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Wiener Klinische Wochenschrift May 2020The history of medicine and the history of placebo are closely intertwined. To understand placebo and its effects this article gives a brief overview about its history,... (Review)
Review
The history of medicine and the history of placebo are closely intertwined. To understand placebo and its effects this article gives a brief overview about its history, the possible mechanisms of action and its counterpart, nocebo.The Catholic Church used placebo around the sixteenth century for the separation from real and incorrect exorcisms, but it needed Henry Beecher during World War II to quantify the placebo effect as control arm in well-designed studies.Until today the different mechanisms of action of placebo remain poorly researched. Understanding them would allow its effect to be modulated to better serve in research and clinical settings. Expectation, psychosocial context and conditioning play a significant role in the effect size and amplitude.The counterpart, nocebo, is even less investigated, even it is commonly observed as adverse effects during medical treatments.Conclusion: Placebo and nocebo are both underestimated and underresearched in their value. Through further investigation doctors could strengthen the placebo response and prevent adverse effects to help their patients at low cost. These techniques would benefit the patient-doctor relationship, which is the alter of a trust-based successful therapy.
Topics: Drug-Related Side Effects and Adverse Reactions; Humans; Male; Nocebo Effect; Pain; Physician-Patient Relations; Placebo Effect
PubMed: 32211987
DOI: 10.1007/s00508-020-01626-9 -
Advances in Therapy Oct 2021This commentary provides the authors' point of view about the biopsychosocial perspective of placebo effect on musculoskeletal pain in the rehabilitation field.
This commentary provides the authors' point of view about the biopsychosocial perspective of placebo effect on musculoskeletal pain in the rehabilitation field.
Topics: Exercise Therapy; Humans; Musculoskeletal Pain; Placebo Effect
PubMed: 34476754
DOI: 10.1007/s12325-021-01894-5 -
Philosophical Transactions of the Royal... Jun 2011Meta-analyses and re-analyses of trial data have not been able to answer some of the essential questions that would allow prediction of placebo responses in clinical... (Review)
Review
Meta-analyses and re-analyses of trial data have not been able to answer some of the essential questions that would allow prediction of placebo responses in clinical trials. We will confront these questions with current empirical evidence. The most important question asks whether the placebo response rates in the drug arm and in the placebo arm are equal. This 'additive model' is a general assumption in almost all placebo-controlled drug trials but has rarely been tested. Secondly, we would like to address whether the placebo response is a function of the likelihood of receiving drug/placebo. Evidence suggests that the number of study arms in a trial may determine the size of the placebo and the drug response. Thirdly, we ask what the size of the placebo response is in 'comparator' studies with a direct comparison of a (novel) drug against another drug. Meta-analytic and experimental evidence suggests that comparator studies may produce higher placebo response rates when compared with placebo-controlled trials. Finally, we address the placebo response rate outside the laboratory and outside of trials in clinical routine. This question poses a serious challenge whether the drug response in trials can be taken as evidence of drug effects in clinical routine.
Topics: Bioethics; Clinical Trials as Topic; History, 20th Century; History, 21st Century; Humans; Placebo Effect; Publishing; Research Design
PubMed: 21576146
DOI: 10.1098/rstb.2010.0384 -
Progress in Neuro-psychopharmacology &... Dec 2018The placebo (and the nocebo) effect is a powerful determinant of health outcomes in clinical disease treatment and management. Efforts to completely eradicate placebo... (Review)
Review
The placebo (and the nocebo) effect is a powerful determinant of health outcomes in clinical disease treatment and management. Efforts to completely eradicate placebo effects have shifted dynamically, as increasingly more researchers are tuned to the potentially beneficial effects of incorporating those uncontrollable placebo effects into clinical therapeutic strategies. In this review, we highlight the major findings from placebo research, elucidating the main neurobiological systems and candidate determinants of the placebo phenomenon, and illustrate a perspective that can effectively frame future research on the topic. Finally, we issue a call for increased research on the efficacy of therapeutic strategies that incorporate placebo "tools," and argue that clinical trials of the placebo response in neuropsychiatric diseases and disorders has important and far-reaching translational and clinical relevance.
Topics: Humans; Mental Disorders; Pain; Pain Management; Placebo Effect
PubMed: 28595945
DOI: 10.1016/j.pnpbp.2017.06.003 -
Chinese Medical Journal Jul 2018Placebo was defined as any therapy that is used for its nonspecific psychological and physiologic effect but has no specific pharmacologic impact on the condition being... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Placebo was defined as any therapy that is used for its nonspecific psychological and physiologic effect but has no specific pharmacologic impact on the condition being treated. Besides medication therapies, studies have found that the optimal dietary approach as well as physical activity and education are useful to control hyperglycemia in patients with type 2 diabetes (T2DM). The aim of this study was to evaluate the placebo effects of antidiabetic therapies in Asian and Caucasian T2DM patients and make a comparison between the two ethnicities.
METHODS
A search using the MEDLINE database, EMBASE, and Cochrane Database was performed, from when recording began until December 2016. The main concepts searched in English were sulfonylurea (SU); alpha glucosidase inhibitors (AGI); metformin (MET); thiazolidinediones (TZD); dipeptidyl peptidase-4 inhibitors (DPP-4i); sodium-glucose cotransporter 2 inhibitors (SGLT2i); glucagon-like peptide-1 receptor agonist (GLP-1RA); type 2 diabetes (T2DM); placebo controlled; and randomized controlled trials. Using the Cochrane instrument, we evaluated the adequacy of randomization, allocation concealment procedures, and blinding.
RESULTS
This study included 63 studies with a total of 7096 Asian patients involved and 262 studies with a total of 27,477 Caucasian patients involved. In Caucasian population, the use of placebo led to significant reductions of glycosylated hemoglobin (HbA1c), -0.683% (P = 0.008) in SU monotherapy treatment, -0.193% (P = 0.001) in DPP-4i treatment, and -0.230% (P < 0.001) in SGLT2i treatment, respectively. In Asian population, the use of placebo resulted in significant decreases of HbA1c, -0.162% (P = 0.012) in DPP-4i treatment and -0.269% (P = 0.028) in GLP-1RA add-on therapy, respectively. The placebo also significantly reduced body weight. In Caucasian population, placebo use resulted in 0.833 kg (P = 0.006) weight loss by SU treatment and 0.953 kg (P = 0.006) weight loss by GLP-1RA treatment. In Asian population, the placebo led to a weight change of 0.612 kg (P < 0.001) by GLP-1RA analog treatment. The changes of HbA1c and weight due to the placebo effect in other treatments were not significant in both Asian and Caucasian population. Comparisons of the placebo effect on HbA1c change and weight change in each treatment group indicated that no significant difference was found between Asian and Caucasian population.
CONCLUSIONS
The overall differences of the placebo effect on HbA1c changes as well as on body weight changes were not significant between Asian and Caucasian T2DM patients. The placebo effect on HbA1c changes and weight changes was not associated with baseline age, gender, baseline body mass index, baseline HbA1c, duration of diabetes, or study duration.
Topics: Blood Glucose; Diabetes Mellitus, Type 2; Dipeptidyl-Peptidase IV Inhibitors; Glycated Hemoglobin; Humans; Hypoglycemic Agents; Male; Placebo Effect; Treatment Outcome
PubMed: 29941715
DOI: 10.4103/0366-6999.235107 -
Arquivos de Neuro-psiquiatria Jan 2015Knowledge of placebo and nocebo effects is essential to identify their influence on the results in clinical practice and clinical trials, and thereby properly interpret... (Review)
Review
Knowledge of placebo and nocebo effects is essential to identify their influence on the results in clinical practice and clinical trials, and thereby properly interpret their results. It is known that the gold standard of clinical trials research is the double-blind, placebo-controlled, randomized clinical study. The objective of this review is to distinguish specific from non-specific effects, so that the presence of positive effects in the group that received placebo (placebo effect) and the presence of adverse effects in the group receiving placebo (nocebo effect) lead to confounding in interpreting the results. Placebo and nocebo effects have been considered in neurological diseases such as depression, pain, headache, multiple sclerosis, epilepsy. As placebo and nocebo effects are also present in clinical practice, the purpose of this review is to draw attention to their influence on neurological practice, calling attention to the development of measures that can minimize them.
Topics: Headache; Humans; Neuralgia; Neurology; Nocebo Effect; Placebo Effect; Randomized Controlled Trials as Topic
PubMed: 25608129
DOI: 10.1590/0004-282X20140180 -
Revista Da Associacao Medica Brasileira... 2024
Topics: Homeopathy; Humans; Placebo Effect; Evidence-Based Medicine
PubMed: 38716949
DOI: 10.1590/1806-9282.20231438 -
International Review of Neurobiology 2018
Topics: Animals; History, 19th Century; Humans; Neurobiology; Placebo Effect; Placebos; Translational Research, Biomedical
PubMed: 30146061
DOI: 10.1016/S0074-7742(18)30087-4 -
Trends in Cognitive Sciences Nov 2021Pain is a fundamental experience that promotes survival. In humans, pain stands at the intersection of multiple health crises: chronic pain, the opioid epidemic, and... (Review)
Review
Pain is a fundamental experience that promotes survival. In humans, pain stands at the intersection of multiple health crises: chronic pain, the opioid epidemic, and health disparities. The study of placebo analgesia highlights how social, cognitive, and affective processes can directly shape pain, and identifies potential paths for mitigating these crises. This review examines recent progress in the study of placebo analgesia through affective science. It focuses on how placebo effects are shaped by expectations, affect, and the social context surrounding treatment, and discusses neurobiological mechanisms of placebo, highlighting unanswered questions and implications for health. Collaborations between clinicians and social and affective scientists can address outstanding questions and leverage placebo to reduce pain and improve human health.
Topics: Analgesia; Cognitive Neuroscience; Humans; Pain; Pain Management; Placebo Effect
PubMed: 34538720
DOI: 10.1016/j.tics.2021.07.016 -
Experimental Dermatology Jan 2017The role of placebo and nocebo effects-that is positive or negative treatment effects that are entirely a consequence of the patient's expectations and beliefs about a...
The role of placebo and nocebo effects-that is positive or negative treatment effects that are entirely a consequence of the patient's expectations and beliefs about a treatment outcome in terms of efficacy, safety, usability or side effects-has been shown for almost all types of diseases and physiological response systems. Evidence for the relevance of placebo and nocebo effects in dermatology is also increasing, particularly for symptoms of itch and learned (conditioned) immune function. In addition, increasing knowledge is available about the neurobiological mechanisms of action, such as the role of the dopaminergic system. Studies on this topic offer innovative perspectives to unravel the multifactorial pathways of treatment effects and to use research designs for experimental research that provide full insight into the role of placebo and nocebo effects. Moreover, intervention strategies can be developed for dermatology practice that optimize regular treatments with innovative non-pharmacological treatment strategies (e.g. optimized doctor-patient communication and treatment adherence, or prevention of nocebo reactions with regard to adverse side effects). In addition, evidence on learned immune function offers new pathways to optimize pharmacological treatments (e.g. dosage adjustments and conditioning of physiological responses), the ultimate goal being to prevent individual treatment failures and maximize regular treatment effects.
Topics: Anticipation, Psychological; Communication; Dermatology; Drug-Related Side Effects and Adverse Reactions; Humans; Nocebo Effect; Placebo Effect; Skin Diseases; Suggestion; Treatment Outcome
PubMed: 27489170
DOI: 10.1111/exd.13158