Psychiatrists OK treating with placebos

MCGILL (CAN) — A recent survey shows Canadian psychiatrists embrace the power of placebos more than other physicians.

One in five respondents—physicians and psychiatrists in Canadian medical schools—have administered or prescribed a placebo. An even higher proportion of psychiatrists (more than 35 percent) reported prescribing subtherapeutic doses of medication (that is, doses that are below, sometimes considerably below, the minimal recommended therapeutic level) to treat their patients.

Prescribing pseudoplacebos—that is treatments that are active in principle, but that are unlikely to be effective for the condition being treated, such as using vitamins to treat chronic insomnia—is more widespread than previously thought, according to the results published in the Canadian Journal of Psychiatry.

The survey, which was also designed to explore attitudes toward placebo use, found that the majority of responding psychiatrists (more than 60 percent) believe that placebos can have therapeutic effects. This is a significantly higher proportion than for other medical practitioners.

“Psychiatrists seem to place more value in the influence placebos wield on the mind and body,” says Amir Raz, professor of psychiatry at McGill University. Only 2 percent of those psychiatrists believe that placebos have no clinical benefit at all.

“While most physicians probably appreciate the clinical merits of placebos, limited guidelines and scientific knowledge, as well as ethical considerations, impede open discussion about the best way we may want re-introduce placebos into the medical milieu,” says Raz. “This survey provides a valuable starting point for further investigations into Canadian physicians’ attitudes towards and use of placebos.”

The research was funded by the Canadian Institute of Health Research, the Natural Sciences and Engineering Research Council of Canada, and the Oxford-McGill Neuroscience Collaboration.

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