Implications of placebos and nocebos in clinical research

Journal title PNEI REVIEW
Author/s Luana Colloca, Nathaniel Haycock
Publishing Year 2018 Issue 2018/1 Language English
Pages 16 P. 112-127 File size 1116 KB
DOI 10.3280/PNEI2018-001009
DOI is like a bar code for intellectual property: to have more infomation click here

Below, you can see the article first page

If you want to buy this article in PDF format, you can do it, following the instructions to buy download credits

Article preview

FrancoAngeli is member of Publishers International Linking Association, Inc (PILA), a not-for-profit association which run the CrossRef service enabling links to and from online scholarly content.

While studies on physiological bases of placebo and nocebo effects have contributed to elucidating their underlying mechanisms, little progress has been made in translating placebo and nocebo knowledge into improved clinical research. Here the Authors discuss the importance of considering specific mechanisms of placebo and nocebo effects to improve clinical research and outcomes. In order to apply this knowledge to clinical research, it must be coupled with a person-level assessment of patients’ expectations, understanding of genetic variations among patients, and consideration of both framing effects and treatment history. The Authors suggest some elements for how, when, and why to apply knowledge of placebo and nocebo effects to clinical research.

Keywords: Expectations, clinical trial designs, Placebo responders, Placebo non-responders, Phenotypes, Framing effects.

  1. Amanzio M. and Benedetti F. (1999). Neuropharmacological dissection of placebo analgesia: expectation-activated opioid systems versus conditioning-activated specifi c subsystems. J. Neurosci., 19(1): 484-494.
  2. André-Obadia N., Magnin M. and Garcia-Larrea L. (2011). On the importance of placebo timing in rTMS studies for pain relief. Pain, 152(6): 1233-1237.
  3. Apkarian A.V., Bushnell M.C., Treede R.D., Zubieta J.K. (2005). Human brain mechanisms of pain perception and regulation in health and disease. Eur. J. Pain, 9(4): 463-463.
  4. Arias A.J., Gelernter J., Gueorguieva R., Ralevski E. and Petrakis I.L. (2014). Pharmacogenetics of naltrexone and disulfi ram in alcohol dependent, dually diagnosed veterans. Am. J. Addict., 23(3): 288-293.
  5. Atlas L.Y. and Wager T.D. (2014). A Meta-analysis of Brain Mechanisms of Placebo Analgesia: Consistent Findings and Unanswered Questions. In: Benedetti F., Enck P., Frisaldi E. and Schedlowski M., editors, Placebo. Heidelberg: Springer Berlin.
  6. Atlas L.Y., Whittington R.A., Lindquist M.A., Wielgosz J., Sonty N. and Wager T.D. (2012). Dissociable infl uences of opiates and expectations on pain. J. Neurosci., 32(23): 8053-8064. DOI: 10.1523/JNEUROSCI.0383-12.201
  7. Auer C.J., Glombiewski J.A., Doering B.K., Winkler A., Laferton J.A., Broadbent E. and Rief W. (2016). Patients’ Expectations Predict Surgery Outcomes: A Meta-Analysis. Int. J. Behav. Med., 23(1): 49-62.
  8. Barefoot J.C., Brummett B.H., Williams R.B., Siegler I.C, Helms M.J., Boyle S.H., Clapp-Channing N.E. and Mark D.B. (2011). Recovery expectations and long-term prognosis of patients with coronary heart disease. Arch. Intern. Med., 171(10): 929-935.
  9. Benedetti F. (2008). Mechanisms of placebo and placebo-related effects across diseases and treatments. Annu. Rev. Pharmacol. Toxicol., 48: 33-60.
  10. Benedetti F., Amanzio M. and Maggi G. (1995). Potentiation of placebo analgesia by proglumide. Lancet, 346(8984): 1231. DOI: 10.1016/S0140-6736(95)92938-
  11. Benedetti F., Amanzio M., Vighetti S. and Asteggiano G. (2006a). The biochemical and neuroendocrine bases of the hyperalgesic nocebo effect. J. Neurosci., 26(46): 12014-12022. DOI: 10.1523/JNEUROSCI.2947-06.200
  12. Benedetti F., Arduino C., Costa S., Vighetti S., Tarenzi L., Rainero I. and Asteggiano G. (2006b). Loss of expectation-related mechanisms in Alzheimer’s disease makes analgesic therapies less effective. Pain, 121(1-2): 133-144.
  13. Benedetti F., Amanzio M., Rosato R. and Blanchard C. (2011). Nonopioid placebo analgesia is mediated by CB1 cannabinoid receptors. Nat. Med., 17(10): 1228-1230.
  14. Bingel U., Wanigasekera V., Wiech K., Ni Mhuircheartaigh R., Lee M.C., Ploner M. and Tracey I. (2011). The effect of treatment expectation on drug effi cacy: imaging the analgesic benefi t of the opioid remifentanil. Sci. Transl. Med., 3(70): 70ra14.
  15. Blasini M., Corsi N., Klinger R. and Colloca L. (2017). Nocebo and pain: An overview of the psychoneurobiological mechanisms. Pain Rep., 2(2): e585. DOI: 10.1097/PR9.000000000000058

Luana Colloca, Nathaniel Haycock, Implications of placebos and nocebos in clinical research in "PNEI REVIEW" 1/2018, pp 112-127, DOI: 10.3280/PNEI2018-001009