THE

PLACEB
O
EFFECT
THE SCIENCE OF BELIEF
 “DEPRESSION TASTES LIKE
THE TABLET PRESCRIBED BY
THE DOCTOR, WHO USES
PLACEBOS EXTENSIVELY.”
—Indie nik
 MEET MY
SQUAD
• HAMZA MUHAMMAD SHAREEF-188
• HASSAN AHMED LODHI-190
• HAMZA MOHIUDDIN SIDDIQUI-182
• ARMUGHAN KASHIF-189
• DIYAL BEHZAD-183
 HISTORY

THROUGHOUT THE AGES

History is the version of past events that people have decided to

agree upon.
Napoleon Bonaparte
EARLY VISION ABOUT
PLACEBO EFFECT
 AS EARLY AS WHEN PHYSICIANS FOUND OUT THAT THEIR PATIENTS’ FAITH
IN THEM AND THEIR MEDICATION IS FIRM,

 ANY MEDICAMENT HAVING LOW OR NO ACTUAL MEDICAL VALUE,

CHEMICALLY AFFECTING NOTHING, STILL TENDS TO PRODUCE SURPRISING
POSITIVE RESULTS IN IMPROVING AND CURING THE VALETUDINARIANS.

 PHYSICIANS OF FOREGOING CENTURIES STARTED USING PLACEBOS

INSTEAD OF ACTUAL MEDICINES AVOIDING ANY NEGATIVE IMPACT OR SIDE
EFFECT.

 THIS BRING FORTH THE CONCEPT OF THE PLACEBO EFFECT WHICH IN

LATIN MEANS; “I SHALL PLEASE”.
 PLACEBOS THROUGH OUT
THE AGES
• From the beginning of time, the sorcerer, the interpreter of dreams,
the fortune-teller, the charlatan, the quack, the wild medicine-man,
the educated physician, the mesmerist, and the hypnotist have made
use of the client's imagination to help them in their work.

• They have all recognized the potency and availability of that force.

• Physicians cure many patients with a bread pill; they know that
where the disease is only a fancy, the patient's confidence in the
doctor will make the bread pill effective.
TIMELINE OF DISCOVERIES
First modern An important written
research on the research done by T.G.
placebo effect by Nicholas of Harvard
Bishop John Douglas University

1775 1799 1893 1922

First scientific The earliest

demonstration of controlled trial in
the placebo effect by psychiatry on the
John Haygarth placebo effect
• In the late 18th century the term "placebo" became part of medical
jargon.

• The main reason for administering placebos in late 18th-century

medical practice was to satisfy the patient's demand and his
expectations.

• In most cases these 18th century physicians did not administer

"pure" placebos but resorted to any kind of medicine which they
thought simple, feeble, or altogether powerless, non-perturbing
medicines.

• In the 18th century those physicians who prescribed placebo usually

thought of drugs which were considered not very effective in the
particular case, e.g. a mild ointment.

• At the same time, only very few brilliant minds came up with the
ingenious idea of using inert substances as placebo. An alternative to
milk sugar used as placebo in homeopathy was bread pills.
•  Recent research suggests that expectancy is an integral part of
the placebo effect.

• The term placebo has first been mentioned in the Scriptures,

but it was not until the 19th century that it appeared in a
medical context.

•  It was only by the end of the 18th century that a placebo-
controlled trial has been conducted, repudiating the
therapeutic effect of mesmerism.

• The advent, in the late 1940s, of effective treatments, which

also had serious adverse effects, made the distinction between
placebo and putative, active drug effects more relevant and
urgent, and cleared the way for double-blind, randomized,
placebo-controlled trials.
 TABLE OF CONTENTS

1 INTRODUCTIO
Foundation of the
N
3 APPLICATIONS
Therapeutics,
medications, and
concept
experiments.

2 NOCEBO EFFECT
Dangers and
disadvantages
4 CONCLUSION
Final thoughts
 1
INTRODUCTION
DIVING INTO THE BASICS OF PHENOMENON
 CONTENT
• Definition

• Explanation

• Mechanism

• Expectation Effect

• Effectiveness

• Variety
DEFINTION
“A real placebo effect is a psychobiological phenomenon occurring in the
patient's brain after the administration of an inert substance, or of a sham
physical treatment such as sham surgery, along with verbal suggestions (or
any other cue) of clinical benefit.”

-Fabrizio Benedetti (Subject Specialist)

BRIEF EXPLANATION
• If you watched the Rio Olympics, you probably noticed that several athletes,
including swimmer Michael Phelps, were covered in bizarre circular marks.

• These bruises were caused by cupping.

• A study found that patients who received cupping reported the same degree of
pain relief as patients who unknowingly received a sham version of the therapy
(in which the cups had a hole in them and couldn’t create proper suction).

• Now, to be clear, there is no evidence that a placebo can shrink a tumor or heal a
broken bone.

• But when it comes to ailments grounded in self-awareness, such as pain, the

placebo effect can be tremendous.

• If you think that all of this sounds a bit unbelievable, you are not alone. For
decades the placebo effect was written off as an illusion.
MECHANISM
● Say you are experiencing pain and spontaneously decide to eat a sugar pill chances are
you won’t feel better.

● However, if a physician prescribes you the same pill (unbeknownst to you, it’s just
sugar), you expect that pill to have a therapeutic benefit.

● This expectation activates reward pathways in the brain, in turn stimulating the release
of substances called endorphins and occasionally dopamine.

● Therefore, in response to positive expectations of treatment, your brain becomes

flooded with its own supply of natural painkillers.

● This effect can be partially negated by a chemical called naloxone.

 EXPECTATIONS
The placebo effect is intertwined with person’s expectations. If you have
preconceived expectations, they will influence the outcome of placebo
dose. Factors for increased expectation include:

VERBAL ACTIONS SOCIAL

A doctor or nurse may tell you that You may feel better when Your doctor’s tone of voice,
a pill will be effective at treating you’ve actively done something confidence in treatment, body
your condition. to address your condition. language.
EFFECTIVENESS
EFFICIENCY
The placebos are highly efficient
when highly expected.

PROBABILITY
Not all placebos work every time
and not on everyone.
 VARIETY OF
PLACEBOS

MEDICINES TREATMENTS SURGERIES

Sugar pills and bread Fake injections with no Sham surgeries
pills having no medical intervention convincing pateints
therapeutical value through hoax blood and
procedure
 2
APPLICATIONS AND
THERAUPEUTICS
TREATMENTS, MEDICAMENTS AND MEDICATIONS
CONSEQUENCES
OF DELICATE
TREATMENT
COLORS SIZE PACKAGING
Color of the pills vary the Size of the medicament Delicate and fine
effect produced by packaging
placebos

COST ENVIRONME MEDIC

The more costly the Hospital and medical Character and words of
procedure the more
NT
environments contribute the physician prove to be
effective it is to the effect highly effective.
COST-EFFECT
RELATIONSHIP
● The more expensive, delicate and organized
the treatment is, the more effect it seems to
have on the patient despite being a placebo.

● This is a clear indication of psychological

effect in progress

● Making the valetudinarian to believe in his

medic and the treatment he is receiving
cause much more improvement then using
ordinary placebos or even real low-cost
treatment.
DOMAINS OF THE
PLACEBO EFFECT
NEUROLOG PSYCHOLO
Functionality of brain Effect of faith and
Y GY
belief

PHYSIOLOG PHARMACE
Bodily functions as per Role of medicaments
Y
mentality
UTICS
EXPERIMENT 01
HROBJARTSSON AND GOETZSCHE, AT UNIVERSITY OF COPENHAGEN (2001)

CONTROL
GROUP
EXPERIMENTAL
GROUP

SUBJECTI NO OBJECTI
VE CHANGE VE
“There is a pesky utterly unscientific feeling that
some things [placebo responses] just ought to be
true”
JOHN BAILAR, HARVARD PUBLIC HEALTH PHYSICIAN
(2001)
EXPERIMENT 02
CHILDREN’S TREATMENT
Some children were given placebos in case of
fever in a study, some of them were given real
medicine and some were given none.

EXPERIMENT CONTROL ORDINARY

AL

PILLS

EFFECTS

RESULTS
 POWER OF PLACEBOS
POISONS
Placebos are also
effective against
poisons and venoms

PAI
Effectual behavior
NS
against pains
 PLACEBO WILL WORK ON ONE THIRD,

2,333,333,333
KINDS OF
EFFECT
THE EFFECT

PLACE NOCE
BO BO

Beneficial Fruitless Deleterious Ineffectual

 3
NOCEBO EFFECT
HORRORS OF BLIND FAITH
DEFINITION AND CONCEPT
Nocebo Effect is almost like a negative self-fulfilling prophecy.
Some people maintain that belief kills (e.g., “voodoo death” or
“evil eye”)  a and belief heals (e.g., faith healing). That’s why it’s
also called “voodoo effect”.

• It’s an evil twin of the formerly discussed placebo effect.

• People get worse because they believe they’ll get worse.

• Like the placebo effect The term nocebo (Latin nocebo, “I

shall harm”) was coined by Walter Kennedy in 1961 to
denote the counterpart to the use of placebo (Latin placebo,
“I shall please”).

• The nocebo effect might even be powerful enough to kill. e

THE DARK SIDE

DANGERS
Believing in the
negativity can cause
symptoms of the
expected disease.

HORRORS
Even the fear of the
unactive toxin can
prove to be fatal.
 NEGATIVITY
AILMENTS
Believing in the danger
can actually increase the
intensity of the illness

DEATH
In severe conditions
Nocebo effect can also
cause death.
EXPERIMENT 01
In one study, 50 people who
suffered from chronic back pain
were randomly divided in two
groups and were told
beforehand,

• Group A: Weren’t told GROUP A GROUP B

anything
 
PAIN
• Group B: Were told that
procedure will cause pain
PROCEDURE

RESULTS
As a result it was found that
people of group B experienced
more pain as well as results
were observed from both sides.
FRAMINGHAM HEART STUDY
One example of the nocebo effect was
extracted from the Framingham Heart Study,
which began in 1948 to identify common
factors that contribute to cardiovascular
disease. It began with 2,873 women and 2,336
men. Women who believed they were prone to
heart disease were nearly four times as likely
19% 76 %
to die as women with similar risk factors – high
blood pressure, excessive weight, high
cholesterol – who didn’t believe.
NON-BELIEVERS BELIEVERS
Women who don’t believe Women who believe that
that they were affected they are prone to heart
disease
 4
CONCLUSION
FINAL THOUGHTS
FAITH HEALING
This phenomenon is often related to self-
fulfilling prophecy. After all the research
done out there, there is no exact answer
as to why this effect happens, except
faith. Belief is what that heals the person,
he manifests the cure himself.
 HOMEOPATHY
Homeopathy is a medical system based on the
belief that the body can cure itself. Those who
practice it use tiny amounts of natural
substances, like plants and minerals. They
believe these stimulate the healing process.
It is the best current daily life example of the
placebo effect.
 ETHICAL
CONSIDERATIONS
Informed consent
• The policy of informed consent holds that you can’t fully
consent to a procedure or treatment if you aren’t given all
the information about it. 
• Placebo effect will be considered unethical if not clearly
addressed to the patient receiving it, either it is for benefit or
not.
Research
• Even just researching the nocebo effect raises issues. Useful
studies would require investigators to have people
experience the nocebo effect.
• This would mean intentionally causing people to experience
negative side effects or outcomes, which is generally
considered unethical when it comes to human studies.
 A DECISIVE
MOMENT
Now is the time for you to decide the
route you want to take. Either you
believe in the placebo effect or not, but
in the light of all the observations,
experiments and clinical trials that are
performed to this day, it’s a reality for
sure, but one thing is certain, placebos
don’t work on everyone and not
necessarily does every time.
REFERENCES
• Knowledgeable magazine

• PubMed

• Beecher h. K. 1956. ”Relationship of significance of wound to pain experienced”

• Kienle g. S., Kiene h. 1997. ”The powerful placebo effect: fact or fiction?”

• Levine j. D., Gordon n. C., Fields h. L. 1978. ”The mechanism of placebo analgesia”.

• Star pearls

• Richard Kradin, “The placebo response and the power of unconscious healing”

• Brain in labor

• Healthline

• Cochrane
 HAMZA MUHAMMAD SHAREEF

DIYAL BEHZAD HAMZA MOHIUDDIN ARMUGHAN KASHIF HASSAN AHMED LODHI

SIDDIQUI
THANK
S