspirin relieved the headache, but the pacifier had no effect. In group a, aspirin and a pacifier had the same effect.
There are many studies on the effects of placebo and nocebo and their impact on clinical practice and communication tactics of medical personnel with patients. And all these studies suggest that the opioid, CCK, cannabinoid, and dopaminergic systems mediate these effects. There is no miracle, just that psychic stimuli can sometimes replace pharmacological ones.
I can assume that a person initially has mechanisms for recognizing various substances. The placebo effect always assumes that a person is aware of WHAT EXACTLY they are taking. And while taking the placebo drug, the human response mechanism is triggered through consciousness.
Seryozha, the placebo effect is the presence of a mind-body connection, as well as the presence of the body's inherent ability to heal itself.
We need to recognize the fact that physiological changes from placebo are not always the result of positive thinking alone. Our body is a self-healing structure that constantly strives to maintain the relative constancy of its internal environment (blood, fluid, lymph) and the stability of its basic physiological functions(blood circulation. respiration, metabolism).
This is one of the ways to reboot the brain. The brain is a biocomputer. Receiving a signal from the body's cells about a violation in the work of the electromagnetic basis of cellular activity, the part of the brain involved in regulating a particular process seems to be dependent. This is due to the fact that the brain does not fully understand whether it is possible to continue the active life of a particular “device” in the body, or whether rest is needed for recovery. Having taken a placebo, a person seems to give a command to the brain: The brain comes out of its stupor and gives a command at the electromagnetic level of interaction, which leads to such chemical reactions in cells that correspond to the mode of active activity, and not to a painfully inhibited state. As a result, metabolic processes in cells and the processes of their division are more active, despite failures in the work of individual organs. And by changing the mode of operation, most of the cells in these organs restore their status to the level of normal or, at least, to a better level than it was before the brain received the command to restart. And the person naturally feels relief of his condition. If the disease is not too serious, then recovery occurs. If a failure in cellular activity cannot be eliminated by simply resetting the regulating automation of the “processor”, then the person feels only a short-term relief, followed by a new and deeper deterioration in condition and well-being. If it's time to install a serious “Antivirus”, reinstall the “operating system” or change something in the “hardware”, then no placebo will help. All the best.
If we do not go into the biochemical details, then the placebo effect, i.e. a “dummy” instead of a drug, is used only in multicenter studies of new drugs, and not at all for treatment. The purpose of the research is to determine how effective the drug really is . People who also take medication . and a placebo, they think that everyone is given the drug.When taking a placebo, the symptoms-pain , nausea, diarrhea-go away only in those patients who are extremely impressive and who have a predominant psychosomatic disorder. In other words, autosuggestion works . But if a person has “organic changes due to chronic diseases”, i.e. arterial hypertension, colitis, chronic bronchitis, bronchial asthma, then placebo does not work at all compared to medications. Placebos are used exclusively for research purposes and in no way for medical purposes. A careful attitude to a person with a sincere interest in his problems always has a curative effect, temporary. There is a well-known saying : “If you didn't feel a little better after your first visit to the doctor ,then it wasn't a doctor.”