Ted Kaptchuk at Harvard Medical School and colleagues at Beth Israel Deaconess Medical Center conducted a clinical trial and found a placebo pill without any active ingredient was better than no treatment at helping patients with irritable bowel syndrome.

The therapeutic effect observed in the IBS patients who received the placebo treatment was not the common placebo effect, which is something observed in patients who do not know they are taking a dummy pill in the first place.

In this study, the researchers actually told those on the placebo treatment that they were using a placebo pill, but not a medicine.

The study published on December 22 in PLoS ONE suggests that any placebo treatment (which at least won't cause adverse or side effect) can be better than no treatment.

That is what many American physicians believe.  They use placebos not only in clinical trials, but also in clinical practice for a variety of diseases and conditions.

Rachel Kermen MD and colleagues at Northwestern University and other organizations conducted a survey and found 56 percent of American family physicians had used a placebo in clinical practice with 40 percent using antibiotics as a placebo and 11 percent using inert substances.

The researchers found the common reason for prescribing placebos was "after unjustified demand for medications."

Eighty five percent of physicians believed placebos benefit patients both psychologically and physically and 61 percent recommended using a placebo over using no treatment whereas 8 percent believed use of placebos should be banned.

For the survey, Kermen et al. sent a questionnaire with 20 questions about placebo use and beliefs to 1,000 members of the American Academy of Family Physicians.  A total of 412 physicians responded.

The common placebos given to patients included antibiotics for viral or other non-bacterial diagnoses (40% of placebo cases); vitamins (23%); herbal supplements (12%); sub-therapeutic dose of medication (10%); ibuprofen or other painkiller for symptoms unrelated to pain (9%); saline infusion or saline intramuscular injections (6%); prepared placebo tablets (3%); and sugar or artificial sweetener pills (2%).

The reasons for giving placebos included after unjustified demand for medication (32%); to calm patient (21%); after all clinically indicated treatments were tried (20%); as supplemental treatment (19%); for non-specific complaints (15%); to get patients to stop complaining (15%); as a diagnostic tool (15%); to control pain (10%); and to buy time before next regular dosage of medication (4%).

Physicians believed placebos may both psychologically and physiologically benefit patients with pain (62% of physicians believed so); mental or emotional disorders (62%); gastrointestinal disorders (59%); sexual dysfunction (58%); recovery from drug addiction (49%); neurological disorders (47%); rheumatological disorders (44%); immune problems or allergies (40%); cancer (38%); cardiovascular disorder (33%); and infectious disease (31%). More physicians believed that placebos rendered psychological benefits only.

The survey results were reported in the October 2010 issue of Family Medicine.

David Liu