Placebos Work Even When Patients Know They’re Dummy Pills

By Iris Tse, MyHealthNewsDaily contributor


For years, placebos have been valued for their supposed ability to do nothing — unlike medications with active ingredients, placebos derive their healing ability psychologically, by fooling patients into thinking they’re receiving a “real” drug.

However, a new study shows that placebos can offer effective treatment even when patients know they’re taking a so-called “dummy pill.”

Among patients with irritable bowel syndrome (IBS), 59 percent of those who knowingly took a placebo pill said their symptoms were adequately relieved after three weeks, while just 35 percent of patients who took no pills reported such relief.

“We were surprised by how effective the placebo pills were,” said study researcher Ted Kaptchuk, an associate professor of medicine at the Harvard Medical School.

In most drug studies, a treatment that works 20 percent better than the control is seen as statistically significant and clinically meaningful. “But here, you have something that is almost two-folds better,” Kaptchuk said.

In fact, the study showed the effects of the placebo pills were comparable to the effects of the powerful, but risky, IBS medication alosetron (sold under the brand name Lotronex).

“And most importantly, the placebo pills worked even when the patients know they were taking placebo pills and not real drugs,” Kaptchuk told MyHealthNewsDaily.

The researchers gave 80 patients with irritable bowel syndrome two treatments. One group, the control group, received only consultations with doctors and nurses. The second group received the same consultations and inert microcyrstalline cellulose pills, which were clearly labeled as “placebos,” and were told to take them twice a day.

Other placebo researchers said the results were interesting.

“Our current understanding is that, in order for placebos to work, patients have to believe strongly that the placebo is a real, active drug,” said Damien Finniss, a researcher at the University of Sydney who was not involved in this study.

“But this challenges our thinking. This shows that some form of placebo effect still exists, and can still have a powerful positive effect, even when patients know they’re not taking an active drug,” Finniss said.

Kaptchuk said he and and his colleagues conducted the study when a previous study showed that as many as 50 percent of American physicians gave placebos to unsuspecting patients because patients respond so well to them.

“All too often, patients in clinical trials worry that when they’re given the placebo, they won’t receive proper treatment. We want to learn more about placebos, and this is our way of measuring the effects with total transparency, trust and informed consent,” Kaptchuk said.

However, Kaptchuk said that while more research will be needed to replicate the findings in a larger group of patients, the study has advanced placebo research.

“Armed with this knowledge, we now know that we can measure the power of placebos in a responsible way in future trials and treatments, without having to deceive the patients and leading them on.”

The findings were published today (Dec. 22) in the journal PLoS ONE.

Four ways to avoid getting sick during the holiday season

By Madison Park, CNN


(CNN) — The Badger family holidays are filled with medical catastrophes.

One year, Melissa Badger’s niece stopped breathing at the Thanksgiving table because of a strep infection. In 2003, Badger’s son came down with a severe fever and ended up in the emergency room on Christmas. On Christmas Eve 2005, Badger tripped on ice while delivering presents to needy families and sprained her ankle.

This year, Badger’s husband complains of cold-like symptoms — fatigue, coughing and a sore throat. Badger struggled with a bug going around her office that was giving everyone stuffy noses and cold symptoms.

“Now, we get to worry about that lingering cold all of us have, since we’re hosting family this Christmas Eve,” said Badger. Hosting family means more than 30 people at their Beloit, Wisconsin, home.

Illness for many of us seems to knock at the most inopportune moments — after finishing a year-end project, before a holiday or after taking exams.

It had Shannon Duffy, who spent this Thanksgiving in bed with the flu, asking: “Is too much excitement and anticipation of the holiday season a bad thing? Or is it that my immune system just gets so overloaded with life stresses that when I step back and take a break, it is like an open invitation for the flu bug to intervene?”

With Mom sick in bed, Duffy’s sons had to microwave their TV dinners for Thanksgiving.

“I’ve been sick a lot during the holidays,” said the Palm Springs, California, resident. “If it’s not Thanksgiving, it’s Christmas.”

There are a few theories why sickness comes at the worst time.

“The holidays are a virus-distribution system,” said Dr. William Schaffner, chair of the department of preventive medicine at Vanderbilt University. “They help us distribute the viruses, influenza and other common cold virus from person-to-person because of close contact.”

1) Achoo to you, and you, and you

Flu season reaches its height in late fall and early winter. This is because viruses circulate better in the colder weather, said Dr. Philip Tierno, director of microbiology and immunology at New York University’s Langone Medical Center.

It’s not only cold and flu bugs that become active during colder seasons. CDC: Seasonal FluView

Other viruses, such as the norovirus and rotavirus, become more active during winter. Norovirus, known as the stomach flu, easily spreads through contamination in food, drink and surface contact. The virus is found in the stool and vomit of infected people. Rotavirus also causes diarrhea, vomiting, fever, and abdominal pain.

Advice: If you’re sick, cough into the crook of your arm.

If someone is coughing or wiping his or her nose, don’t hug or kiss the person. Use common sense, Tierno said.

5 Immunity boosting tips for moms

2) The sea of humanity … at the mall

Think of the holiday traditions: catching a show, shopping at a crowded mall, attending holiday parties.

All this means you’re indoors in crowds and exposed to everyone’s germs. As people cluster indoors, they use the same doorknobs, banisters and surfaces after wiping their noses or sneezing.

“During the winter season, we’re more subject to crowding, touching something that’s not hygienic and crowding,” Tierno said.

People get less fresh air, too.

“They don’t open up windows to get fresh air. They don’t go outside as much during cold weather. They decide to stay in, so any virus that may be present would be more easily spread,” he said.

Advice: Practice frequent hand-washing (at least 20 seconds wiping both the top, bottom of hands and between the fingers prior to eating and drinking) or use hand sanitizers.

Occasionally open the window to let fresh air circulate.

Must-know winter health & safety tips

3) Germs fly free

Air travel means if there’s a small flu outbreak on the West Coast, that virus could be in New York in less than five hours.

“Human travel is synonymous with virus travel,” said Shaffner, an infectious disease expert.

When family members travel across the country, they’re bringing along pathogens that have been in their communities and exposing them to new places.

It’s not only the act of being in an enclosed cabin of a car, bus, train or plane, Shaffner said.

“Remember we’re talking about being on an airplane, getting to the airplane, making your way through the crowds and other crowds in the other end,” he said. “It is just as important as the airplane.”

Advice: The Centers for Disease Control and Prevention recommends everyone older than 6 months old be vaccinated for influenza. Get your flu vaccine to reduce chances of getting sick.

Dr. Sanjay Gupta talks to Sebelius about flu shots

4) You’re super-stressed before vacation

End-of-the-year projects, reports, final exams — it could be all that work before break that spikes a stress hormone in your body.

“The increased cortisol level induces likelihood of infection during the holidays,” said Dr. Robert Hasty, assistant professor of internal medicine at Nova Southeastern University’s medical school.

Cortisol is a natural hormone that responds to stress, lowering immunity and making you more susceptible to infections.

The interval between acquiring a virus and becoming sick takes about 48 to 72 hours. You may have become infected when you were stressed and the symptoms may start to show right when you go on holiday break.

Advice: Stress might be unavoidable, but try getting enough sleep and hydrating.

Prevent the stress hormones from wreaking havoc by better planning, avoiding traffic, buying presents earlier.

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Music Fires Up Emotions in the Brain

By RICK NAUERT PHD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on December 21, 2010


In a new study using brain imaging, researchers have identified how key aspects of musical performance cause emotion-related brain activity.

Edward Large, Ph.D., the study’s principal investigator, and Heather Chapin, Ph.D., the lead author, believe that their study pinpoints how musical performances charge up the brain’s emotional centers, and said that their technique will lead to new ways of studying responses to music and other emotional stimuli.

The researchers first recorded an expert musician’s performance of Frédéric Chopin’s Étude in E-Major, Op. 10, No. 3 on a computerized piano (the “expressive” performance), then they synthesized a version of the same piece using a computer, without the human performance nuances (the “mechanical” performance).

Both versions had the same musical elements — melody, harmony, rhythm, average tempo and loudness — and both were recorded on the same piano.

But only the expressive performance included dynamic changes in tempo and loudness, the performance variations that pianists use to evoke emotional responses. In the listening study, Large and Chapin used participants with an affinity for music.

They combined behavioral analysis with fMRI neuroimaging, a specialized MRI scan which measures change in blood flow related to neural activity in the brain, as participants listened to both performances. The listening study was conducted in three parts.

First, participants reported their emotional responses in real-time using specialized computer software. Immediately after providing their emotion ratings, they were placed in the fMRI and instructed to lie motionless in the scanner with their eyes closed and asked to listen to both versions of the music without reporting their emotional response. Immediately following the fMRI, they performed the emotion rating assignment again.

“We deliberately implemented these three steps in our study to ensure the consistency of the emotions our participants reported in the behavioral study with the results of the fMRI,” said Large.

The fMRI served as a critical tool to examine which areas of the brain “lit up” in response to the music. The analysis of brain activity compared responses to the expressive performance with responses to the mechanical performance, and responses of experienced listeners with those of inexperienced listeners. It also compared the tempo changes of the performance to the brain activations of listeners in real-time.

The results from this study have confirmed the hypothesis that the human touch of an expressive performance by a skilled pianist evokes emotion and reward-related neural activity. Furthermore, musically experienced listeners were found to have increased activity in the emotion and reward centers of the brain.

“Our experienced listeners were not professional musicians, but did have experiences performing music, such as singing in a choir or playing in a band,” said Large.

“The fMRI data suggests that experienced listeners get a greater charge out of the music, although we can’t say from this data whether the increased neural activation is due to their experience or whether these individuals seek out musical experiences because they derive greater pleasure from music.”

Perhaps most interestingly, the results also revealed neural activity that followed performance nuances in real-time.

These activations occurred in the motor networks of the brain that are thought to be responsible for following the beat of the music and in the brain’s mirror neuron system. The human mirror neuron system appears to play a fundamental role in both understanding and imitating action. This system is “fired up” when someone observes an action they can do being performed by someone else.

“It had previously been theorized that the mirror neuron system provides a mechanism through which listeners feel the performer’s emotion, making musical communication a form of empathy,” said Large. “Our results tend to support that hypothesis.”

The study is published in the journal PLoS One.

Source: Florida Atlantic University

Proven Weight Loss Supplements

Which weight loss supplements really work?

By Hilary Parker


Losing weight can dramatically improve your emotional and physical health, but it can be a slow process. So it’s no wonder that 15% of American adults use diet supplements to boost weight loss, opting for a range of products that claim to decrease appetite, block fat absorption, or increase metabolism.

Currently, most weight loss experts do not recommend many products marketed as weight loss supplements because of a lack of evidence. Also certain diet supplements, including ephedra, may cause heart attack and stroke. (Ephedra, also known as ma huang, was banned by the FDA in 2004 for sale in the U.S.)

However, there are some proven weight loss supplements available. Which weight loss supplements may be safe and helpful during a diet? Here’s a rundown on six products you can buy at most health food or drugstores that have some weight loss evidence behind them:

  • Calcium
  • Fiber
  • Conjugated linoleic acid (CLA)
  • Green tea extract
  • Meal replacements
  • Orlistat, an over-the-counter weight loss drug

Remember, of course, that you should always check with your doctor before taking any type of supplement. Even supplements can have side effects and may interfere with medications you take. And, when it comes to weight loss, there are no quick fixes. A healthy eating plan and regular physical exercise should be the foundation of any weight loss program.

Weight Loss Supplements: Calcium

Bone health may be the first thing that comes to mind when you hear the word calcium, but this mineral may also help you lose fat while preserving muscle.

Research is mixed. Some studies have not found a relationship between calcium intake and weight loss.

However, “there have been several studies that have shown benefits from three daily servings of low-fat dairy foods, including weight loss,” says Toby Smithson, RD, national spokesperson for the American Dietetic Association. Those studies “showed more weight loss from low-fat dairy foods combined with a reduced-calorie diet than from calcium supplements,” Smithson notes.

That’s not to say calcium supplements might not help you in your weight loss efforts. In one analysis, researchers found that dieting women who received 1,000 mg of calcium supplements each day lost, on average, more weight and more body fat than women taking a placebo. Although the differences in the amount of weight and fat lost by the two groups were not significant, the trend suggests there could be a relationship between calcium supplements and weight loss.

Because calcium and weight loss studies have found conflicting results, you can expect a lot more research on this subject. Researchers who have found a connection between calcium and weight loss hypothesize that dietary calcium might play a role in the breakdown and storage of fat. Additionally, the weight loss that has sometimes been observed in people who eat dairy may have something to do with specific dairy proteins and magnesium, another important mineral abundant in dairy products. But so far, these hypotheses are unproven.

Using a type of fat as a weight loss supplement might sound counterintuitive, but it might work, too. Conjugated linoleic acid, a fatty acid that occurs naturally in dairy products and red meat, is a diet supplement that may hold promise for dieters.  

Some studies have found that CLA diet supplements can help you lose body fat and increase lean body mass. When a group of overweight people took 3.2 grams of CLA each day for six months, they lost more body fat than people taking a placebo and gained less holiday weight during the winter months.

Many experts are calling for more clinical studies to learn more about the effectiveness and safety of CLA as a weight loss supplement. What’s the best way for people to reap the benefits of this diet supplement? Can you take too much?

Although conjugated linoleic acid generally has few side effects, it can cause stomach upset with diarrhea and nausea. Be sure to talk with your doctor before taking CLA as a diet supplement.

Weight Loss Supplements: Fiber

When it comes to dropping pounds, weight loss supplements that help keep you full can make it easier to cut back on the amount of food you eat. And when it comes to feeling full, fiber is your friend.

“Things that delay gastric emptying and stay in the stomach longer theoretically will make you feel fuller for a longer period of time,” says Sasha Stiles, MD, an obesity expert at Tufts Medical Center. “There’s enough fairly good research to show that an appropriate amount of fiber, such as bran or psyllium, can do this. Don’t take too much, though, because it can stop you up.”

A recent study found that overweight and obese people who took a fiber diet supplement each day reported less hunger after meals than people taking a placebo, and there was a trend for those using a fiber supplement to lose more weight.

If you decide to increase your fiber intake from food or diet supplements, be sure to add fiber to your diet slowly. Drink plenty of fluids to avoid becoming constipated.

The National Academy of Sciences Institute of Medicine recommends that men under age 50 consume 38 grams of fiber a day, and 30 grams a day after age 50. Women under age 50 should consume 25 grams of fiber per day, and 21 grams per day after age 50. Most people only get about half of this amount.

Weight Loss Supplements: Green Tea Extract

You may have already heard that green tea is loaded with healthy antioxidants, but did you know it might help you lose weight, too?

Although Smithson cautions that there are not enough human studies to prove the effectiveness of green tea extract as a weight loss supplement, she tells WebMD “…there is some thought that regular consumption may promote weight loss by adjusting resting energy usage and increasing the use of energy. The components in green tea extract that have shown some effect on lowering body weight are catechins, caffeine and theanine.”

Not all studies agree. But one recent report found that daily green tea extract supplements helped obese men and women lose weight and lower their body mass index (BMI – an indicator of body fat). Green tea extract also helped reduce amounts of dangerous belly fat, which has been linked to an increased risk of death. Not only that, green tea extract lowered blood pressure and LDL, or “bad,” cholesterol at the same time.

Experts agree: The most proven weight loss supplements are meal replacements, including bars and shakes.

But, they only work when used as directed. In many plans, this means substituting a calorie-controlled meal replacement for breakfast and lunch, perhaps with the addition of fresh fruit. Then enjoy a portion-controlled dinner of around 500 calories.

“There’s very good scientific literature around meal replacements that is encouraging — this is a strategy for some people that is efficient and safe,” says Steven R. Smith, MD, professor and assistant to the executive director for clinical research at the Pennington Biomedical Research Center.

“For folks who adopt that strategy, there’s pretty good long-term success,” says Smith. “The reason for that is that it’s simple, it’s structured and it allows people to continue to enjoy food with their evening meal.”

Weight Loss Supplements: Over-the-Counter Orlistat

Technically, Orlistat is a medicine, not a supplement. However, it’s approved by the FDA for sale without a prescription (brand name Alli), thus many people consider it a diet supplement.

“This is the one that has the data behind it,” says Caroline Apovian, MD, the director of the Center for Nutrition and Weight Management at Boston Medical Center. “It blocks 25% of the fat calories eaten from being absorbed. You can hang your hat on this data.”

Orlistat helps people lose weight as long as they also follow a diet and exercise. But it can have some unpleasant intestinal side effects. Be sure to follow the product’s recommendations to limit fat intake to minimize potentially embarrassing problems with anal leakage and gas.

General Suggestions for Using Weight Loss Supplements

If you do use weight loss supplements, be aware that the vast majority of products sold as diet supplements are not regulated by the FDA. To make sure that the product you are purchasing has undergone quality control testing, look for diet supplements that bear a United States Pharmacopeia (USP) seal.

Be sure to ask your doctor about taking weight loss supplements before you use them. Avoid products with excessive levels of caffeine, which can cause side effects, such as increased heart rate and blood pressure.

WebMD Feature


 

Popping a Pill Can Help Some Alcoholics Curb Drinking

ScienceDaily (Dec. 16, 2010)


A little-used medication can help treat alcoholism, an updated review of studies confirms. At any given time, about 5 percent of the population suffers from an addiction to alcohol, often with devastating consequences to work, family, friends and health. Twelve-step programs have been the mainstay for helping alcoholics to quit drinking, but a significant number of people who try these programs do not find them helpful or suffer relapses.

The Cochrane review finds that the medication naltrexone — brand names are Depade and ReVia — when combined with counseling or interventions like Alcoholics Anonymous, can help cut the risk of heavy drinking in patients who are dependent on alcohol.

Naltrexone works by blocking the pleasurable feelings, or “high,” a person gets from drinking alcohol, thereby reducing motivation to drink. Naltrexone can be taken daily as a pill and is available as a long-acting injection.

The review was published by the Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

“Hundreds of drugs have been tried for relapse prevention [in alcoholism] and basically all others have failed,” said Michael Soyka, M.D., senior author of the review. “From a clinical point of view, there are few pharmacologic options for the treatment of alcohol dependence, so it is important to study those options that look promising.” Soyka and lead review author Suanne Roesner are associated with the psychiatric hospital at the University of Munich.

Alcohol dependence is different from alcohol abuse or misuse. The symptoms of alcohol dependence include craving for alcohol, an inability to control drinking, the presence of withdrawal symptoms if one tries to quit and tolerance — the need to increase alcohol amounts to feel the same effect. People who only abuse alcohol and are not dependent on it have no trouble controlling their drinking, once they decide to do so.

Soyka and colleagues examined the results of 50 previously published high-quality studies on naltrexone and alcohol dependence. Overall, the studies enrolled nearly 7,800 patients diagnosed with alcohol dependence. Of these, about 4,200 patients took naltrexone or a similar drug called nalmefene. The rest of the patients took a placebo or had some other type of treatment. Treatment with naltrexone ranged from four weeks to a year, with most patients receiving about 12 weeks of treatment. Most patients also received counseling.

Researchers found that patients who received naltrexone were 17 percent less likely to return to heavy drinking than were patients who received a placebo treatment. “That would mean that naltrexone can be expected to prevent heavy drinking in one out of eight patients who would otherwise have returned to a heavy drinking pattern,” Soyka said.

Naltrexone also increased the number of people who were able to stay abstinent by 4 percent.

While at first glance that might not seem like a miracle cure for alcoholism, Soyka said that the effectiveness of naltrexone is on par with medications used for other psychiatric conditions.

“Naltrexone is moderately effective in reducing alcohol intake. It’s about as effective as antidepressants in depressive disorders,” he said. “From a safety point of view, there are few safety concerns. Nausea is the most frequent side effect.”

Carlton Erickson, Ph.D., director of the Addiction Science Research and Education Center at the University of Texas in Austin, says naltrexone can help a person with alcohol dependence move toward the goal of abstinence.

“Anytime you reduce the severity of drinking, the individual is more open to treatment for abstinence,” he said. “It’s almost like putting them through a series of steps if you can get them to cut down; once they start to cut down they are more likely to become abstinent with continued treatment and continued exposure to 12-step programs.” Erickson is not associated with the review or any of its authors.

Despite its possible benefits in treating alcohol dependency, naltrexone is not widely used in the United States or elsewhere, Erickson said. Some addiction specialists fear that the widespread use of naltrexone or other medications will result in patients not receiving the counseling or psychological interventions they need.

There is also a lingering attitude that the treatment of alcohol dependency must rely solely on psychological or spiritual methods.

“People in 12-step programs typically don’t believe in medications for the treatment of alcoholism,” Erickson said. “Therefore they are unlikely to accept anyone into their 12-step meetings who is on a medication like naltrexone. Secondly, they would not want to accept it for themselves, unless a physician talked them into it as part of their treatment plan.”

In addition, most large alcohol treatment centers, with the exception of Hazelden, do not advocate for the use of medications in the management of addiction, he said.

However, Erickson said that naltrexone is FDA-approved only as an adjunct to abstinence-based therapies, like Alcoholics Anonymous. “Naltrexone is not something you give to someone who says ‘I want to stop drinking, give me a pill.’ Naltrexone is only a helper to that process. The medication itself is not a magic bullet.”

The review discloses that two authors received speaker/consultancy/advisory board honoraria from pharmaceutical companies.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Health Behavior News Service, part of the Center for Advancing Health. The original article was written by Katherine Kahn