Examinando um poderoso efeito de cura através de uma lente cultural, e encontrando significado
DOI:
https://doi.org/10.21680/2446-5674.2022v9n16ID25760Palabras clave:
Efeito Placebo, Significado, CorpoResumen
Neste artigo, argumento que o "efeito placebo" não existe; placebos existem, mas eles são inertes, portanto não têm efeitos (é isso que "inerte" significa). No entanto, sabemos que muitas vezes acontecem coisas após a administração de placebo. Dentre as várias causas para tal mudança, atribuo alguns efeitos aos significados que os placebos transmitem aos participantes do evento médico - os médicos, enfermeiras, pacientes, família, comunidade, etc., do paciente. Chamo isso de "respostas significativas" e pesquiso aqui algumas das maneiras como elas ocorrem (com ou sem a presença de placebos). Em seguida, descrevo alguns estudos recentes que complicam dramaticamente a interpretação dos ensaios clínicos randomizados e nossos entendimentos que, talvez, sejam excessivamente simplistas acerca da natureza da eficácia médica.
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ADER, R. The role of conditioning in pharmacotherapy. In: HARRINGTON, A. (Org.). The placebo effect: An interdisciplinary exploration. Cambridge, MA: Harvard University Press, 1997, p. 138-165.
BENEDETTI, F. et al. (2003). Open versus hidden medical treatments: The patient's knowledge about a therapy affects the therapy outcome. Prevention & Treatment, v. 6, n. 1. Disponível em: https://doi.org/10.1037/1522-3736.6.1.61a. Acesso em: 25 de jun. 2021.
BENEDETTI, F.; AMANZIO, M. The neurobiology of placebo analgesia: from endogenous opioids to cholecystokinin. Progress in Neurobiology, v. 52, n. 2, p. 109–25, 1997. Disponível em: https://pubmed.ncbi.nlm.nih.gov/9185235/. Acesso em: 25 de jun. 2021.
BRANTHWAITE, A.; COOPER, P. Analgesic effects of branding in treatment of headaches. British medical journal (Clinical research ed.), v. 282, n. 6276, p. 1576-1578, 1981. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1505530/. Acesso em: 25 de jun. 2021.
BUCHBINDER, R. et al. A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. New England Journal of Medicine, v. 361, n. 6, p. 557–568, 2009. Disponível em: https://www.nejm.org/doi/full/10.1056/nejmoa0900429. Acesso em: 25 de jun. 2021.
CHERKIN, D. C. et al. A randomized trial comparing acupuncture, simulated acupuncture, and usual care for chronic low back pain. Archives of Internal Medicine, v. 169, n. 9, p. 858–866, 2009. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2832641/. Acesso em: 25 de jun. 2021.
COLLOCA, L. et al. Overt versus covert treatment for pain, anxiety, and Parkinson’s disease. Lancet Neurology, v. 3, n. 11, p. 679–684, 2004. Disponível em: https://pubmed.ncbi.nlm.nih.gov/15488461/. Acesso em: 25 de jun. 2021.
CRAEN, A. J. et al. Placebo effect in the treatment of duodenal ulcer. British Journal of Clinical Pharmacology, v. 48, n. 6, p. 853–860, 1999. Disponível em: https://doi.org/10.1046/j.1365-2125.1999.00094.x. Acesso em: 25 de jun. 2021.
CRAEN, A. J. et al. Effect of colour of drugs: systematic review of perceived effect of drugs and of their effectiveness. British medical journal (Clinical research ed.), v. 313, n. 7072, p. 1624–1626, 1996. Disponível em: https://pubmed.ncbi.nlm.nih.gov/8991013/. Acesso em: 21 de jun. 2021.
DE CRAEN, A. J. et al. Placebo effect in the acute treatment of migraine: Subcutaneous placebos are better than oral placebos. Journal of Neurology, v. 247, n. 3, p. 183–188, 2000. Disponível em: https://pubmed.ncbi.nlm.nih.gov/10787112/. Acesso em: 21 de jun. 2021.
DE LA FUENTE-FERNANDEZ, R. et al. Expectation and dopamine release: Mechanism of the placebo effect in parkinson’s disease. Science, v. 293, n. 5532, p. 1164–1166, 2001. Disponível em: https://pubmed.ncbi.nlm.nih.gov/11498597/. Acesso em: 25 de jun. 2021.
GOODMAN, L. S.; GILMAN, A. The pharmacological basis of therapeutics. Nova York: The Macmillian Company, 1970.
GRACELY, R. H. et al. Clinicians’ expectations influence placebo analgesia. Lancet, v. 8419, n. 43, 1985. Disponível em: https://pubmed.ncbi.nlm.nih.gov/2856960/. Acesso em: 25 de jun. 2021.
GRACELY, R. H. et al. The effect of naloxone on multidimensional scales of postsurgical pain in nonsedated patients. Society for Neuroscience Abstracts, v. 5, n. 609, 1979.
HAAKE, M. et al. German Acupuncture Trials (GERAC) for chronic low back pain: Randomized, multi-center, blinded, parallel-group trial with 3 groups. Archives of Internal Medicine, v. 167, n. 17, p. 1892–1898, 2007. Disponível em: https://pubmed.ncbi.nlm.nih.gov/17893311/. Acesso em: 25 de jun. 2021.
HYPERICUM DEPRESSION TRIAL STUDY GROUP. Effect of Hypericum perforatum (St John's Wort) in major depressive disorder. The Journal of the American Medical Association, v. 287, n. 14, p. 1807–1814, 2002. Disponível: https://pubmed.ncbi.nlm.nih.gov/11939866/. Acesso em: 25 de jun. 2021.
HRÓBJARTSSON, A.; GØTZSCHE, P. C. Is the placebo powerless? An analysis of clinical trials comparing placebo with no treatment. New England Journal of Medicine, v. 344, n. 21, p. 1594–1602, 2001. Disponível em: https://www.nejm.org/doi/full/10.1056/nejm200105243442106. Acesso em: 25 de jun. 2021.
JOHNSON, A. G. (1994). Surgery as a placebo. Lancet, v. 344, n. 8930, p. 1140–1142, 1994. Disponível em: https://pubmed.ncbi.nlm.nih.gov/7934500/. Acesso em: 25 de jun. 2021.
KALLMES, D. F., et al. A randomized trial of vertebroplasty for osteoporotic spinal fractures. New England Journal of Medicine, v. 361, n. 6, p. 569–579, 2009. Disponível em: https://www.nejm.org/doi/full/10.1056/nejmoa0900563. Acesso em: 25 de jun. 2021.
KAPTCHUK T. J., et al. (2010). Placebos without deception: a randomized controlled trial in irritable bowel syndrome. PLoS One, v. 5, n. 12, 2010. Disponível em: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0015591. Acesso em: 25 de jun. 2021.
KELLY, K. G.; ZISSELMAN, M. Update on electroconvulsive therapy (ECT) in older adults. Journal of the American Geriatrics Society, v. 48, n. 5, p. 560–566, 2000. Disponível em: https://pubmed.ncbi.nlm.nih.gov/10811552/. Acesso em: 25 de jun. 2021.
LEON, M. B., ET al. A blinded, randomized, placebo-controlled trial of percutaneous laser myocardial revascularization to improve angina symptoms in patients with severe coronary disease. Journal of the American College of Cardiology, v. 46, n. 10, p. 1812–1819, 2005. Disponível: https://pubmed.ncbi.nlm.nih.gov/16286164/. Acesso em: 25 de jun. 2021.
LEON, M. DMR in regeneration of endomyocardial channels trial (DI-RECT). 12th Annual Transcatheter Cardiovascular Therapeutic, Washington DC, p. 17-22, 2000.
LEUCHTER, A. F., et al. Changes in brain function of depressed subjects during treatment with placebo. American Journal of Psychiatry, v. 159, n. 1, p. 122–129, 2002. Disponível em: https://pubmed.ncbi.nlm.nih.gov/11772700/. Acesso em: 25 de jun. 2021.
LEVINE, J. D.; GORDON, N. C.; FIELDS, H. L. The mechanism of placebo analgesia. Lancet, v. 2, n. 8091, p. 654–657, 1978. Disponível em: https://pubmed.ncbi.nlm.nih.gov/80579/. Acesso em: 25 de jun. 2021.
LINDE, C., et al. (1999). Placebo effect of pacemaker implantation in obstructive hypertrophic cardiomyopathy. PIC Study Group. Pacing In Cardiomyopathy. American Journal of Cardiology, v. 83, n. 6, p. 903–907, 1999. Disponível em: https://pubmed.ncbi.nlm.nih.gov/10190407/. Acesso: 25 de jun. 2021.
MAYBERG, H. S., et al. The functional neuroanatomy of the placebo effect. American Journal of Psychiatry, v. 159, n. 5, p. 728–737, 2002. Disponível em: https://pubmed.ncbi.nlm.nih.gov/11986125/. Acesso em: 25 de jun. 2021.
MOERMAN, D. E. Cultural variations in the placebo effect: Ulcers, anxiety, and blood pressure. Medical Anthropology Quarterly, v. 14, n. 1, p. 1–22, 2000. Disponível em: https://pubmed.ncbi.nlm.nih.gov/10812563/. Acesso em: 25 de jun. 2021.
MOERMAN, D. E. Meaning, Medicine and the “Placebo Effect”. Cambridge: Cambridge University Press, 2002.
PHILLIPS, D. P., et al. The Hound of the Baskervilles effect: Natural experiment on the influence of psychological stress on timing of death. British medical journal (Clinical research ed.), v. 323, n. 7327, p. 1443–1446, 2001. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC61045/. Acesso em: 25 de jun. 2021.
PHILLIPS, D. P.; RUTH, T. E.; WAGNER, L. M. Psychology and survival. Lancet, v. 342, n. 8880, p. 1142–1145, 1993. Disponível em: https://www.thelancet.com/journals/lancet/article/PII0140-6736(93)92124-C/fulltext. Acesso em: 25 de jun. 2021.
POLANYI, M.; PROSCH, H. Meaning. Chicago: The University of Chicago Press, 1975.
PRICE, D. D. Assessing placebo effects without placebo groups: An untapped possibility? Pain, v. 90, n. 3, p. 201–203, 2001. Disponível em: https://pubmed.ncbi.nlm.nih.gov/11207391/. Acesso em: 25 de jun. 2021.
SILBERMAN, S. Placebos are getting more effective. Drugmakers are desperate to know why. Wired, Nova York, 24 de ago. 2009. Disponível em: https://www.wired.com/2009/08/ff-placebo-effect/. Acesso em: 25 de jun. 2021.
WALSH, B. T., et al. Placebo response in studies of major depression: Variable, substantial, and growing. The Journal of the American Medical Association, v. 287, n. 14, p. 1840–1847, 2002. Disponível em: https://pubmed.ncbi.nlm.nih.gov/11939870/. Acesso em: 25 de jun. 2021.
WEINSTEIN, J. N. Balancing science and informed choice in decisions about vertebroplasty. New England Journal of Medicine, v. 361, n. 6, p. 619–621, 2009. Disponível em: https://www.nejm.org/doi/full/10.1056/nejme0905889. Acesso em. 25 de jun. 2021.
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