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April 7, 2011
In Today's Issue
- 1 Quick Technique To Burn More Fat
- Taking Medicine? How Expectation Effects Outcome...
- Announcing: Doctor Approved Store Cupboard Remedies that Really Work...
1 Quick Technique To Burn More Fat
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Taking Medicine? How Expectation Effects Outcome...
Dear Reader,
Belief is powerful, and a new bit of research finds that what you expect about a medication might just affect how well that drug works for you.
Study participants who take an inert substance (sugar pill, distilled water, saline solution), believing it to be a medication, and benefit, have experienced what researchers call the "placebo effect". The more you believe you're going to benefit, the better the chances are that you will actually see a tangible benefit.
A new study finds that the opposite might also be the case - your pain level might be influenced by the belief that you're being given more (or less) of a powerful medication, even when the dose of the drug hasn't changed.
For the research, the team gave 22 healthy volunteers an opioid painkiller known as remifentanil, and then tested the effect of the drug by changing the patient's expectations of the treatment. The subjects were placed in MRI scanners, an IV started and then heat applied to their leg to the point of causing pain. The heat was set at a level that had the subjects rating their pain at 70 out of 100. At this time the volunteers were given the painkilling drug, but told nothing.
At this point, pain levels dropped from 66 to 55 on that 100 point scale. The team then told the subjects that the remifentanil had just been started (even though they'd already been getting the drug) and as you would expect, pain levels fell off quite a bit, to just 39 points. Interesting that pain levels for subjects went up when they were told that the pain medication had been discontinued (the "nocebo" effect).
To learn more about the nocebo effect, neurologist Dr. Ulrike Bingel, out of Germany's University of Hamburg Medical Center and his team then told the subjects they were stopping the medication, and that they might start to feel more pain, even though the drug was still being administered. At this point in the experiment, the subject's pain levels shot up to an average of 64 points. So the pain was right back up at the place it was before any medication had been given.
Continues below...
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Taking Medicine? How Expectation Effects Outcome... Continued...
MRI scans at each point of the experiment showed different brain activity depending
on the subject's expectation of pain or relief of pain. In those who were primed
to think they were getting the painkilling medication, sections of the brain
were engaged that made it harder for pain signals to reach the brain or spinal
chord.
This suggests that a physician may need to deal with a patient's beliefs about
a medication - both positive and negative - according to the researchers. It
appears from this work that the expectations of a drug's affect influences its
therapeutic effectiveness. So having positive expectancy doubled the analgesic
benefit of the medication being used. While negative expectancy completely abolished
the painkilling effect.
Intriguing that this pattern was found in the activation of those areas of the
brain known to be involved in the sensation of pain intensity.
The work does open up a new area of research - linking drugs and patient personalities
and expectations. The findings also have implications for clinical practice -
patients' beliefs, expectations and earlier experiences with drug treatments
should be assessed and integrated into the treatment plan for any condition.
To your good health,
Kirsten Whittaker
Daily Health Bulletin Editor
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Sources:
http://www.medicinenet.com/script/main/art.asp?articlekey=126041
Scientific American story on the placebo effect, 02.25.09:
http://www.scientificamerican.com/article.cfm?id=placebo-effect-a-cure-in-the-mind
MedicineNet info on the placebo effect:
http://www.medterms.com/script/main/art.asp?articlekey=31481
Info on the nocebo effect:
http://en.wikipedia.org/wiki/Nocebo
WebMD info on the brain:
http://www.webmd.com/brain/picture-of-the-brain
Time, Health and Science article on the flip side of placebos:
http://www.time.com/time/health/article/0,8599,1929869,00.html
Study abstract, Feb. 16, 2011, Science Translational Medicine:
http://pubget.com/search?q=authors%3A%22Ulrike%20Bingel%22
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