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Re: NEJM Article says placebo effect small

Posted by Cam W. on May 27, 2001, at 12:19:50

In reply to Re: NEJM Article says placebo effect small Jane D, posted by SLS on May 27, 2001, at 11:16:05

There has been some very good research on placebo effect of late. In particular:

Stefano GB, Fricchione GL, Slingsby BT, & Benson H. The placebo effect and relaxation response: neural processes and their coupling to constituitive nitric oxide. Brain Research Reviews; 35 (2001): 1 - 19.

This review concludes "...that enough scientific information exists to support these phenomena as actual physical processes that can be harnessed to provide better patient care."

The show, using 166 references, how placebo and relaxation response have similar peripheral and central nervous system mechanisms. "Central to our hypothesis, is the significance of norepinephrine, nitric oxide and opiod signaling both in the central and peripheral nervous systems. In this regard, we find that nitric oxide controls norepinephrine processes on many levels, including synthesis, release and actions."

Also: "With regard to human history, we have always been aware of this innate protective response. For example, in Greek culture, 2000 years ago, it was believed that the healthy mind and the healthy body went hand-in-hand, establishing a link between mind-body experiences. This type of association can be found in many societies/cultures throughout human history, and it even exists in present day society. Anecdotally, we have perceived that there may be more to health maintenance than just a particular pathologic situation, suggesting that the mind's cognitive as well as non-cognitive link to the body may be involved in a proactive manner with promoting our health. Additionally, given the evolution of cognition, we propose that we may be able to initiate this innate proactive health-oriented process at will. Furthermre, the existence of such a protective process can be surmised from human longevity; mechanisms must exist to promote our health for this extended period of time. In this regard, the mind-body link can be viewed as an antibiosenescent process."

The authors show the similarities between placebo effect and relaxation response seen in some types of psychological therapies. They also give mechanisms why placebo effect does not work under all pathological circumstances and show that the placebo processes are organically based. They finish with:

"This speculative review has not been designed to answer all questions in regard to the relaxation response or the placebo effect. However, it does attempt to access these phenomena in light of current knowledge. In this regard, we conclude that there is a scientific basis for their presence. We further predict that an even greater number of physiological and biochemical processes will be found that will offer an even greater understanding of their operation. Finally, it is by way of this research, that we may be able to harness the body's own 'healthy' processes, allowing us to live longer and healthier lives."

Three of the authors (Stefano, Fricchione, and Benson) work at The Mind/Body Institute, CareGroup, Department of Medicine, Beth Isreal Deaconess Medical Center, Harvard Medical School, Boston, MA, so they can do have some credible credentials.

- Cam




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