To ask if a placebo is a placebo if it works?

[Karlwho]

'Debate' with DH over this. What are your thoughts?

Yes,

Placebos are known to not only work but can have a powerful curative effect.

Placebo merely means that that there is nothing pharmacological occurring.

It's a placebo as it has an effect with no active ingredient/action. You can also have side effects from something with no active component which is called a nocebo

Yes.

Yes - even people taking a placebo who have been TOLD its a placebo can still experience a scientifically significant positive effect that the control group who get nothing at all don't get.

Yes. It works due to psychosomatic factors rather than chemically active ingredients. If you knew it was a placebo, it would not work.

Yes it is because it's not the placebo that is helping it's the mind. The placebo effect is a very real thing but sadly is nothing to do with "medicine" which isn't medicine at all.

A placebo is a drug product with no proven active ingredient. Whether it works is not part of the definition.

Yes, of course it's still a placebo -- it's still a sugar pill (or equivalent) with no active ingredient.

Thanks for answering!

I remember watching something on TV about this.
iirc Injection placebos work better than pill placebos, and operation placebos work better than injection ones!

I can't remember who it was exactly, a tv dr was asked this question, she laughed and answered by not answering.

Yes, it still is a placebo.

Placebo means that it has no active ingredient. There's no physical reason for it to have a therapeutic benefit.

I believe there is somewhere about a 30% efficacy from placebos. The mind is very powerful.

www.bbc.co.uk/programmes/b0bmblb8

There are also nocebos ...

en.wikipedia.org/wiki/Nocebo

I love Nocebo, it sounds exactly like a pun name :)

The placebo effect also applies to medication, not just sugar pills. The manner in which the medicine is packaged and prescribed can affect how well it works. This is why saying that unbranded aspirin is just as good as branded aspirin isn’t strictly true.

Of course - surely the point of the placebo concept is that - despite no active ingredient - they have an 'impact' in some situations/on some people. There was an excellent Michael Moseley programme on placebo, and they did a placebo test where some people saw a radical healthcare improvement (back pain iirc). What I thought was amazing was even after they were told that they had been given a placebo, a substantial number of them continued to experience the improvement. There was even someone who had had a placebo operation - where they went through all the set up of an op, but were not operated on. And saw a substantial improvement in mobility. Bonkers really, but just shows us how important mental perceptions are, esp in experiences of pain.

Sorry, @DGRosetti, just saw you've already linked the programme - it's well worth a watch OP!

TL;DR, we still know very little about how the mind works ...

"The manner in which the medicine is packaged and prescribed can affect how well it works."

Totally true - red and yellow painkillers work better than any other colours, and blue and green calming/soothing stuff works the best for those. If the packaging looks more expensive, it works better.

Yes, it's still a placebo.

We sometimes used to do 'placebo plasters' when DDs were younger and hurt themselves. It cut out the moaning so worked for us.

The manner in which the medicine is packaged and prescribed can affect how well it works.

I think that's true of anything, really ...

Injection placebos work better than pill placebos, and operation placebos work better than injection ones!
Yes and the placebo for morphine is a stronger painkiller than paracetamol, and black and red tablets work better than white.

I think I've read somewhere that placebos can work in 30% of cases, but can't find a link.

Strongly recommend Ben Goldacre's book "Bad Science" on this one, nice bit from the blog:

www.badscience.net/2004/04/whats-wrong-with-the-placebo-effect/