What's the Latest Development?
Harvard medical researcher Ted Kaptchuk is finding that how placebos are administered plays a very important role in their ability to cause physiological changes in the body. A trained acupuncturist, Kaptchuck has tested the treatment's ability to work as a placebo by offering his patients qualitatively different treatments. In other words, patients who receive more care and "schmaltz" from their medical professional tend to receive the greatest benefit from sham treatments. Kaptchuk wonders to what extend, if at all, Western medicine can take advantage of the placebo effect to improve treatment.
Whats the big idea?

For decades, the medical establishment has treated all placebo effects equally but Kaptchuk's studies show the importance of how fake treatments are administered. What has become most clear is that, despite the emphasis Western medicine places on material and chemical changes, medicine is a ritualistic event. Beyond the science of pharmaceuticals is the science of care, a role which encompasses how pills affect our physiology. Critics argue that were placebos to be encouraged in the practice of medicine, patients could delay other treatments with longer- lasting benefits.

Similar to the placebo effect, in which a fake medication can give patients the benefits of having taken the real drug, the nocebo effect is the little-studied fact that patients taking a fake drug can also experience real negative side effects. "In one remarkable case, a participant in an antidepressant drug trial was given placebo tablets—and then swallowed 26 of them in a suicide attempt. Even though the tablets were harmless, the participant's blood pressure dropped perilously low." Other data comes from drug trials where patients stop taking their placebo pills because they experience adverse side effects.
The nocebo effect extends beyond fake medication to drugs that doctors prescribe patients for genuine medical problems. How doctors warn patients of side effects partially determines how those effects will be experienced. "The nocebo effect presents doctors and nurses with an ethical dilemma: on one hand, they are required to tell patients about the potential complications of a treatment; on the other hand, they want to minimize the likelihood of side effects. But if merely telling patients about side effects increases their likelihood, what is to be done?" Psychologists recommend doctors receive better training in how to communicate with patients.
As in all brain actions, the placebo effect is the product of chemical changes. Numerous studies have supported the conclusion that endorphins in the brain produce the placebo effect. In patients with chronic pain, for example, placebo responders were found to have higher concentrations of endorphins in their spinal fluid than placebo nonresponders.

Conclusion_ At one time, researchers viewed the placebo effect as an impediment--a statistical annoyance that got in the way of objectively evaluating the efficacy of potentially legitimate therapies. That view has changed. The placebo effect is today seen as an important part of the healing process. It's been studied as a treatment for Parkinson's disease, depression, chronic pain, and more. For large numbers of patients—the placebo responders—belief in the therapy will create or enhance its effectiveness.