Placebo Effects happen when a substance is administered that is supposed to treat, cure, or prevent disease. But, it could also be a treatment or a placebo. Placebo effects happen when a treatment has no medical value, and the patient believes that the substance will cure or prevent something. The placebo effect occurs when the standard of care is not met, and the outcome is not what was promised.
When Does Placebo Effects Occur?
The most common placebo effects occur in the placebo treatments for depression. Placebo effects are observed most frequently when antidepressant drugs are prescribed to depressed patients. The results are most promising when the doctor recommends the drug therapy. In this situation, the doctor may prescribe the drug therapy in order to get the results that the patients are expecting.
Depression is treated using different antidepressant drugs. Among these drugs are tricyclics like Tofranil, Norpramin and Clomipramine, selective serotonin reuptake inhibitors like Anafranil and Pamelor, and newer drugs like Prozac and Zoloft. All these medications have positive and significant results on the patients, but they also cause negative and disappointing results as well. This is because antidepressants can only achieve significant effects on some patients, and they can’t find out through the placebo effects.
Similarly, placebo effects occur when doctors recommend psychostimulants such as Ritalin, Adderall and Concerta. The medications are given to alleviate the symptoms of ADHD, attention deficit disorder and hyperactivity. The beneficial results that the patient’s experience may last for several weeks, and then they will notice that they are once again experiencing the symptoms of ADHD, depression or hyperactivity. In addition, the therapeutic effects may also fade away, and the patients may still exhibit the symptoms of depression or hyperactivity. But, they have completely resolved their problems.
Similar effects occur in the case of SSRIs, such as Prozac and Zoloft. When these drugs are given to the patients, they can experience the expected therapeutic effects, but these results cannot be compared with the positive results they experienced earlier. However, the researchers can conclude that SSRIs and placebo are not necessarily unrelated. Although these medications can help the patients’ symptoms, they also suppress their natural defences, and they can have long term adverse effects on the patient’s health.
Research: Placebo Effects
The second group of researchers who study placebo effects claim that the results of the studies conducted on the SSRIs prove that social desirability is one of the factors that increase the risks of the treatment. They argue that the increased risks are caused by the double-blind procedure, where neither the doctor nor the patient knows whether they are being treated with a placebo or with real medication. During the procedure, the doctors are instructed not to provide any stimulant to the patients. Thus, the doctors can’t evaluate whether they will treat the patients according to their real needs or the patients will respond according to their expectations. As a result, they conclude that the placebo effect is caused by the patients’ social desirability and not by the actual treatment itself.
Another group of researchers believe that the results of placebo research show that patients tend to overestimate the effectiveness of medical treatments. They claim that this overestimation is based on their general expectations about medical treatment. These expectations are usually formed before the patients start to see the effects of the treatment. For example, if the doctor tells the patient that his treatment will give him a better recovery rate, most of the time, the patient will not believe him. They also believe that the doctors know exactly what they are doing; thus, there is no need to give them any information about the medical treatments.
To conclude, placebo effects are found in all types of placebo trials. However, in all types of placebo trials, there is always a significant amount of misclassification among the controls. Therefore, there is always a chance that a true treatment effect and an overestimation of the placebo effect may exist. This is why a high allocation to the placebo arm can be noted in clinical trials.