Do amnesiacs benefit from the placebo effect?
January 5, 2012 2:17 PM Subscribe
Do amnesiacs benefit from the placebo effect?
"Amnesiac" is way too broad a term to make this kind of generalization. (Unless you're talking about...)
The most famous case study of anterograde amnesia, HM (who recently passed away and was revealed to be named Henry Molson), was spared in several memory faculties despite bilateral hippocampectomy. Among these were spatial memory and motor skills, or procedural memory. (What was destroyed is generally referred to as episodic memory, where one remembers a specific instance, as opposed to more generalized knowledge.) In addition, he had intact memories of his childhood and earlier life.
So to flesh out the question a bit, assuming you're referring to anterograde amnesia, the inability to create new memories... that's an interesting question. My guess is yes, it would help, given that he knows at the time he's taking the placebo pill that it's supposed to make him better. Granted, he wouldn't remember taking it for long, but it should be enough to at least start whatever process causes the placebo effect in normal controls.
Or are you thinking more of retrograde amnesia, in which the patient wouldn't even remember that medicine helps cure illness?
posted by supercres at 3:07 PM on January 5, 2012 [1 favorite]
The most famous case study of anterograde amnesia, HM (who recently passed away and was revealed to be named Henry Molson), was spared in several memory faculties despite bilateral hippocampectomy. Among these were spatial memory and motor skills, or procedural memory. (What was destroyed is generally referred to as episodic memory, where one remembers a specific instance, as opposed to more generalized knowledge.) In addition, he had intact memories of his childhood and earlier life.
So to flesh out the question a bit, assuming you're referring to anterograde amnesia, the inability to create new memories... that's an interesting question. My guess is yes, it would help, given that he knows at the time he's taking the placebo pill that it's supposed to make him better. Granted, he wouldn't remember taking it for long, but it should be enough to at least start whatever process causes the placebo effect in normal controls.
Or are you thinking more of retrograde amnesia, in which the patient wouldn't even remember that medicine helps cure illness?
posted by supercres at 3:07 PM on January 5, 2012 [1 favorite]
Wait, now I'm confused. Above I answered the question "Would someone with amnesia get better on a placebo drug?" Are you instead asking whether, by virtue of not remembering they're sick, people with amnesia would get better faster than people without it? No. I think the illness itself would be a pretty constant reminder of that, which would cancel out any benefit.
To get a glimpse inside the mind of someone suffering from both retrograde and anterograde amnesia, I highly recommend reading about Clive Wearing. (There are also bits of documentaries about him on Youtube, etc.)
posted by supercres at 3:15 PM on January 5, 2012 [1 favorite]
To get a glimpse inside the mind of someone suffering from both retrograde and anterograde amnesia, I highly recommend reading about Clive Wearing. (There are also bits of documentaries about him on Youtube, etc.)
posted by supercres at 3:15 PM on January 5, 2012 [1 favorite]
I would have thought this would be very hard to test ethically, since you'd basically be testing for the effects of a substance given to the subject without them knowing.
(If you could do a test like that ethically I can think of some interesting trials on the effectiveness of homeopathic cures that could be run)
posted by Artw at 3:26 PM on January 5, 2012
(If you could do a test like that ethically I can think of some interesting trials on the effectiveness of homeopathic cures that could be run)
posted by Artw at 3:26 PM on January 5, 2012
The placebo effect is more than the null effect muddgirl seems to be describing - the placebo effect is the difference between sham treatment (e.g. a sugar pill) and no treatment.
Assuming you're thinking about anterograde amnesia, I would expect that it would depend partly on how soon the effect of the placebo would be expected to happen. If the effect were expected to be immediate - for example, a fake topical anesthetic - then I don't see why an anterograde amnesiac would have any more trouble with it than anyone else. If it were a treatment that one would expect to take days, weeks, months, or years to take effect, that would be less likely to take effect.
But even then, a long-term effect might be possible; most anterograde amnesiacs can retain some memory - for example, some subconsciously remember the punchlines to jokes, I think most can be trained using operant conditioning (they won't shake the hand of the doctor who always has a joy buzzer on his hand, though they may not consciously know why), and I believe I've heard that some can be quite good at procedural learning (learning skills). So even if there's a memory component to the placebo effect (which seems likely) the particular memory pathway that is used by the placebo effect might not be impacted by the amnesia.
I'm making all this up, obviously - I don't know if anyone's done any actual research. People do do research on amnesiacs, though, so there must be some way of obtaining consent (presumably through their guardians).
posted by mskyle at 4:47 PM on January 5, 2012 [1 favorite]
Assuming you're thinking about anterograde amnesia, I would expect that it would depend partly on how soon the effect of the placebo would be expected to happen. If the effect were expected to be immediate - for example, a fake topical anesthetic - then I don't see why an anterograde amnesiac would have any more trouble with it than anyone else. If it were a treatment that one would expect to take days, weeks, months, or years to take effect, that would be less likely to take effect.
But even then, a long-term effect might be possible; most anterograde amnesiacs can retain some memory - for example, some subconsciously remember the punchlines to jokes, I think most can be trained using operant conditioning (they won't shake the hand of the doctor who always has a joy buzzer on his hand, though they may not consciously know why), and I believe I've heard that some can be quite good at procedural learning (learning skills). So even if there's a memory component to the placebo effect (which seems likely) the particular memory pathway that is used by the placebo effect might not be impacted by the amnesia.
I'm making all this up, obviously - I don't know if anyone's done any actual research. People do do research on amnesiacs, though, so there must be some way of obtaining consent (presumably through their guardians).
posted by mskyle at 4:47 PM on January 5, 2012 [1 favorite]
Yeah, this question could have a lot of interpretations. Can a placebo help amnesiacs? Does a placebo help someone who doesn't know they're sick? Someone who doesn't remember taking medicine?
In the words of Jessamyn... What problem are you trying to solve here?
posted by cmoj at 4:56 PM on January 5, 2012 [1 favorite]
In the words of Jessamyn... What problem are you trying to solve here?
posted by cmoj at 4:56 PM on January 5, 2012 [1 favorite]
This thread is closed to new comments.
Furthermore, "amnesiac" can mean a lot of things. I think for the answer to this question to be yes, the patient would have to be so delirious that they don't even recognize that they are sick.
posted by muddgirl at 2:57 PM on January 5, 2012