The Placebo Response in the Treatment of Chronic Fatigue Syndrome: A Systematic Review and Meta-Analysis

  title={The Placebo Response in the Treatment of Chronic Fatigue Syndrome: A Systematic Review and Meta-Analysis},
  author={Hyong Jin Cho and Matthew Hotopf and Simon Wessely},
  journal={Psychosomatic Medicine},
Objective: The placebo response is conventionally asserted to be high in chronic fatigue syndrome (CFS) because of the latter’s subjective nature and obscure pathogenesis, but no systematic review of placebo responses has been undertaken. We report such a study. Patient expectation is known to be important in the placebo response. It is also known that CFS patients attending specialist clinics often have strong physical attributions regarding causation and hence skepticism about psychological… 

Placebo response in trials of drug treatments for cancer-related fatigue: a systematic review, meta-analysis and meta-regression

There is some evidence, based on trials with small samples, that the PR in trials testing drugs for CRF is non-trivial in size and statistically significant.

Identifying placebo responders and predictors of response in osteoarthritis: a protocol for individual patient data meta-analysis

The results of this study may be useful for pharmaceutical companies, who could improve the design of their studies in order to separate the specific treatment from the non-specific contextual (i.e. placebo) effects.

Cognitive behaviour therapy for chronic fatigue syndrome in adults.

CBT is effective in reducing the symptoms of fatigue at post-treatment compared with usual care, and may be more effective in reduced fatigue symptoms compared with other psychological therapies, according to a review of 15 randomised controlled trials.

Placebo Responses and Placebo Effects in Functional Gastrointestinal Disorders

It is concluded that, contrary to common belief and discussion, the placebo effect seen in RCT in FGD is not specifically high and extraordinary as compared to other comparable disorders, and very few predictors have yet been identified that determine its effect size.

Listening to placebo in clinical trials for female sexual dysfunction.

  • A. Bradford
  • Psychology, Medicine
    The journal of sexual medicine
  • 2013
P Procedural and methodological factors are likely to contribute to placebo response in trials for FSD, though additional research is needed to clarify these effects.

Clinical methodology and its implications for the study of therapeutic interventions for chronic fatigue syndrome: a commentary.

The role of clinical methodology in the study of the therapeutics of CFS is not trivial, and may confound the understanding of pragmatic recommendations for treatment.

The placebo effect and its determinants in osteoarthritis: meta-analysis of randomised controlled trials

The placebo effect is effective in the treatment of OA, especially for pain, stiffness and self-reported function, and the size of this effect is influenced by the strength of the active treatment, the baseline disease severity, the route of delivery and the sample size of the study.

Placebo response in pain, fatigue, and performance: Possible implications for neuromuscular disorders

The factors that contribute to improved outcomes in the placebo arm, with specific attention to pain and fatigue, are described, as well as some of the most important psychobiological mechanisms that may explain such a response.



A randomised, controlled, triple-blind trial of the efficacy of homeopathic treatment for chronic fatigue syndrome.

Interventions for the treatment and management of chronic fatigue syndrome: a systematic review.

To assess the effectiveness of all interventions that have been evaluated for use in the treatment or management of CFS in adults or children, 350 studies initially identified demonstrated mixed results in terms of effectiveness.

Placebo response in studies of major depression: variable, substantial, and growing.

The response to placebo in published trials of antidepressant medication for MDD is highly variable and often substantial and has increased significantly in recent years, as has the response to medication.

The treatment of chronic fatigue syndrome: science and speculation.

A preliminary placebo-controlled crossover trial of fludrocortisone for chronic fatigue syndrome.

Low-dose fludrocortisone does not provide sufficient benefit to be evident in a preliminary blinded trial of unselected patients with chronic fatigue syndrome, and evidence of marked functional impairments is found.

Randomized, double blind, controlled placebo-phase in trial of low dose phenelzine in the chronic fatigue syndrome

The data support the hypothesis of reduced sympathetic drive, although an alternative hypothesis of pain alleviation is also possible, and no evidence for this was found, suggesting that CFS is not an illness due to patients' being overly suggestible.

Placebos, Placebo Effect, and the Response to the Healing Situation: The Evolution of a Concept

This work presents the historical changes of the concept of placebo and the ethical issues raised by their use, and suggests that progress in this area may promote useful clinical applications, enabling physicians to broaden their perspectives on the healing process.

A randomized, double-blind placebo-controlled trial of moclobemide in patients with chronic fatigue syndrome.

Moclobemide produces some improvement in key symptoms experienced by patients with chronic fatigue syndrome, not dependent on the presence of concurrent psychological distress and likely to be shared with other monoamine oxidase inhibitors.