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I was reading about the placebo effect, and I wondered if there exists or ever existed a disease with the following properties:

  1. There are no known treatments for the disease that perform better than a placebo.
  2. The placebo has a positive effect on patient outcomes.

If there is a disease like this, what do doctors do? Do they give out prescriptions for sugar pills because the pills will do better than nothing?

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    $\begingroup$ The ethics of knowingly providing a placebo are iffy. There was a study once of placebos for asthma, or something like it. Some patients reported feeling better, but objective measurements of lung function showed they were not. That misconception could have been dangerous for the patients. $\endgroup$ – swbarnes2 Jul 5 '16 at 21:33
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    $\begingroup$ psychosomatic or imaginary ones. comes to mind. $\endgroup$ – John Jan 9 at 16:10
  • $\begingroup$ I'm voting to close this question as off-topic because it is not about biology in terms of SE Biology but about medicine or medical ethics. $\endgroup$ – David Jun 8 at 16:56
  • $\begingroup$ I agree this can be moved to Medical Sciences SE. $\endgroup$ – Jan Jun 10 at 11:28
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Doctors sometimes use "open-label placebos" - substances that have no known physiological effect on the treated disease, but have been associated with symptoms improvement in some studies. Open-label means doctors openly tell people it's placebo. The example is treatment of irritable bowel syndrome.

Doctors use not only fake drugs, but also real drugs as placebos. There are some doctors who don't have a courage to say they don't know how to help, so they just prescribe "something" (a real but ineffective drug) in the hope they will convince someone that they provided some help.

Prescribing "placebo treatments": results of national survey of US internists and rheumatologists (BMJ, 2008)

Prescribing placebo treatments seems to be common and is viewed as ethically permissible among the surveyed US internists and rheumatologists. Vitamins and over the counter analgesics are the most commonly used treatments. Physicians might not be fully transparent with their patients about the use of placebos and might have mixed motivations for recommending such treatments.

There is a common practice to prescribe:

  • Vitamins or antibiotics for common cold, flu and other viral infections (Montana DPHHS ; JRSM Open)
  • Antipsychotics, antidepressants and sedatives for personal problems that can't really help to solve those problems
  • Various drugs for fibromyalgia

The seeming effect of placebo can discourage a person to seek for the real treatment.

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  • $\begingroup$ This may be a valid comment on the “common” behaviour of some doctors but does not answer the quite specific question regarding specific diseases and “state of the art” which I assume means recommended treatment in this context. $\endgroup$ – David Jun 10 at 12:40
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    $\begingroup$ Treatment of depression, fibromyalgia and irritable bowel syndrome is typically treated with various drugs, even when there is insufficient evidence about their effectiveness, so they are placebos in this regard - even if doctors who prescribe them disagree. So, for the mentioned conditions using placebos is the state of the art. $\endgroup$ – Jan Jun 10 at 16:08
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    $\begingroup$ Keep going. You may even manage to convince yourself. $\endgroup$ – David Jun 10 at 16:12

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