The placebo response in medicine: minimize, maximize or personalize?

@article{Enck2013ThePR,
  title={The placebo response in medicine: minimize, maximize or personalize?},
  author={Paul Enck and Ulrike Bingel and Manfred Schedlowski and Winfried Rief},
  journal={Nature Reviews Drug Discovery},
  year={2013},
  volume={12},
  pages={191-204}
}
  • P. Enck, U. Bingel, W. Rief
  • Published 1 March 2013
  • Psychology, Medicine, Biology
  • Nature Reviews Drug Discovery
Our understanding of the mechanisms mediating or moderating the placebo response to medicines has grown substantially over the past decade and offers the opportunity to capitalize on its benefits in future drug development as well as in clinical practice. In this article, we discuss three strategies that could be used to modulate the placebo response, depending on which stage of the drug development process they are applied. In clinical trials the placebo effect should be minimized to optimize… 
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491 Citations
Highly Influential Citations
23
Background Citations
188
Methods Citations
19
Results Citations
10

491 Citations

Lessons to be learned from placebo arms in psychopharmacology trials.
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This chapter discusses explanations for the increasing placebo effect, and highlights the contribution of spontaneous remission to the improvement in placebo groups, but focuses particularly on the role of patient and clinician expectations.
Why we need more research into the placebo response in psychiatry
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More research is needed into the placebo response in psychiatric medicine for three broad reasons: awareness of factors that cause placebo response, for whom, and when, within clinical trials will allow for better evidence efficacy of new treatments, and exploring the biological mechanisms of placebo effects might reveal tractable targets for novel treatment development.
Placebos and the Placebo Effect in Drug Trials.
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It should be the goal of all therapeutic trials to minimize the placebo effect in clinical trials, while utilizing and maximizing it in clinical routine.
Placebo response in clinical trials: Taming the human brain
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It is important to take a two-pronged approach- first, placebo as a treatment, for example, in neurological diseases, and second, adequately designed studies that minimize the placebo response.
Analysis of the placebo response to the therapeutic environment
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If placebo responses seen in humans are the result of phenotypic plasticity, then placebo-like effects should be observable in other species—particularly in cases where the environment has been altered to disrupt its reliability.
Placebo 2.0: the impact of expectations on analgesic treatment outcome.
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The key role of negative expectations in pain perception is corroborated by experimental nocebo studies, indicating that the mere expectation of more intense or more frequent pain can modulate pain sensitivity at the behavioural and neural level.
Pain, placebo, and test of treatment efficacy: a narrative review.
Placebo effects in health and disease : how expectations shape treatment outcomes
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The notion that patients with ID are influenced by contextual factors in clinical trials in spite of severe cognitive deficits is validated, as the effect of the real drug in open-label context was associated with better treatment outcomes than the same drug in a placebo-controlled context.
Increasing uncertainty in CNS clinical trials: the role of placebo, nocebo, and Hawthorne effects
Reevaluating the placebo effect in medical practice.
TLDR
This research has partially elucidated the role of how patients' expectations and the quality of physician-patient communication can influence the efficacy of interventions and overall clinical outcomes.
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