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Research papers on The placebo effect

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  2. A Comprehensive Review of the Placebo Effect: Recent Advances and Current Thought

    Donald D. Price, Damien G. Finniss, Fabrizio Benedetti · 2007 · Annual Review of Psychology · 1,148 citations

    Our understanding and conceptualization of the placebo effect has shifted in emphasis from a focus on the inert content of a physical placebo agent to the overall simulation of a therapeutic intervention. Research has identified many types of placebo responses driven by different mechanisms depending on the particular context wherein the placebo is given. Some placebo responses, such as analgesia, are initiated and maintained by expectations of symptom change and changes in motivation/emotions. Placebo factors have neurobiological underpinnings and actual effects on the brain and body. They are not just response biases. Other placebo responses result from less conscious processes, such as cl

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  4. A comparison of placebo effects in clinical analgesic trials versus studies of placebo analgesia

    Lene Vase, Joseph L. Riley, Donald D. Price · 2002 · Pain · 435 citations

    A previous meta-analysis of clinical analgesic trial studies showed generally low magnitudes of placebo analgesia (N. Engl. J. Med. 344 (2001) 1594). However, as studies included in their analysis used only placebo as a control condition, we conducted two meta-analyses, one in which 23 studies used only placebo as a control condition, and one in which 14 studies investigated placebo analgesic mechanisms. Magnitudes of placebo analgesic effects were much higher in the latter (mean effect size=0.95) as compared to the former (mean effect size=0.15) and were significantly different (P=0.003). This difference as well as differences in effect sizes within studies of placebo mechanisms may be pars

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  5. Effect of Lactobacillus rhamnosus HN001 in Pregnancy on Postpartum Symptoms of Depression and Anxiety: A Randomised Double-blind Placebo-controlled Trial

    R. Slykerman, Fiona Hood, K. Wickens, et al. · 2017 · EBioMedicine · 363 citations

    Background Probiotics may help to prevent symptoms of anxiety and depression through several putative mechanisms. Objective The aim of this study was to evaluate the effect of Lactobacillus rhamnosus HN001 (HN001) given in pregnancy and postpartum on symptoms of maternal depression and anxiety in the postpartum period. This was a secondary outcome, the primary outcome being eczema in the offspring at 12 months of age. Design, Setting, Participants A randomised, double-blind, placebo-controlled trial of the effect of HN001 on postnatal mood was conducted in 423 women in Auckland and Wellington, New Zealand. Women were recruited at 14–16 weeks gestation. Intervention Women were randomised to r

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  6. Neuro-Bio-Behavioral Mechanisms of Placebo and Nocebo Responses: Implications for Clinical Trials and Clinical Practice

    Manfred Schedlowski, Paul Enck, Winfried Rief, et al. · 2015 · Pharmacological Reviews · 321 citations

    The placebo effect has often been considered a nuisance in basic and particularly clinical research. This view has gradually changed in recent years due to deeper insight into the neuro-bio-behavioral mechanisms steering both the placebo and nocebo responses, the evil twin of placebo. For the neuroscientist, placebo and nocebo responses have evolved as indispensable tools to understand brain mechanisms that link cognitive and emotional factors with symptom perception as well as peripheral physiologic systems and end organ functioning. For the clinical investigator, better understanding of the mechanisms driving placebo and nocebo responses allow the control of these responses and thereby hel

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  7. Psychobiological Mechanisms of Placebo and Nocebo Effects: Pathways to Improve Treatments and Reduce Side Effects.

    K. Petrie, W. Rief · 2019 · Annual review of psychology · 277 citations

    Placebo effects constitute a major part of treatment success in medical interventions. The nocebo effect also has a major impact, as it accounts for a significant proportion of the reported side effects for many treatments. Historically, clinical trials have aimed to reduce placebo effects; however, currently, there is interest in optimizing placebo effects to improve existing treatments and in examining ways to minimize nocebo effects to improve clinical outcome. To achieve these aims, a better understanding of the psychological and neurobiological mechanisms of the placebo and nocebo response is required. This review discusses the impact of the placebo and nocebo response in health care. W

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  8. The Placebo Effect in Pain Therapies

    L. Colloca · 2018 · Annual review of pharmacology and toxicology · 237 citations

    Pharmacological strategies for pain management have primarily focused on dampening ascending neurotransmission and on opioid receptor-mediated therapies. Little is known about the contribution of endogenous descending modulatory systems to clinical pain outcomes and why some patients are mildly affected while others suffer debilitating pain-induced dysfunctions. Placebo effects that arise from patients’ positive expectancies and the underlying endogenous modulatory mechanisms may in part account for the variability in pain experience and severity, adherence to treatment, distinct coping strategies, and chronicity. Expectancy-induced analgesia and placebo effects in general have emerged as us

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  9. Patient Expectancy as a Mediator of Placebo Effects in Antidepressant Clinical Trials

    Bret R. Rutherford, M. Wall, Patrick J. Brown, et al. · 2016 · The American journal of psychiatry · 154 citations

    Objective Causes of placebo effects in antidepressant trials have been inferred from observational studies and meta-analyses, but their mechanisms have not been directly established. The goal of this study was to examine in a prospective, randomized controlled trial (RCT) whether patient expectancy mediates placebo effects in antidepressant studies. Method Adult outpatients with Major Depressive Disorder (MDD) were randomized to Open or Placebo-controlled citalopram treatment. Following measurement of pre- and post-randomization expectancy, subjects were treated with citalopram or placebo for 8 weeks. Independent samples t tests determined whether patient expectancy differed between the Open

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  11. Placebo-related effects in clinical trials in schizophrenia: what is driving this phenomenon and what can be done to minimize it?

    L. Alphs, F. Benedetti, W. Fleischhacker, et al. · 2012 · The International Journal of Neuropsychopharmacology · 84 citations

    The effect of placebo observed in schizophrenia clinical trials represents a growing problem that interferes with signal detection for treatments, increases costs of development, discourages investment in schizophrenia research and delays the introduction of new treatments. This paper seeks to clarify key issues related to this problem and identify potential solutions to them. Differences between placebo effect and response are characterized. Recent insights into the central nervous system mechanisms of placebo effect are described. This is followed by a description of protocol/study design and study conduct issues that are contributing to a growing placebo effect in clinical trials. Potenti

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  12. Introduction to placebo effects in medicine: mechanisms and clinical implications

    Karin Meißner, Niko Kohls, Luana Colloca · 2011 · Philosophical Transactions of the Royal Society B Biological Sciences · 84 citations

    The field of placebo research has made considerable progress in the last years and it has become a major focus of interest. We know now that the placebo effect is a real neurobiological phenomenon and that the brain's 'inner pharmacy' is a critical determinant for the occurrence of psychobiological and behavioural changes relevant to healing processes and well-being. However, harnessing the advantages of placebo effects in healthcare is still a challenge. The first part of the theme issue summarizes and discusses the various kinds of placebo mechanisms across medical fields, thereby not only focusing on two main explanatory models-expectation and conditioning theory-but also taking into acco

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  13. The Powerful Placebo Effect in Cough: Relevance to Treatment and Clinical Trials

    Ronald Eccles · 2019 · Lung · 71 citations

    Interest in the placebo effect of medicines has developed from the use of placebo treatments as controls in clinical trials into a whole new area of research around how placebos fit into a psychosocial model of therapeutics. The large placebo effect associated with cough medicines is both a problem and an opportunity for researchers: a problem for clinical trials on new actives as the active must beat the large placebo effect, and an opportunity for harnessing the placebo effect to produce effective cough medicines without any pharmacologically active ingredient. This review discusses the mechanisms associated with the placebo effect of cough medicines and distinguishes between a 'perceived

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  14. The therapeutic effect of clinical trials: understanding placebo response rates in clinical trials – A secondary analysis

    Harald Walach, Catarina Sadaghiani, Cornelia Dehm, et al. · 2005 · BMC Medical Research Methodology · 64 citations

    Background and purpose: Placebo response rates in clinical trials vary considerably and are observed frequently. For new drugs it can be difficult to prove effectiveness superior to placebo. It is unclear what contributes to improvement in the placebo groups. We wanted to clarify, what elements of clinical trials determine placebo variability. Methods: We analysed a representative sample of 141 published long-term trials (randomized, double-blind, placebo-controlled; duration > 12 weeks) to find out what study characteristics predict placebo response rates in various diseases. Correlational and regression analyses with study characteristics and placebo response rates were carried out. Result

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  15. Effect of Empagliflozin on Endothelial Function in Patients With Type 2 Diabetes and Cardiovascular Disease: Results from the Multicenter, Randomized, Placebo-Controlled, Double-Blind EMBLEM Trial

    Atsushi Tanaka, M. Shimabukuro, Noritaka Machii, et al. · 2019 · Diabetes Care · 56 citations

    Recent large trials on sodium–glucose cotransporter 2 (SGLT2) inhibitors showed that these agents improved cardiovascular outcomes in patients with type 2 diabetes (T2D) with a high risk of cardiovascular events (1). However, the underlying mechanisms of these clinical benefits and vascular effect of SGLT2 inhibitors in that patient group remain uncertain. Endothelial dysfunction is exacerbated by metabolic disorders, such as diabetes, and involved in the pathophysiology of diabetes-related cardiovascular complications (2,3). We therefore investigated whether empagliflozin added to standard therapy, compared with placebo, affected endothelial function in patients with T2D and established car

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  16. Placebo effect in clinical trials involving patients with allergic rhinitis.

    A del Cuvillo, Joaquin Sastre, Joan Bartra, et al. · 2011 · PubMed · 49 citations

    Interest in understanding the underlying mechanisms of the placebo effect has considerably grown during the last few decades. Studies made in this sense have led to a change in the conception of this peculiar phenomenon, and nowadays the placebo effect is viewed as a psychobiological event resulting from the interaction between individual patient factors and factors relating to the physician and the therapeutic environment. Investigation of the placebo effect in disease conditions such as pain or Parkinson's disease has improved our understanding of its underlying psychological and neurobiological mechanisms. Clinical studies directly designed to investigate the placebo effect have shown pla

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  18. Is the therapeutic effect of occlusal stabilization appliances more than just placebo effect in the management of painful temporomandibular disorders? A network meta-analysis of randomized clinical trials.

    A. S. Alkhutari, A. Alyahya, P. C. Rodrigues Conti, et al. · 2020 · The Journal of prosthetic dentistry · 46 citations

    STATEMENT OF PROBLEM Occlusal devices, particularly the stabilization appliances, have been commonly used as treatment for painful temporomandibular disorders (TMDs). However, the mechanisms of action of these devices are still unclear, including the role of the placebo effect in the pain management. PURPOSE The purpose of this network meta-analysis was to identify to what extent the degree of efficacy of stabilization appliances in the management of painful TMDs arises from the placebo effect only or whether it arises chiefly from an actual effect. MATERIAL AND METHODS An electronic search was undertaken to identify randomized clinical trials (RCTs) published up to April 2020, comparing

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  20. Different Placebos, Different Mechanisms, Different Outcomes: Lessons for Clinical Trials

    Fabrizio Benedetti, Sara Dogue · 2015 · PLoS ONE · 44 citations

    Clinical trials use placebos with the assumption that they are inert, thus all placebos are considered to be equal. Here we show that this assumption is wrong and that different placebo procedures are associated to different therapeutic rituals which, in turn, trigger different mechanisms and produce different therapeutic outcomes. We studied high altitude, or hypobaric hypoxia, headache, in which two different placebos were administered. The first was placebo oxygen inhaled through a mask, whereas the second was placebo aspirin swallowed with a pill. Both placebos were given after a conditioning procedure, whereby either real oxygen or real aspirin was administered for three consecutive ses

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  21. Placebo Effect and Clinical Trials in Migraine Therapy

    James R. Couch, Jr. · 1987 · Neuroepidemiology · 38 citations

    Migraine is a cyclical condition in which the cycles may occur or remit in an unpredictable fashion. The goal of prophylactic antimigraine therapy is to induce remission of an active cycle of migraine or to inhibit occurrence of individual headaches until the cycle remits for other reasons. The placebo effect probably takes advantage of these cycles. The placebo effect is significant and quite potent. The placebo effect may be divided into (1) the initial effect and (2) the continuing effect which is seen following a stabilization period. The initial placebo effect is dramatic with 62% of 188 subjects improving by 75% after 4 weeks of placebo. The continuing effect is demonstrated by occurre

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