This paper reflects the research and thoughts of a student at the time the paper was written for a course at Bryn Mawr College. Like other materials on Serendip, it is not intended to be "authoritative" but rather to help others further develop their own explorations. Web links were active as of the time the paper was posted but are not updated.
1999 Second Web Reports
In my last web paper I struggled with the idea that Melatonin is supposed to make people sleepy. If anything I became more restless. Well, what is that all about? So, in this paper, I decided that I wanted to find out, what that was "about". If you pull it apart, you can tell that it has something to do with the preconceived ideas that we have running around in our heads. So then, I thought, well, that is the placebo effect right? If you think that something, such as a drug or supplement, is supposed to perform a certain way, then even if it is nothing more than a sugar pill some people will have a larger tendency to play out that reaction. This is not a conscious choice.
From the little neurobiology background I have, I would venture a guess to say that the preconceived notion of what is supposed to happen acts a triggering signal that would create an change in the membrane permeability of the neuron. And that would in turn cause an action potential and be the beginning of some sort of effect. So to dissect it with my previous example, if we were, theoretically, under the assumption that these Melatonin supplements truly had no effect. The population at large would, through the media and other advertising schemes, be made to believe that this drug supplement would induce sleep. Therefore that notion would lead to changes in the nervous system that were brought about by these beliefs causing a placebo effect. But the heart of my question here is that does this idea work in the other direction?
My hypothesis previous to my beginning my research was yes. Not only because the Melatonin did not work for me and family, but because of what we have been discussing in class. If the majority of the functions in our bodies are inhibitory ones, why can't this be one as well. But logistically is it possible for someone to turn off the effects of a drug/supplement?
I know that it is boring, but I need to describe a little bit about the history of placebos. Until the twentieth century, most of the drugs and medications were not the least bit effective. In many cases, the drugs were even harmful. "In a sense, then, the history of medical treatment until relatively recently is the history of the placebo effect." (1).
As the saying goes: A treated cold will last seven days, but untreated it may last for a week.
But now with the innovation of drugs that are truly effective, the consequence is no longer merely left to up our minds. Now our personal opinions and suggestability have to compete with those of the clinician as well as the possible neurochemical alterations that may be occurring in the brain. "Sensory experience and thoughts can effect neurochemistry and that the body's neurochemical system affects and is affected by other biochemical systems, including the hormonal systems... attitude is essential to [one's] physical well being." (2). I think I am getting closer to thoroughly understanding, well not all that thoroughly, the connection between the brain and behavior. It sort of all makes sense now. Each input from the outside, be it a drug, be it an experience, be it a... preconceived idea of an outcome, will undoubtedly create an output.
So, while sifting through all the web research I came up with, I had to ask myself these questions that I previously posed. And there is only a few key points that I could take away from my research. I believe to some extent that there is efficacy beyond the placebo. I don't know if I can do this graphically but here, let me try.
No effect < Inhibited < Drug's true effect > Enhanced > Enhanced effect
I had this idea that the anti-placebo effect idea that I was pushing for, although it should be, inherently, the opposite of a placebo effect, but I don't think it is. A placebo effect alters the final response given off by taking a particular drug or supplement. But so does my "anti-placebo effect". So what I am inferring from my web research and the topics that we have been discussing in class is that if your preconceived idea makes you believe that something is going to be more effective it will be. But, on the same line, if you believe that something is not going to be effective than it won't be. There is a certain point where the drug/supplement inherently causes an output. "Assuming that the clinical outcome is equal to its active effect plus its placebo effect plus its placebo effect, the fasstidious approach takes an additive/subtractive approach for defining the boundary line of efficacy." (3) My point would be that your preconceived notions would either serve to enhance or inhibit these effects. Simple, eh?
2)The placebo effect,
3)Some Thoughts on Efficacy Beyong the Placebo Effect,
Other sources to look at:
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