Research shows doctors may someday prescribe sugar pills for chronic pain

Washington: According to a recent study, Someday doctors may prescribe sugar pills for certain chronic pain patients based on their brain anatomy and psychology. And the pills can reduce the pain as effectively as any powerful drug on the market.

A. Vania Apkarian, author of the study said, "Their (Patients) brain is already tuned to respond. They have the appropriate psychology and biology that puts them in a cognitive state that as soon as you say, 'this may make your pain better,' their pain gets better." There's no need to fool the patient, Apkarian said.

"You can tell them, 'I'm giving you a drug that has no physiological effect but your brain will respond to it. You don't need to hide it. There is a biology behind the placebo response," Apkarian adds.

The findings of the study have three potential benefits:

Prescribing non-active drugs rather than active drugs.

"It's much better to give someone a non-active drug rather than an active drug and get the same result," Apkarian said. "Most pharmacological treatments have long-term adverse effects or addictive properties. Placebo becomes as good an option for treatment as any drug we have on the market."

Eliminating the placebo effect from drug trials.

"Drug trials would need to recruit fewer people, and identifying the physiological effects would be much easier," Apkarian said. "You've taken away a big component of noise in the study."

Reduced health care costs.

A sugar pill prescription for chronic pain patients would result in vast cost savings for patients and the healthcare system, Apkarian said.

As part of the research, about 60 chronic back pain patients were randomized into two arms of the study. In one arm, subjects didn't know if they got the drug or the placebo. Researchers didn't study the people who got the real drug. The other study arm included people who came to the clinic but didn't get a placebo or drug. They were in the control group.

The individuals whose pain decreased as a result of the sugar pill had a similar brain anatomy and psychological traits. The right side of their emotional brain was larger than the left, and they had a larger cortical sensory area than people who were not responsive to the placebo. The chronic pain placebo responders also were emotionally self-aware, sensitive to painful situations and mindful of their environment.

"Clinicians who are treating chronic pain patients should seriously consider that some will get as good a response to a sugar pill as any other drug," Apkarian said. "They should use it and see the outcome. This opens up a whole new field."

The full findings are present in the Journal of Nature Communications.