This study shows the mind and patient beliefs dramatically affect drug effects both able to increase the effect and descrease it - not just on a pain scale but in actual physically measurable functioning. Makes you wonder if everyday thoughts are just as important to control... :-)
http://www.sciencedaily.com/releases/2011/02/110226212356.htm
 
The Oxford University team, along with colleagues from the University  Medical Center Hamburg-Eppendorf in Germany, Cambridge University, and  the Technische Universität München, set out to investigate these effects  among 22 healthy adult volunteers by giving them an opioid drug and  manipulating their expectations of the pain relief they might receive at  different points.
The volunteers were placed in an MRI scanner and heat applied to the  leg at a level where it begins to hurt -- set so that each individual  rated the pain at 70 on a scale of 1 to 100. An intravenous line for  administration of a potent opioid drug for pain relief was also  introduced.
After an initial control run, unknown to the participants, the team  started giving the drug to see what effects there would be in the  absence of any knowledge or expectation of treatment. The average  initial pain rating of 66 went down to 55.
The volunteers were then told that the drug would start being  administered, although no change was actually made and they continued  receiving the opioid at the same dose. The average pain ratings dropped  further to 39.
Finally, the volunteers were led to believe the drug had been stopped  and cautioned that there may be a possible increase in pain. Again, the  drug was still being administered in the same way with no change. Their  pain intensity increased to 64. That is, the pain was as great as in  the absence of any pain relief at the beginning of the experiment.
The researchers used brain imaging to confirm the participants'  reports of pain relief. MRI scans showed that the brain's pain networks  responded to different extents according to the volunteers' expectations  at each stage, and matching their reports of pain.
This showed the volunteers really did experience different levels of  pain when their expectations were changed, although the administration  of pain relief remained constant.
Professor Tracey notes that these results have been seen in a small,  healthy group of volunteers, and that these are short-term, not  sustained, manipulations of the participants' beliefs about the  treatment.
But she says it's important not to underestimate the strength of the  effect of such expectations on any treatment, and that clinicians need  to know how to manage that.
Professor Tracey says there may also be lessons for the design of  clinical trials. These are often carried out comparing a candidate drug  against a dummy pill to see if there is any effect of a drug above and  beyond that of the placebo.'We should control for the effect of people's  expectations on the results of any clinical trial. At the very least we  should make sure we minimize any negative expectations to make sure  we're not masking true efficacy in a trial drug.'
					
					
					
					
					
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