Which placebo is more effective?
A "generic" placebo, or a placebo labeled as "name- brand"?
A new brain-scan study published in Pain Medicine Journal found that the 'consciousness areas' of the brain perceive less pain taking "name-brand" than "generic" placebo. This is a wonderful and sobering discovery because it reveals how strongly our beliefs effect us to the core.
Beliefs are powerful. They can influence us to think there are benefits to all kinds of products, therapies, and services that may have no real value at all. Brain scans show that deep levels of awareness bias us toward familiar and popular items. Our belief that generic aspirin is inferior causes us to prefer another product based only on its recognized name.
In the case of placebo, these delusions can work for or against us - in a sense.
Pain Med. 2015 Apr 30.
Placebo Responses to Original vs Generic ASA Brands During Exposure to Noxious Heat: A Pilot fMRI Study of Neurofunctional Correlates.
Fehse K1, Maikowski L, Simmank F, Gutyrchik E, Meissner K.
We studied the expectation effects associated with brands by labeling placebo interventions (original and generic analgesic) and investigating the potential differences in efficacy between the two placebos in dealing with noxious heat pain, as well as exploring the neurometabolic correlates of the placebo response.
We applied a two by two design with two identical placebo interventions that differed only in their labeling. One group was told that they received 500 mg of "Aspirin" (original brand) while the other group was told that they received a popular ASA generic (1A Pharma). After establishing the individual pain level of each subject, we measured pain intensities behaviorally before and after the intervention and looked for corresponding brain areas with increased hemodynamic response using functional magnetic resonance imaging.
At the behavioral level, we found decreases in pain intensity from baseline to the intervention condition with the original brand only. At the neuronal level, we specifically observed activations of the anterior insulae under the baseline conditions, complemented by activations of the dorsomedial prefrontal cortex after the interventions. A direct comparison of the two placebo conditions revealed higher values of activation for the bilateral dorsolateral (as well as dorsomedial) prefrontal cortex for the original brand.
Our data indicate a behavioral placebo response for the original brand only. Expectations by subjects appear to be triggered not only by the placebo treatment itself but also by the trusted brand, which thus serves as an enhanced placebo. Both processes appear to be based on fronto-cortical neural networks, as these areas showed significantly stronger activations with the original brand.