[Placebo Effects in Analgesia : Influence of Expectations on the Efficacy and Tolerability of Analgesic Treatment]

Overview

Journal Schmerz

Date 2023 Jan 13

PMID 36637498

Authors

Angelika Kunkel

Ulrike Bingel

Affiliations

Soon will be listed here.

Abstract

Expectations of patients influence the perception and neuronal processing of acute and chronic pain and modulate the effectiveness of analgesic treatment. The expectation of treatment is not only the most important determinant of placebo analgesia. Expectations of treatment also influence the efficacy and tolerability of "active" pharmacological and non-pharmacological treatment of pain. Recent insights into the psychological and neurobiological mechanisms underlying the clinically relevant effects of treatment expectations enable and call for the systematic integration and modulation of treatment expectations into analgesic treatment concepts. Such a strategy promises to optimize analgesic treatment and to prevent or reduce the burden of unwanted side effects and the misuse of analgesics, particularly of opioids. This review highlights the current concepts, recent achievements and also challenges and key open research questions.

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References

Bakalos G, Zintzaras E . Drug Discontinuation in Studies Including a Switch From an Originator to a Biosimilar Monoclonal Antibody: A Systematic Literature Review. Clin Ther. 2018; 41(1):155-173.e13. DOI: 10.1016/j.clinthera.2018.11.002. View

Petrie K, Cameron L, Ellis C, Buick D, Weinman J . Changing illness perceptions after myocardial infarction: an early intervention randomized controlled trial. Psychosom Med. 2002; 64(4):580-6. DOI: 10.1097/00006842-200207000-00007. View

Lyby P, Forsberg J, Asli O, Flaten M . Induced fear reduces the effectiveness of a placebo intervention on pain. Pain. 2012; 153(5):1114-1121. DOI: 10.1016/j.pain.2012.02.042. View

Jensen K, Kaptchuk T, Kirsch I, Raicek J, Lindstrom K, Berna C . Nonconscious activation of placebo and nocebo pain responses. Proc Natl Acad Sci U S A. 2012; 109(39):15959-64. PMC: 3465419. DOI: 10.1073/pnas.1202056109. View

Moore R, Cai N, Skljarevski V, Tolle T . Duloxetine use in chronic painful conditions--individual patient data responder analysis. Eur J Pain. 2013; 18(1):67-75. PMC: 4302330. DOI: 10.1002/j.1532-2149.2013.00341.x. View

Stein N, Sprenger C, Scholz J, Wiech K, Bingel U . White matter integrity of the descending pain modulatory system is associated with interindividual differences in placebo analgesia. Pain. 2012; 153(11):2210-2217. DOI: 10.1016/j.pain.2012.07.010. View

Levine J, Gordon N . Influence of the method of drug administration on analgesic response. Nature. 1984; 312(5996):755-6. DOI: 10.1038/312755a0. View

Schmidt K, Berding T, Kleine-Borgmann J, Engler H, Holle-Lee D, Gaul C . The beneficial effect of positive treatment expectations on pharmacological migraine prophylaxis. Pain. 2021; 163(2):e319-e327. DOI: 10.1097/j.pain.0000000000002341. View

Colloca L, Miller F . Harnessing the placebo effect: the need for translational research. Philos Trans R Soc Lond B Biol Sci. 2011; 366(1572):1922-30. PMC: 3130404. DOI: 10.1098/rstb.2010.0399. View

10.

Klinger R . [The potential of the analgetic placebo effect - s3-guideline recommendation on the clinical use for acute and perioperative pain management]. Anasthesiol Intensivmed Notfallmed Schmerzther. 2010; 45(1):22-9. DOI: 10.1055/s-0029-1243374. View

11.

Tinnermann A, Geuter S, Sprenger C, Finsterbusch J, Buchel C . Interactions between brain and spinal cord mediate value effects in nocebo hyperalgesia. Science. 2017; 358(6359):105-108. DOI: 10.1126/science.aan1221. View

12.

Zunhammer M, Gerardi M, Bingel U . The effect of dopamine on conditioned placebo analgesia in healthy individuals: a double-blind randomized trial. Psychopharmacology (Berl). 2018; 235(9):2587-2595. DOI: 10.1007/s00213-018-4951-3. View

13.

Heisig S, Shedden-Mora M, Hidalgo P, Nestoriuc Y . Framing and personalizing informed consent to prevent negative expectations: An experimental pilot study. Health Psychol. 2015; 34(10):1033-1037. DOI: 10.1037/hea0000217. View

14.

Geuter S, Buchel C . Facilitation of pain in the human spinal cord by nocebo treatment. J Neurosci. 2013; 33(34):13784-90. PMC: 6618657. DOI: 10.1523/JNEUROSCI.2191-13.2013. View

15.

Krummenacher P, Candia V, Folkers G, Schedlowski M, Schonbachler G . Prefrontal cortex modulates placebo analgesia. Pain. 2009; 148(3):368-374. DOI: 10.1016/j.pain.2009.09.033. View

16.

Rief W, Shedden-Mora M, Laferton J, Auer C, Petrie K, Salzmann S . Preoperative optimization of patient expectations improves long-term outcome in heart surgery patients: results of the randomized controlled PSY-HEART trial. BMC Med. 2017; 15(1):4. PMC: 5223324. DOI: 10.1186/s12916-016-0767-3. View

17.

Hall K, Loscalzo J, Kaptchuk T . Genetics and the placebo effect: the placebome. Trends Mol Med. 2015; 21(5):285-94. PMC: 4573548. DOI: 10.1016/j.molmed.2015.02.009. View

18.

Baliki M, Petre B, Torbey S, Herrmann K, Huang L, Schnitzer T . Corticostriatal functional connectivity predicts transition to chronic back pain. Nat Neurosci. 2012; 15(8):1117-9. PMC: 3411898. DOI: 10.1038/nn.3153. View

19.

Benson S, Hagen S, Hoffmann O, Pasler A, Bingel U, Schedlowski M . Can a brief psychological expectancy intervention improve postoperative pain? A randomized, controlled trial in patients with breast cancer. Pain. 2019; 160(7):1562-1571. DOI: 10.1097/j.pain.0000000000001546. View

20.

Scott D, Stohler C, Egnatuk C, Wang H, Koeppe R, Zubieta J . Placebo and nocebo effects are defined by opposite opioid and dopaminergic responses. Arch Gen Psychiatry. 2008; 65(2):220-31. DOI: 10.1001/archgenpsychiatry.2007.34. View