2012-02-05 12:34:04
Our beliefs can reduce the effectiveness of medications
Research in Medicine, in addition to improving the treatments of many diseases, has also revealed interesting peculiarities of the human mind. One of them is known as the placebo effect (from the Latin, I will do you good). This effect occurs because the simple belief that a certain treatment or medication is going to do us good actually affects whether it does us good. The placebo effect is the healing power of the mind in action. Faith, if it does not move mountains, perhaps it can cure a headache.
The placebo effect explains the benefits of homeopathic treatments, in cases where they occur. This has been demonstrated by very solid scientific studies, carried out a few years ago. Why people continue to believe and use homeopathy, in addition to the huge benefits it generates for some (the price per gram of homeopathic medicine is close to infinity), is probably for the same reason that explains why many continued to believe that the Earth was flat even though Elcano had already gone around the world: either they didn’t find out, or they didn’t believe it. Lack of faith and knowledge can also leave mountains in their place, even if someone has moved them.
HARMFUL POWER OF THE MIND
As with the yin and yang of Eastern philosophy, a concept that describes how two opposing forces or entities are, in reality, interconnected and cannot exist independently, the placebo effect has its opposite effect: the so-called nocebo effect (from Latin, I will hurt you). This effect manifests itself because the belief that a certain medication or treatment is not going to be effective, or an external factor is going to harm us, has a negative impact on our health.
The nocebo effect does not have as much scientific evidence as the placebo effect, since while a placebo is administered to patients when clinical trials of new drugs are carried out, they are not administered a nocebo. However, clinical studies have demonstrated the existence of this effect, since many patients who were administered a placebo felt worse, not better or the same, as a consequence of said administration.
Some studies have studied this effect directly. In one of them, two-thirds of a total of 34 university students developed a headache when they were told that an electric current that was going to be passed through the ceiling of the room could induce such pain. However, what caused the headache was the belief in what they were told, since the electric current was never applied. Added to this are two recent studies (meta-analysis) that have investigated the existence of the nocebo effect in clinical trials carried out with anti-migraine drugs. These studies revealed that 5% of patients treated with placebo voluntarily withdrew from clinical trials due to adverse effects, which could only be generated by their negative beliefs, since they were not administered any medication. Surprisingly, the adverse effects suffered by patients were those expected for the real drug. It seems that the knowledge that patients have about the type of medication in question affects the adverse subjective experiences that they themselves generate.
But the nocebo effect goes further. In a study conducted in early 2011, English and German researchers showed that a simple countersuggestion can neutralize the real beneficial effects of a painkiller. That is, if we do not believe that the medication we are prescribed will work, our mind can, in effect, block its operation, even if it is effective.
TRUST AND HEALTH
One of the factors that can induce the nocebo effect is distrust in the safety of medications and in the general health system. The patient’s distrust, not only in the medication, but in the doctor who prescribes it, or in the means used for diagnosis, could also nullify its beneficial effects. Episodes such as what happened recently in France with the drug Mediator, a slimming antidiabetic drug prescribed to millions of patients for more than three decades, until it was withdrawn from the market in 2009, after it was proven that it caused the death of more than 2,000 people and tens of thousands of hospitalizations, nor do they inspire confidence, neither in doctors nor in patients. If the human lives lost in this episode do not move the French authorities, perhaps the billions of euros in reparations for not having dedicated adequate resources to the public drug regulatory agency will.
Certainly, a space for reflection opens up in the current moments of cuts and general discouragement, of fear among many of losing what has been achieved in the area of public health. In any case, if you need to go to the doctor, take medication or undergo treatment, try to do so with the best possible spirit and confidence: you will then have taken a good path towards your cure. It’s not just an opinion, it seems that science proves it.
WORKS BY JORGE LABORDA.
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