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Revue Medicale Suisse Sep 2023The placebo effect is one of the mechanisms at work in the success of comprehensive care. It relies on psychological, biological and environmental mechanisms. If its...
The placebo effect is one of the mechanisms at work in the success of comprehensive care. It relies on psychological, biological and environmental mechanisms. If its effectiveness has been documented, it should be noted that its power of effect remains weak and that it depends on the context. Although real, the placebo effect is remembered to be associated with manipulation concerning the success of a treatment, we pose as an ethical defender of its use. This article aims to recall the psychobiological mechanisms at work and to replace the placebo effect in clinical practice.
Topics: Humans; Neurosciences; Placebo Effect
PubMed: 37671762
DOI: 10.53738/REVMED.2023.19.840.1614 -
Journal of Psychosocial Nursing and... May 2008The concept of a placebo-what it is, what it does, and how it works-is very complex. In this article, I discuss some important aspects of the placebo effect on the basis... (Review)
Review
The concept of a placebo-what it is, what it does, and how it works-is very complex. In this article, I discuss some important aspects of the placebo effect on the basis of clinical research studies in pharmacology. The prevalence and magnitude of a placebo effect depend on how the clinical-placebo effect is measured, the characteristics of the condition being studied, and the experimental or clinical context in which the placebo is administered. Although the placebo effect is real, placebos are unlikely to work as effectively in real-world settings. Next month's article will describe important findings about the psychological and neurobiological processes that underlie the placebo effect.
Topics: Double-Blind Method; Humans; Mental Disorders; Placebo Effect; Randomized Controlled Trials as Topic
PubMed: 18548866
DOI: 10.3928/02793695-20080501-06 -
Psychotherapy and Psychosomatics 2018Placebo and nocebo effects occur in clinical or laboratory medical contexts after administration of an inert treatment or as part of active treatments and are due to...
BACKGROUND
Placebo and nocebo effects occur in clinical or laboratory medical contexts after administration of an inert treatment or as part of active treatments and are due to psychobiological mechanisms such as expectancies of the patient. Placebo and nocebo studies have evolved from predominantly methodological research into a far-reaching interdisciplinary field that is unravelling the neurobiological, behavioural and clinical underpinnings of these phenomena in a broad variety of medical conditions. As a consequence, there is an increasing demand from health professionals to develop expert recommendations about evidence-based and ethical use of placebo and nocebo effects for clinical practice.
METHODS
A survey and interdisciplinary expert meeting by invitation was organized as part of the 1st Society for Interdisciplinary Placebo Studies (SIPS) conference in 2017. Twenty-nine internationally recognized placebo researchers participated.
RESULTS
There was consensus that maximizing placebo effects and minimizing nocebo effects should lead to better treatment outcomes with fewer side effects. Experts particularly agreed on the importance of informing patients about placebo and nocebo effects and training health professionals in patient-clinician communication to maximize placebo and minimize nocebo effects.
CONCLUSIONS
The current paper forms a first step towards developing evidence-based and ethical recommendations about the implications of placebo and nocebo research for medical practice, based on the current state of evidence and the consensus of experts. Future research might focus on how to implement these recommendations, including how to optimize conditions for educating patients about placebo and nocebo effects and providing training for the implementation in clinical practice.
Topics: Consensus; Drug-Related Side Effects and Adverse Reactions; Evidence-Based Practice; Humans; Nocebo Effect; Physician-Patient Relations; Placebo Effect
PubMed: 29895014
DOI: 10.1159/000490354 -
Naunyn-Schmiedeberg's Archives of... Nov 2022Our aims were to provide updated information on placebo/nocebo effect and the potential use of placebo in clinical practice. This article can only provide a rough... (Review)
Review
Our aims were to provide updated information on placebo/nocebo effect and the potential use of placebo in clinical practice. This article can only provide a rough overview on the placebo and nocebo effect and is intended to serve as a starting point for the reader to go deeper into the corresponding literature. The placebo effect has been observed in multiple medical conditions, after oral administration, with manual therapies as well as with surgery and invasive procedures. The use of placebo in clinical trials is fundamental, although the ethics of its use is under discussion. The placebo may behave like a drug from the pharmacokinetic and pharmacodynamic point of view and can also be associated with adverse events (nocebo effect). Placebo can modify treatment by increasing or decreasing the effects of drugs. The factors associated with the occurrence of placebo effect are multiple, but in addition to those that depend on the placebo itself, the doctor-patient relationship would be the most important. As a result of findings that were published in the last two decades, the psycho-neurobiological basis of placebo is becoming better understood, although further studies are needed. In conclusion, the placebo effect in the clinic exhibits weak to moderate intensity. Placebo, in addition to its use in the clinical trial, should be considered another therapeutic remedy either as stand alone or in association with treatment, and could be useful in certain circumstances. The use of placebo should be regulated by the European health authorities through a guide in clinical practice that will improve patient care.
Topics: Humans; Nocebo Effect; Physician-Patient Relations; Placebo Effect
PubMed: 35943515
DOI: 10.1007/s00210-022-02280-w -
Internal Medicine Journal Apr 2014Placebo and nocebo effects are often regarded by clinicians as either a quaint reminiscence from the pre-therapeutic era, or simply as a technique for establishing the... (Review)
Review
Placebo and nocebo effects are often regarded by clinicians as either a quaint reminiscence from the pre-therapeutic era, or simply as a technique for establishing the efficacy of therapeutic interventions within the locus of evidence-based practice. However, neither of these explanations sufficiently account for their complexity or their persistence and impact in clinical medicine. Placebo and nocebo effects are embedded in the very fabric of therapeutic relationships and are both a manifestation and outcome of the rituals that characterise clinical practice. They are also a stark reminder of the many personal and environmental factors, including the attitudes, beliefs and expectations of both doctor and patient, that shape the outcomes of health professional-patient interactions. We describe how recent biological and neuropsychiatric data have clarified the operation of placebo and nocebo effects in clinical practice - demonstrating the ability of the therapeutic context to modulate endogenous biological processes in a targeted manner. This, in turn, illustrates the potent philosophical and sociocultural aspects of medical praxis.
Topics: Evidence-Based Medicine; Humans; Nocebo Effect; Placebo Effect; Randomized Controlled Trials as Topic
PubMed: 24754688
DOI: 10.1111/imj.12380 -
Perspectives in Biology and Medicine 2018What is known as the "placebo effect" has received increasing attention in recent years in scientific investigation and the news media. The concept of the placebo...
What is known as the "placebo effect" has received increasing attention in recent years in scientific investigation and the news media. The concept of the placebo effect, however, is subject to confusion and misleading implications, especially when applied broadly. This essay argues that it is desirable to confine the concept, as applied to biomedicine, to the therapeutic effects of deliberate placebo interventions. The author examines in detail the conceptual problems in characterizing the therapeutic benefits that flow from communication in the clinician-patient relationship as placebo effects.
Topics: Communication; Humans; Physician-Patient Relations; Placebo Effect; Treatment Outcome
PubMed: 30293972
DOI: 10.1353/pbm.2018.0046 -
European Journal of Sport Science Apr 2020The aim of this review was to determine the magnitude of the placebo and nocebo effect on sport performance. Articles published before March 2019 were located using...
The aim of this review was to determine the magnitude of the placebo and nocebo effect on sport performance. Articles published before March 2019 were located using Medline, Web of Science, PubMed, EBSCO, Science Direct, and Scopus. Studies that examined placebo and nocebo effects of an objective dependent variable on sports performance, which included a control or baseline condition, were included in the analysis. Studies were classified into two categories of ergogenic aids: (1) nutritional and (2) mechanical. Cohen's effect sizes were calculated from 32 studies involving 1513 participants. Small to moderate placebo effects were found for both placebo ( = 0.36) and nocebo ( = 0.37) effects and when separated by nutritional ( = 0.35) and mechanical ( = 0.47) ergogenic aids. The pooled effect size revealed a small to moderate effect size across all studies ( = 0.38). Results suggest that placebo and nocebo effects can exert a small to moderate effect on sports performance.
Topics: Athletic Performance; Dietary Supplements; Humans; Nocebo Effect; Performance-Enhancing Substances; Placebo Effect; Transcutaneous Electric Nerve Stimulation
PubMed: 31414966
DOI: 10.1080/17461391.2019.1655098 -
JAMA Apr 2017
Topics: History, 20th Century; Humans; Placebo Effect; Psychotherapy
PubMed: 28444266
DOI: 10.1001/jama.2017.0645 -
Alimentary Pharmacology & Therapeutics Jun 2017
Topics: Crohn Disease; Double-Blind Method; Humans; Placebo Effect; Remission Induction
PubMed: 28474828
DOI: 10.1111/apt.14036 -
Annual Review of Pharmacology and... Jan 2024Adverse nocebo responses can cause harm to patients and interfere with treatment adherence and effects in both clinic practice and clinical trials. Nocebo responses... (Review)
Review
Adverse nocebo responses can cause harm to patients and interfere with treatment adherence and effects in both clinic practice and clinical trials. Nocebo responses refer to negative outcomes to active medical treatments in clinical trials or practice that cannot be explained by the treatment's pharmacologic effects. Negative expectancies and nocebo effects are less known than placebo responses. Nocebo effects can be triggered by verbal suggestions, prior negative experiences, observation of others experiencing negative outcomes, and other contextual and environmental factors. As research advances over the years, mechanistic knowledge is accumulating on the neurobiological mechanisms of nocebo effects. This review summarizes studies on different facets of nocebo effects and responses and discusses clinical implications, ethical considerations, and future directions.
Topics: Humans; Nocebo Effect; Placebo Effect
PubMed: 37585661
DOI: 10.1146/annurev-pharmtox-022723-112425