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PubMed1991

Magic or medicine? Clinical pharmacological basis of placebo medication.

A placebo may be a pharmacologically active or an inert substance, a procedure, or a patient-doctor interview. Placebos work best in symptoms or disease which vary over time and between patients. The placebo works best in behaviour disorders, somatic autonomic disorders like pain, and neurohumoral disorders like hypertension. However, placebo action is incompletely defined in its molecular pharmacology. The endogenous brain systems of opioid, antiopioid, and gamma-aminobutyric acid polypeptide transmitters and neuronal receptors account in part for placebo analgesia. Non-painful stress may be mediated through other neurohumoral systems. A separate neural system might control these subsystems. Confidence based on the doctor's empathy commonly evokes the placebo effect. How the symbolic input of thought or emotion is translated into neuronal events is unknown. Double-masked 'controlled' clinical trials use placebo to reduce bias; overuse of placebo here may harm some patients. Oral placebos for routine use include thiamine at low dose. Potent drugs like glucocorticoids cannot be justified as placebo in mild disease or non-disease. Both patient and doctor are usually unaware of the placebo effect during interviews. Doctors may increase placebo efficacy by improving interpersonal skills.

Humans↗
PubMedDate not supplied

Reproductive activity is a magic spell to connect the genesis of cancers of the uterine cervix and endometrium.

The present study investigated the relation between the reproductive activity and the risk for cervical and endometrial cancers using both domestic and international materials. An association of increased risk for cervical cancer (C) with fertility at the levels of both an individual and a population was contrasted to another association of increased risk for endometrial cancer (E) with infertility at the same two levels. Both C and E patients experienced a delay of menstrual cycle (over 30 days) at high incidences (35-49%), whereas healthy controls and breast cancer patients were essentially free from such menstrual delay. The possible impact of the above hormonal characteristics of C and E patients on uterine carcinogenesis is discussed in the light of comparative endocrinology.

Age Factors↗
PubMed1989

Lithium: a therapeutic magic wand.

The premodern and modern history of lithium in medicine spans 130 years. While today the drug has a firmly established role in psychiatry, many issues have yet to be fully resolved. Discussed within (but still not fully resolved) are the effectiveness of lithium in treatment-resistant depression, whether a rebound relapse occurs following abrupt discontinuation, which serum levels are most desirable for acute and maintenance therapy, whether a certain dosage schedule is kinder to the kidney, the relationship of dosage schedule to 12-hour serum level, how to best monitor thyroid function, whether lithium causes kidney rot, and whether lithium and neuroleptics make a uniquely neurotoxic combination.

Bipolar Disorder↗