How Placebos Can Be Effective Method Of Treatment

The placebo effect has been affecting people for hundreds of years. In the 1940s sugar pills were sold in doctors’ catalogs specifically for the purpose of prescribing them to psychiatric patients. Today, over 60% of doctors admit to prescribing placebos to their patients, although there is an unwritten rule among doctors in the United States that placebos should no longer be given to patients. Some even do it on a regular basis because they believe the effect a fake drug has on the brain is more effective for its price than the real medication or treatment. In the documentary, Placebo: Cracking the Code, viewers see a few different perspective of the placebo effect. They hear from doctors, patients, and researchers to more fully understand the ins and outs of the placebo effect. These different viewpoints serve as an effective way to bring light the producers’ purpose: to show just helpful and sometimes harmful placebo drugs can be.

The World Health Organization projects that, by 2040, neurodegenerative diseases will become more common than cancer (Cashell, 2014). Parkinson’s Disease (PD) is widely listed as the second most common neurodegenerative disease (Wuong, 2012; Gillies et al., 2014; Cashell, 2014; Walker, Davidson, & Gray, 2012). This disease, usually characterized by a tremor, but featuring systemic effects, has been diagnosed in one to two percent of people over age 65 (Casey, 2013). Parkinson’s disease is incurable; the goal of the healthcare team is to help the patient to maintain function, independence and quality of life (Miertová et al., 2014; Magennis, Lynch, & Corry, 2014). In the discussion that follows, current understanding of the causes and treatment of PD will be summarized, along with examples of nursing interventions.

J.N., a 65-year-old Caucasian female with a history of anxiety and depression, presents for diagnostic testing at Saint Mary Medical Center in Hobart, Indiana to confirm or deny a diagnosis of Parkinson’s Disease, after presenting with recent onset of upper extremity tremor affecting both sides and facial masking. Patient history also includes bradykinesia, restlessness, fatigue, muscle weakness, and poor balance and coordination, all of which are common in a diagnosis of Parkinson’s Disease. J.N. was referred to the Neurology Department of Saint Mary Medical Center after a routine appointment with her Cardiologist, who noted the recent onset of additional signs and symptoms. J.N. is my mother and my inspiration for this assignment.

Placebos have been used in clinical trials since the eighteenth century but did not become a research topic until the late twentieth century (van Haselen, 2013). Most often when using placebos in clinical trials it is to determine whether or not the active agent has more effect on a patient than the placebo by providing each to the same number of recipients. The trials are almost always double blinded, this means that both person giving the drug and the person receiving it are unaware whether or not it is active so that good care and relationships must be present in the recipients at all times (Tavel, 2014). Ovosi, Ibrahim, & Bello-Ovosi (2017) declared “The choice between placebo and active controls in clinical trials affects the quality of the result as well as the ethical and scientific acceptability by both the public and regulatory bodies. It has, therefore, continued to generate discuss among researchers” (para. 3). This goes against the autonomy of a patient which is the right for a person to

The author continues to demonstrate how the placebo effect works by comparing it to the famous biological study by Ivan Pavlov. In Pavlov’s experiment, dogs are conditioned to respond to a specific stimulus and eventually begin to respond to the same stimulus in the same way all the time. Bjerklie explains that, “as far as the placebo effect is concerned, we may as well be those impressionable canines.” What Bjerklie means is that the human mind has the ability to be conditioned to expect certain outcomes. The placebo effect builds on the human minds ability to be conditioned and an individual’s faith in the healthcare providers it choses to visit. Overtime the human mind has come to believe that if given a medication that is suppose to have a positive effect on a specific pathology, it will in fact have an positive effect.

The purpose of this study was to see whether implanted embryonic dopamine neurons in Parkinson's disease patients led to a relieve of symptoms and also to see whether age played a role in whether the implanted neurons survived. All the participants were patients with Parkinson's disease who had if for at least seven years and had all three signs of Parkinson's disease. The patients were placed in groups of ten, some were given sham surgery and others transplantation. This was a double blind study. What was found was that patients who were 60 or younger actually responded better to the treatment and of the 40 patients only 39 actually completed the study, one of the patients died in a car crash before the study was finished the study lasted for a whole year. Also only patients who were 60 or younger reported positive feedback like showing actual improvement. The other patients were actually showing negative results which is not good because that meant that the disease was actually getting worse. The scores of one of the tests used showed some differences between the sham group and transplant group when not

New and evolving diagnostic tests are always exciting. Especially if these tests could possibly lead us to a cure for those diseases that currently have only treatment, but no cures. Parkinson 's is a progressively degenerative disease, which affects millions of people every year. Patients suffering from Parkinson 's incur high costs from drug therapy, fall-related injuries, and hospitalizations. By diagnosing this disease earlier, treatment can be started earlier and hopefully the symptoms can be delayed and less severe for a longer period of time giving the patient a better quality of life. However, with any new test we must use statistical measures to determine if these tests are truly making a difference.

In this study, “Group A received PT and medication therapy (MT) for 6 weeks, followed by MT only for the second 6 weeks. Group B received only MT for the first 6 weeks and PT and MT for the second 6 weeks(5)”. This study helps show how physical therapy can be applied to many different types of medical fields for any type of recovery. In the conclusion of the study, it stated, “People with Parkinson’s disease derive benefits in the short term from the physical therapy group treatment, in addition to their medical therapy, for quality of life related to mobility, long-term benefits were found in the study, and the total scores but varied between groups(5)”. In simpler terms the patients that received physical therapy and medical therapy at the same time opposed to those who only received the medical side showed much more improvement in the recovery and wellness process. Provided this, it is clear that physical therapy can and is playing a large part in many different medical

The main outcome of this Prospective Cohort Study is incidence of dementia in subjects with Parkinson’s disease.

The elevated striatal dopamine levels induced by rasagiline-dependent MAO-B inhibition has been correlated to improvements in PD motor symptoms in both monotherapy and adjunctive therapy studies. The TEMPO (TVP-2012 in Early Monotherapy for Parkinson’s Disease Outpatients) study, a 26-week, randomized, double-blind and placebo-controlled clinical trial observed the efficacy of rasagiline as a monotherapy for 404 early PD patients. Efficacy of rasagiline was quantified using the Unified Parkinson’s Disease Rating Scale (UPDRS), a rating scale used to measure the progression of PD by scoring four primary categories of symptoms: mentation, behavior and mood; activities of daily living; motor examination; and complications of therapy. Higher UPDRS scores correspond to greater severity of disease with the maximum possible score of 199 points representing total disability. The patients in the TEMPO trial had a mean baseline UPDRS score of 25 points and were subsequently divided into three groups: 1 mg rasagiline qd, 2 mg rasagiline qd or placebo. At the end of the trial period, compared with the placebo group, the average change in total UPDRS score was -3.56 for the 2 mg rasagiline group and -4.20 for the 1 mg rasagiline group. Of the four UPDRS categories, the greatest change was observed in the motor examination sub-scale with a mean change of -2.71 for the 1 mg rasagiline group and -1.68 for the 2 mg rasagiline group. This reduction in UPDRS score, especially with regards to

I have now come to the conclusion that many concerns I had about your original idea of comparing heathy controls to parkinson's disease patiance can be quited by using a baseline period and a task of unknown difficulty. I will just update myslides to reflect this new concept.

In the United States, around 1% of persons who are older than 60 years are diagnosed with Parkinson disease. This percentage is estimated to double by 2030 (Lamotte, Rafferty, Prodoehl, Kohrt, & Comella, 2015). The signs of Parkinson disease include rigidity, tremor, bradykinesia, and postural instability, along with other motor symptoms that could affect a person’s quality of life and an engaging in exercise include difficulty with motor planning and task performance. There is a need for effective alternative approaches to treat symptoms in Parkinson's disease along with medications and surgical interventions. Currently, several studies revealed that physical therapy intervention approaches increase physical functioning in Parkinson patients, such as improve gait, balance and mobility, fatigue, neurophysiological measures, quality of life, depression, cardiorespiratory function, and motor control measures. Additionally, physical therapy program could help the patient to participate in an exercise program to prevent deterioration related to progressive Parkinson disease (Gisbert, & Schenkman, 2015; Lamotte, Rafferty, Prodoehl, Kohrt, & Comella,

The Earlier versus Later Levodopa Therapy in Parkinson Disease (ELLDOPA) study was a multicentre, randomized, double-blinded, placebo-controlled trial involving 361 patients. The eligible subjects recruited were 30 years of age or older, in their early stages of PD based on the modified HY scale of less than stage 3 (Table 1.1) (Hoehn and Yahr, 1967) and were considered certainly not required therapy for parkinsonian symptoms within the nine months after enrolment to the study. The exclusion criteria for participation in the study were patients who were receiving antiparkinson medication, had been exposed to levodopa or any DA for more than 14 days, able to identify the cause of parkinsonism or had a tremor in any limb that was given a score

Charcot examined a large group of patients within Salpetriere Hospital in Paris, he had developed a way to observe tremors in action and at rest. “He noted that the patients with action tremor had accompanying features of weakness, spasticity, and visual disturbance. In contrast, those with rest tremor differed in having rigidity, slowed movements, a typical hunched posture, and very soft spoken.” (Goetz 2011) Charcot early tremor studies helped to establish Parkinson’s Disease through his very high publicized findings that neurological entity could be confidently be diagnosed. In 1957 a Swedish scientist Arvid Carlsson found out that dopamine in the brain region that is important for movement control. He showed that the levels of dopamine can be reduced in animals to cause symptoms of Parkinson’s Disease and also by giving the animals levodopa (L-dopa) to reverse the symptoms of PD. PD is second most common neurodegenerative after Alzheimer’s Disease and the most common movement disorder. Over 60,000 people here in the United States are diagnosed every year but they say the numbers can be much higher with undiagnosed people out there but over one million people live with Parkinson daily.10 million people worldwide live with Parkinson’s Disease and April 11th is World Parkinson’s Day. On April 11th, 2017 marked 200 years since James Parkinson publicized his essay.

The non-ergot dopamine agonist pramipexole is currently indicated for the treatment of the signs and symptoms of idiopathic Parkinson's disease and for the treatment of moderate-to-severe primary restless legs syndrome. A new extended-release formulation of pramipexole has now also been launched in Europe and the US to improve ease of use, compliance and provide a more continuous therapeutic effect over 24 hours. Before initiating any treatment, the benefit-risk ratio to the individual patient must be considered. For pramipexole in the treatment of Parkinson's disease, this means taking into account the available evidence regarding its symptomatic efficacy, effect on delaying long-term levodopa-related motor complications, beneficial effect