The placebo effect is one of the most confounding aspects of every medical drug. When I’m taking this paracetamol – is it the drug doing the work, or is my brain fooling me? Both, most probably. But how much of each? And can we design drugs that will make smart use of the placebo effect?

Well, such drugs exist already, as homeopathic remedies which contain nothing but sugar. No question there about the source of the effect, then. It’s not such a bad idea, until you remember that those remedies cost a lot of money, and encourage people to ignore or delay conventional medical treatment… and usually the conventional medicine has better ways of dealing with most situations than the homeopathic placebo effect. So the question remains: why not combine the placebo effect with conventional medicine? It turns out that’s exactly what a group of researchers from the University of Rochester School of Medicine & Dentistry has done.

The Researchers used the placebo effect to successfully treat psoriasis patients with one quarter to one half of their usual dose of a widely used steroid medication, according to an early study published online today in the journal Psychosomatic Medicine. Early results in human patients suggest that the new technique could improve treatment for several chronic diseases that involve mental state or the immune system, including asthma, multiple sclerosis and chronic pain.

“Our study provides evidence that the placebo effect can make possible the treatment of psoriasis with an amount of drug that should be too small to work,” said Robert Ader, Ph.D., M.D. (hc), professor of Psychiatry and principal investigator of the study.

While that is all good and well, I’m bothered by the fact that Ader and his team chose to use psoriasis patients as a model for their research. Psoriasis is known to have a strong dependency on the state of stress of the patient, and so it is highly susceptible to his or her state of mind. Should this be qualified as placebo? I’m not so sure. Perhaps it is the intrinsic nature of the disorder that causes the effects. All the same, the idea behind the research should be applauded, and it’s good to hear that further studies are underway to confirm the effect and explore similar effects in other disorders.

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The entire paper (requires registration)

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