Homeopathic Remedies Are No More Effective Than Placebos
Like cures like. This is the theory of ]]>homeopathy]]> , which was created in the late 1700s by the German physician Samuel Hahnemann. Dr. Hahnemann postulated that an illness can be treated with a dilute solution of a substance that caused the signs and symptoms of the illness. The offending substance, usually an herb or mineral, is repeatedly diluted until, in some cases, no molecules of the original substance remain. Between each dilution, the solution is shaken vigorously, a process called potentisation. During the course of shaking and serial dilution, homeopathic proponents believe, the “vital essence” of the diluted substance is transferred to the water. Homeopathic physicians often personalize their remedies, based on the patient’s personality and emotional reaction to their illness.
Critics of homeopathy contend that its premise is not scientifically feasible and that there is little proof of efficacy from rigorous clinical studies. Any benefits are, therefore, attributed to the placebo effect, a common phenomenon in clinical studies. Since placebo-controlled trials are usually blinded, which means the patients do not know whether they are taking the active treatment or the inactive placebo, the reported benefits among placebo-takers are likely due to the expectation that they are receiving the active treatment and that they will benefit.
People usually seek homeopathy because they are attracted to the belief that alternative therapies offer a more holistic and natural method of treating the body than conventional medicine does. Homeopathy patients often cite a personal and supportive relationship with their practitioner. Critics content that this belief in holistic medicine and strong practitioner-patient connection leads to an expectation of benefit, which is a perfect example of the placebo effect.
Researchers from the University of Berne in Switzerland investigated whether the benefits of homeopathy are due to the homeopathic remedies themselves or the placebo effect. They compared the results of more than 200 placebo-controlled trials, half involving homeopathy and half involving conventional medicine. Their findings, published in the August 27, 2005 issue of The Lancet , show that the positive effects of homeopathy can indeed be attributed to the placebo effect.
About the Study
Through a careful search of several publication databases, the investigators identified 110 placebo-controlled randomized trials of homeopathy and 110 placebo-controlled randomized trials of conventional medicines. The conventional studies were chosen to match the homeopathic studies in disease state, such as respiratory infections or asthma, and in the outcomes measured. All 220 of the studies were then divided into two groups: smaller, lower-quality trials and larger, higher-quality trials. This division was done because smaller studies are more prone to biases that can obscure reliable findings.
Whether the treatment was homeopathic or conventional, the effects were more likely to be positive in the smaller, lower-quality studies. The researchers explained this finding as a reflection of the many biases that plague smaller trials, making the true effects difficult to determine.
When the researchers focused on the larger and better designed studies, there was a notable difference. The homeopathic treatments were no better at improving outcomes than placebo. In contrast, conventional treatments showed significant effects compared to placebo. These findings support the theory that the benefits associated with homeopathy are due to the placebo effect and not to the remedies.
How Does This Affect You?
Although this is hardly the last word on the subject, this study does suggest that homeopathy’s effects are unlikely to be due to the remedies themselves. This is not the same as saying that homeopathy is not beneficial, or even that it is necessarily less beneficial than conventional therapies for some patients.
The trusting alliance between homeopathic physician and patient is not a trivial matter. While the influence of such a relationship may be termed a “placebo effect” by clinical researchers, it does highlight an important component of quality medical care—the human relationship—which is often lacking in the comparatively rushed and regimented environments found in many conventional medical practices.
While clinical trials to date have not been generally supported of homeopathy’s effective beyond a placebo, other alternative therapies have been shown to be effective in similar studies. Dismissing all alternative therapies, including homeopathy, as useless would be a mistaken conclusion. However, if you are interested in pursuing these therapies, it is essential to keep your conventional physician informed of your plans.
Complementary and Alternative Medicine on PubMed
Johns Hopkins Center for Complementary and Alternative Medicine
National Center for Complementary and Alternative Medicine
The end of homeopathy [editorial]. The Lancet . 2005;366:690.
McCarthy M. Critics slam draft WHO report on homeopathy. The Lancet . 2005;366:705-706.
Shang A, Huwiler-Muntener K, Nartey L, et al. Are the clinical effects of homeopathy placebo effects? Comparative study of placebo-controlled trials of homeopathy and allopathy. The Lancet . 2005;366:726-732.
US Food and Drug Administration. The healing power of placebos. FDA Consumer online. Available at: http://www.fda.gov/fdac/features/2000/100_heal.html . Accessed August 30, 2005.
Vandenbroucke JP. Homeopathy and “the growth of truth” [comment]. The Lancet . 2005;366:691-692.
Last reviewed Sep 2, 2005 by ]]>Richard Glickman-Simon, MD]]>
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