Placebos and Nocebos in Headaches

  • Dimos D. Mitsikostas
  • Fabrizio Benedetti

Part of the Headache book series (HEAD)

Table of contents

  1. Front Matter
    Pages i-ix
  2. Christian Lampl, Elisabeth Bräutigam
    Pages 1-11
  3. Andrea Negro, Paolo Martelletti
    Pages 13-25
  4. Alexandre F. M. DaSilva, Marcos Fabio DosSantos
    Pages 27-41
  5. Elisa Carlino, Lene Vase, Alessandro Piedimonte
    Pages 43-55
  6. Diletta Barbiani, Eleonora Camerone, Fabrizio Benedetti
    Pages 57-63
  7. Jakob Møller Hansen, Messoud Ashina
    Pages 65-74
  8. Christina Deligianni, Dimos D. Mitsikostas
    Pages 75-84
  9. Vanda Faria, David Borsook
    Pages 85-101
  10. Panagiotis Zis
    Pages 103-112
  11. Luana Colloca, Nathaniel Haycock
    Pages 113-124

About this book


This book discusses the role of placebos and nocebos in the treatment of headache disorders. These disorders are usually treatable, but safety and tolerability issues mean that available preventive treatments have often limited success, even in the right hands – one in five patients treated with a migraine preventive pharmaceutical agent discontinues treatment for those reasons. The nocebo effect plays a role here, with patients’ negative expectation and previous unpleasant treatment experiences creating negative belief in the treatment’s benefits and safety, which in turn limits treatment outcomes and adherence significantly. In RCTs on migraine prevention, one in 20 patients treated with a placebo discontinued treatment because of adverse events, indicating a considerable nocebo effect; the fewer potential adverse events described in the consent form, the smaller the nocebo effect. As such, physicians treating headache sufferers should acknowledge nocebo as a significant cofactor for treatment adherence and failure, and plan techniques to limit the effects, such as patient education and close follow-up. This highly informative and painstakingly presented book provides scientific insights for professionals and scholars with an interest in internal medicine, neurology and pain medicine.



migraine adherence complience treatment positive expectation for treatment negative expectation for treatment

Editors and affiliations

  • Dimos D. Mitsikostas
    • 1
  • Fabrizio Benedetti
    • 2
  1. 1.Neurology DepartmentAeginition Hospital, National and Kapodistrian University of AthensAthensGreece
  2. 2.Neuroscience DepartmentUniversity of Turin Medical SchoolTorinoItaly

Bibliographic information

  • DOI
  • Copyright Information Springer Nature Switzerland AG 2019
  • Publisher Name Springer, Cham
  • eBook Packages Medicine Medicine (R0)
  • Print ISBN 978-3-030-02975-3
  • Online ISBN 978-3-030-02976-0
  • Series Print ISSN 2197-652X
  • Series Online ISSN 2197-6538
  • Buy this book on publisher's site