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Neuropsychopharmacotherapy: Aspects of Placebo Effects

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NeuroPsychopharmacotherapy

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Abstract

Clinical and experimental examples of placebo effects are presented. Placebo effects including spontaneous remission are also part of response to active treatment. Placebo effects result from complex interactions between accompanying information about positive and negative (= nocebo) drug effects, characteristics of the experimenter or physician, and experimental setting. They can be observed in any kind of psychiatric and somatic diseases or symptoms, as well as in affective, behavioral, and somatic functions of the individual and may vary with methods of assessment across time. Affective variables (anxiety/depression) or pain-related diseases are most and laboratory parameters of body fluids are least susceptible to placebo/nocebo effects. Personality traits, in particular suggestibility and drug experiences, are most important modifiers of placebo/nocebo responses. None of the personal attributes, including gender and age, can be identified as predictors of a general placebo responder. Major underlying mechanisms, induction of expectations and conditioning, operate additively on conscious processes (perception and motor processes) whilew unconscious responses (hormone or immunological responses), are merely mediated by conditioning. Major biological mediators of placebo as well as nocebo responses detected by neuroimaging techniques, positron emission tomography, and receptor antagonists are release of opioids and dopamine in pain and reward-related brain circuits or inhibition of these transmitters as nocebo responses indicating that relief from negative and induction of positive effects or vice versa also determine the magnitude of responses. Aspects of placebo and nocebo effects in clinical practice and consequences of obtaining informed consent are discussed.

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Authors and Affiliations

  1. Department of Psychology, University of Giessen, Giessen, Germany

    Petra Netter

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  1. Petra Netter
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Correspondence to Petra Netter .

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Editors and Affiliations

  1. Clinic and Policlinic for Psychiatry, Psychosomatics and Psychotherapy, University Hospital Wuerzburg, Wuerzburg, Germany

    Peter Riederer

  2. Institute of Psychological Medicine (IPM), Soyen, Germany

    Gerd Laux

  3. Centre for Research Promotion and Support, Fujita Health University, Toyoake, Aichi, Japan

    Toshiharu Nagatsu

  4. Center Translational Res Neurol Diseases, Dalian Med Uni Shanghai Inst Health Sc Center Translational Res Neurol Diseases, Dalian, China

    Weidong Le

  5. Würzburg, Germany

    Christian Riederer

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  1. Clinic and Policlinic for Psychiatry, Psychosomatics and Psychotherapy, Univsersity of Hospital Würzburg, Würzburg, Germany

    Peter Riederer

  2. Department of Psychiatry, University of South Denmark, Odense, Denmark

    Peter Riederer

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Netter, P. (2022). Neuropsychopharmacotherapy: Aspects of Placebo Effects. In: Riederer, P., Laux, G., Nagatsu, T., Le, W., Riederer, C. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-030-62059-2_441

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  • DOI: https://doi.org/10.1007/978-3-030-62059-2_441

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