What is Placebo Effect?

The word placebo, derived from Latin verb placeo and meaning ‘’I will like it’’ , started to be used in the medical language in the 18th century and was first defined in 1811 in the Hopper's Medical Dictionary as "the treatment applied to please the patient rather than beneficial". Placebo, also known as sugar pill which does not have any pharmacological effect due to the absence of active ingredient, can be administered to the body by mouth(oral), nose (intranasal) or injection (parenteral).
If it is necessary to give some examples of where placebo drugs are used;

Placebo drugs are used in some contraceptives. As it is known, after using contraceptives for 21 days, women should be interrupted for 7 days and restarted during their menstruation period. Therefore, there are 28 tablets in the medicine box and 7 of them are placebo. The reason for this is to make it easier for patients not to confuse the days while using medication. Placebo drugs are also used in vaccine studies. For example, if a virus vaccine has been developed against the currently popular COVID-19 epidemic, half of the volunteer participants are injected with placebo, while the other half are injected with the developed vaccine, without their knowledge, in order to test the effectiveness of this vaccine. Because no protection will be expected in participants who are injected with placebo, and a certain degree of protection will be expected from the participants who are injected with the newly developed vaccine.

The placebo effect is a different concept than placebo. In a broader definition, placebo is part of any treatment process or procedure that has no specific efficacy for the condition being treated. The placebo effect, which should be considered differently from placebo, is the psychological, physiological, or psychophysiological effect of any drug or procedure administered for therapeutic purposes, independent of the pharmacological effects of the drug or the specific effects of the procedure and using a psychological mechanism.

Since the placebo does not have a physically curative power, it derives its therapeutic power entirely from the patient's belief that the drug given is the drug that will work. Placebo is directed towards an aspect that medicine cannot scientifically explain; the power of people to heal themselves if they want to. Many patients, who were deemed unlikely to survive medically, were saved from simply entering the death statistics thanks to this power, and the high morale and recovery determination were mostly effective in the treatment of cancer for which medicine could not find a solution.

Despite its widespread use, the mechanism of placebo's undeniable effect is not fully understood. It is generally accepted that this is of a psychological nature, and it has been suggested that certain personality traits are determinants of the effect of the placebo. Indeed, not all patients benefit from placebo to the same extent.

Placebo effects can be positive or negative. Negative, undesirable effects are called nosebo effects. The word nosebo, derived from the Latin verb noceo and meaning "I will do harm," is used for undesirable effects that occur during administration of placebo, or undesirable effects that cannot be attributed to its pharmacodynamic properties when an active substance is administered.

Mehmet Özbay, MPharm

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