Placebo effects

colored pills spilling out of a bottleGiven the recent news about antidepressants and the ‘placebo effect’ I thought I’d go there first before folks get themselves all in a lather about those medications and their usefulness treating dogs with fear, phobias and anxiety disorders.

That there are other ways to treat mild depression other than medication is not news. Research demonstrating the ‘placebo effect’ in patients suffering from depression dates back to the 1990’s. That antidepressants have been and continued to be used to help modify behavior in dogs is also not news, nor should it be discounted as the flood of critics of big Pharma (of which I wouldn’t label myself a fan) and medication add the newest studies to their quiver and take aim at medications being used to help dogs.

More accurately the ‘placebo effect’ should be called the ‘placebo effects‘. Placebos don’t all work in the same way. Research into the neurobiology of placebos have been able to identify changes in brain functions. Placebos can work because they help lower the anxiety a sick, or depressed person is experiencing. The possibility and expectation of being healed, along with the attentions of a healer, can be very soothing. Kissed any boo-boos lately to stop the sobbing of a child, hurt and scared by their injury? This lowering of anxiety sets a chain of biological responses in motion, ultimately leading to the patient feeling and being better. That anxiety plays such an important role in healing should be noted by those of us living with fearful dogs. Unfortunately for us and our dogs the attention we give them often contributes to their anxiety rather than lowers it.

Along with the lowering of anxiety there is also the anticipation of a reward, in this case the reward of feeling better. Those of us who use reward based training understand how powerful the ‘expectation’ of a reward is. Our brain’s reward system goes into action even before we receive a reward. The chemicals released in our brains when we anticipate a reward help us begin to feel better. Essentially we create the reward ourselves. The difference between humans and dogs is that we know that the pills hidden in the cream cheese are going to make the dog ‘better’. The dog may not even know they are there at all and does not understand the association between pills and what she experiences in the future.

Placebos also work because medications have taught our brains and bodies how to feel better. If we have daily headaches and take aspirins and an hour later we feel better, we might also feel better if after enough experience with real aspirins we take pills that look like aspirins because our brains learned to do whatever aspirin does that makes us feel better. The medications ‘taught’ our brains how to make the changes necessary for relief. How to apply this to our dogs is a challenging proposition.

A common belief held about placebos is that if they work as well, or can work with a significant portion of the population, it must mean that the drug it is being tested against, doesn’t work. That placebos can work as well as an antidepressant in some people does not mean that the drug is not working at all.

We want to be aware of the potential side effects of taking a medication compared to no treatment at all. Risks needs to be weighed. That the early vaccine for polio caused polio in some instances was not a case against vaccines, but one for a safer vaccine. That the risk of being vaccinated against polio by a safer vaccine was less than the risk of contracting polio is evident today in the absence of polio in most developed countries. The interesting side effect of this success is that there are some who did not grow up during the polio epidemic, and have no experience with the risks of the disease, and eschew the use of vaccines.

If people can grow it or make it we can figure out ways to abuse it. We can use use the things we make or grow inappropriately and suffer and die because of them, or at best, gain no benefit from them. Before you toss the baby out with the bathwater when it comes to using behavioral medications, including antidepressants and anxiolytics to help our fearful and anxious dogs, do your research. That there are other ways to treat fear and anxiety in dogs is not a reason for an owner to discount the use of medication for their dog.

We need to lower the constant stress and anxiety our dogs are experiencing in order for them to be able to learn new skills and responses. If you are not able to do this by managing their environment and teaching them skills that help them cope with the stress they do experience, consider the harmful effects of constant stress on a body and brain. When you don’t see results from alternatives to medications don’t wait for gangrene to set in and lose the limb- talk to your vet about the drugs available to help your dog.


11 comments so far

  1. Cowgirl on

    Thank you for such a thorough and well put post. This is a subject I have been thinking about and going back and forth on, regarding my own dog. Lately, she seems to be improving so much since our move to the country. I am thinking that all the open space available to her is giving her more and more confidence. She is still wary of anyone coming on to the property, but it is slowly morphing into more of ‘alerting’ us to the intruders and keeping her distance, and then just shutting up and getting curious about them.
    Anyway, not to belabour the point, but I am seeing improvement and it makes us all happy.

    • fearfuldogs on

      In many cases the ability to create an environment in which the dog ‘feels’ better we’ll start to see an increase in their ability to try new behaviors on for size. Keep an eye on a dog who is basically afraid of people but learning to approach them. If you notice any aggression rethink the set up. Nice to hear that she’s doing better.

      • EngineerChic on

        Good point! Our fearful dog progressed to the point that he started to think, “I’m ready to check that person out” before he really was. Because if the person moved when he got close (no matter how slightly) he’d panic. Hard to tell a visitor, “Oh, he just freaked out because you tucked your hair behind your ear.”

        I’ve learned that the best case is for ME to decide when he is ready to approach (usually after he’s tried to approach a few times and is looking thoroughly bored with the situation).

      • Debbie Jacobs on

        Ha! Or how about ‘ you breathed!’

  2. Barbara McCormick on

    I so appreciate the wisdom you are sharing in your blog, and especially thank you for taking on this controversial topic. My mini Australian Shepherd would NOT have made it through playgroups, training classes, and hearing the doorbell ring without a six month run of Paxil. My vet was kind enough to research the best script for him, and was supportive. Today, (at almost 2 yrs of age) this little guy is more comfortable in his own skin…and does not live in fear of the world. Even if he becomes reactive when meeting a new dog, new situation, he is able to respond to my voice or the clicker and move on with a big *sigh* SO THANK YOU!!!

    • fearfuldogs on

      Sounds like you should thank your vet! But thanks for saying.

  3. scott on

    Could you further explain:
    ” A common belief held about placebos is that if they work as well, … , it must mean that the drug it is being tested against, doesn’t work.”

    If there is not a significant difference between the control group (placebo group) and experimental group (drug group), then you would be left to assume that the independent variable (drug) didn’t significantly effect the dependent variable (measured effect).

    • fearfuldogs on

      There are likely some people who will benefit from a placebo effect and others who will not.

  4. Catherine McBrien on

    Outstanding, extremely thoughtful post!

  5. K9diabetes on

    We also have to take any study with a grain of salt. How many times over the years have two handfuls of studies come up with completely opposite results.

    Many studies do not effectively measure anything and certainly don’t measure what they claim and it seems to me that accurately measuring improvement in any mood/brain disorder is especially difficult.

    While humans may still layer their placebo effects over on to their dogs when the dogs go on medication, dogs may ultimately be the better test of whether there is a nonplacebo benefit of these kinds of drugs. Especially in cases of concrete behavior problems treated with medication where extinction of the behavior would demonstrate success. I don’t advocate treating a problem only with medication but it would be a useful test of the effect the medication alone is having.

    We feel that we have seen concrete improvements in our dog’s overall baseline level of anxiety since starting Prozac, which was added after a great deal of behavioral and training work and which we were reluctant to do. Having seen our dog’s significant improvement, now I wish we had started it sooner.

    • fearfuldogs on

      It’s great that you are seeing improvements with your dog on meds. Many of us have had a similar experience. People come up with all kinds of reasons to not try meds with their dog. It’s too bad. The research, along with our own anecdotal experience show they can help.

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