Placebo And Pain

The placebo effect continues to fascinate scientists, scholars, and clinicians, resulting in an impressive amount of research, mainly in the field of pain. While recent experimental and clinical studies have unraveled salient aspects of the neurobiological substrates and clinical relevance of pain and placebo analgesia, an authoritative source remained lacking until now. By presenting and integrating a broad range of research, Placebo and Pain enhances readers’ knowledge about placebo and nocebo effects, reexamines the methodology of clinical trials, and improves the therapeutic approaches for patients suffering from pain. Review for Placebo and Pain: “This ambitious book is the first comprehensive and unified presentation of the placebo and nocebo phenomena in the area of pain. Written by the international leading experts in the field, the book provides an accurate up-to-date [work] on placebo and pain dealing with current perspectives and future challenging issues. --Ted Kaptchuk, Associate Professor of Medicine, Harvard Medical School Contains historical aspects of the placebo effect Discusses biological and psychological mechanisms of placebo analgesic responses Reviews implications of the placebo effect for clinical research and pain management Includes methodological and ethical aspects of the placebo effect

In this chapter we discuss the various aspects of the clinical applications of placebo effects. In clinical studies, a placebo intervention is often nearly as potent as the effects of the verum that is applied, and placebo effects can have enduring positive consequences. Most research has focused on healthy humans and it is not clear whether the results reported in these people can be transferred to clinical populations. Initial studies on this topic have suggested that patients may profit more from conditioning, which involves a true reduction of the pain experience, than from expectation alone. This current knowledge about the placebo effect, especially about the analgesic placebo effect, suggests that it is time to use it in clinical practice. The concept of the additional placebo effect as part of an active pain treatment enables an ethical application of placebo mechanisms that can enhance the efficacy of pharmacologic—and potentially also psychologic—interventions.

A complete reference source on central pain.

Due to the recent explosion of placebo research at many levels the Editors believe that a volume on Placebo would be a good addition to the Handbook of Experimental Pharmacology series. In particular, this volume will be built up on a meeting on Placebo which will be held in Tuebingen (Germany) in January 2013, and where the most prominent researchers in this field will present and exchange their ideas. The authors who will be invited to write chapters for this volume will be the very same speakers at this meeting, thus guaranteeing high standard and excellence in the topic that will be treated. The approach of the book is mainly pharmacological, including basic research and clinical trials, and the contents range from different medical conditions and systems, such as pain and the immune system, to different experimental approaches, like in vivo receptor binding and pharmacological/behavioral conditioning. Overall, the volume will give an idea of modern placebo research, of timely concepts in both experimental and clinical pharmacology, as well as of modern methods and tools in neuroscience.

Psychodynamic psychotherapy and psychoanalysis have had to defend themselves from a barrage of criticisms throughout their history. In this book David Jopling argues that the changes achieved through therapy are really just functions of placebos that rally the mind's native healing powers. It is a bold new work that delivers yet another blow to Freud and his followers.

Due to advances within neuroscience, we are now in a much better position to be able to describe and discuss the biological mechanisms that underlie the doctor-patient relationship. Using this knowlege, this book describes and demonstrates the power that the doctor's behaviour has on a patient's behaviour and capacity for recovery from illness.

The placebo effect is a fascinating yet puzzling phenomenon which has challenged investigators over the past 50 years. Some researchers have initiated investigations of the effects of placebos in animals, and have shown that associative learning is a major way to elicit placebo responses. Pain is the field in which most of the placebo research has been performed. In contrast to numerous studies involving human subjects, the available literature on placebo-induced analgesia in animal models is rare. This chapter introduces a special drug-conditioning procedure, a cue paired with morphine or aspirin, eliciting analgesic responses in a hot plate test. This established placebo analgesia was considered to be transferable from pain to depression and could produce a significant antidepressant effect in a test on depression in mice. Furthermore, the opioid placebo analgesia was found to be mediated exclusively through a μ-opioid receptor in the rat. The pros and cons of studying placebo in animal models are also discussed at the end of this chapter.