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Commentary
Address for Correspondence: Dr. S.K. Diwan, Department of Medicine, JN Medical College, Sawangi (M) Wardha 442 004, MS, India Email: drskdiwan79@gmail.com
This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
This article was originally published by Medknow Publications and was migrated to Scientific Scholar after the change of Publisher.
The word placebo derived from Latin and means “I shall please,” dates back to Biblical times.[1] First use of the word in medical context started in 18th century, as one of the therapeutic options.
Placebos were in use commonly as an accepted ways to treat patients by physicians and felt as a necessary deception.[2]
Graves was first to describe placebo effect in modern medical science in 1920. However, he considered the effect to be “real psychotherapeutic effect.”
Ever since Evans and Hoyle experimented separately to compare the efficacy of an experimental drug with placebo (dummy simulator), new way to assess the real efficacy of a drug was found.
Advances in statistical methods in modern research methodology made it possible to measure the effect of an experimental drug with a known placebo. This was possible only because of the realization that placebos are associated with some positive benefits in different situations even when they have no known effect in therapeutic terms.
Modern research method is able to differentiate a perceived benefit from a real one. This understanding resulted in skepticism about placebo and seen against the standard practices.
Until the term nocebo was coined, any treatment form unrelated to the condition could be termed as placebo and used as such. Vitamin preparations still hold a large share of prescription as placebo in so many countries, than real therapeutic indications. Vitamin toxicities came to the notice out of such practices only.
While there are real ethical concerns in using known placebo as therapy, its role cannot be denied in development of a drug and establishing effect for real therapeutic purposes. Lately there is renewed interest in placebo and its role is being debated in modern medical practice.
There is a need for clarity on the role of placebo and its use as therapeutic practice need to be curbed specially in developing world. This is possible through regulation.
Article in the current issue discusses the role and relevance of placebo in today's time that will generate a thought provoking discussion.
References
- Placebos and placebo effects in medicine: A historical overview. J R Soc Med. 1999;92:511-5.
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