Open-Label Placebos Improve Symptoms in Allergic Rhinitis: A Randomized Controlled Trial

Schaefer, Michael; Harke, Rebecca; Denke, Claudia

doi:10.1159/000447242

Cited by 88 publications

(132 citation statements)

References 9 publications

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“…The consistency and magnitude of symptomatic relief across these studies—performed in hospitals on two continents—suggest that open label placebo may have a real therapeutic benefit. Three smaller pilot or feasibility clinical studies of open label placebo—two in people with allergic rhinitis (n=25, n=45)1011 and one in depression (n=20)12—also suggest potential benefits. In addition, two independent studies in chronic low back pain (n=127) and cancer related fatigue (n=40) recently reported significant positive results 1314…”

Section: Open Label Placebo Studiesmentioning

confidence: 99%

Open label placebo: can honestly prescribed placebos evoke meaningful therapeutic benefits?

Kaptchuk

Miller

2018

BMJ

107

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Section: Open Label Placebo Studiesmentioning

confidence: 99%

Open label placebo: can honestly prescribed placebos evoke meaningful therapeutic benefits?

Kaptchuk

Miller

2018

BMJ

107

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“…This is counterintuitive since placebos supposedly work because people believe they do, but (presumably) knowing a treatment is a mere sugar pill makes it difficult to believe they will work. In spite of the lack of intuitive appeal, numerous studies have demonstrated that deception may not be needed to elicit placebo effects and have also demonstrated potential effectiveness at improving significant clinical outcomes in patients with irritable bowel syndrome (IBS) (Kaptchuk et al, 2010), chronic low back pain (Carvalho et al, 2016), depression (Park & Covi, 1965), attention-deficit hyperactivity disorder (ADHD) (Sandler, Glesne, & Geller, 2008), rhinitis (Schaefer, Harke, & Denke, 2016), and cancer-related fatigue (Hoenemeyer, Kaptchuk, Mehta, & Fontaine, 2018). …”

Section: Do Placebos Require Deception? the Mysterious Case Of Opementioning

confidence: 99%

“…Often, the open-label placebos were delivered in addition to the TAUs and importantly with explicit positive suggestions (Carvalho et al, 2016; Hoenemeyer et al, 2018; Kaptchuk et al, 2010; Schaefer et al, 2016) proving a rationale (e.g., “Pavlovian conditioning”) and instilling some hope of improvement. The only study that lacked any positive framing and instruction sets had the smallest effect size (Kelley et al., 2012).…”

Section: Potential Mechanismsmentioning

confidence: 99%

Placebos Without Deception: Outcomes, Mechanisms, and Ethics

Colloca

Howick

2018

International Review of Neurobiology

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Scientific research indicates that open-label and dose-extending placebos (that patients know are placebos) can elicit behavioral, biological, and clinical outcome changes. In this chapter, we present the state-of-the-art evidence and ethical considerations about open-label and dose-extending placebos, discussing the perspective of giving placebos with a rational, as dose extension of active drugs, or expectancy boosters. Previous comprehensive reviews of placebo use have considered how to harness placebo effects in medicine and the need to focus on elements of the clinical encounter as well as patient–clinician relations. Here, we illustrate the similarities and differences between standard (deceptive) placebos, open-label placebos and dose-extending placebos. We conclude that placebos without deception would override ethical barriers to their clinical use. This paves the way to future large-scale, pragmatic randomized trials that investigate the potential of ethical open-label and dose-extending placebos to improve patients’ outcomes, and reduce side effects.

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“…Patients may improve simply because they are placed in places that are symbols of competent care [33], as the study by Park and Covi [34], in which patients were told they were given placebos and yet improved, indicates. Such a study has recently been replicated [35]. In specific settings, only the interested and enthusiastic physician obtained significant improvement with active drugs compared with placebo, whereas the physician's lack of interest did not yield such differences [36,37].…”

Section: Treatment Outcome As a Multifactorial Productmentioning

confidence: 99%

The Clinical Inadequacy of the Placebo Model and the Development of an Alternative Conceptual Framework

Fava

Guidi

Rafanelli

et al. 2017

Psychother Psychosom

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Placebo effects are often attributed to clinical interactions and contextual factors that affect expectations of the patient about the treatment and result in symptom changes. The prevailing conceptualization consists of an undifferentiated placebo response that needs to be minimized in controlled investigations and maximized in clinical practice. However, treatment outcome is the cumulative result of the interaction of several classes of variables with a selected treatment: living conditions (housing, nutrition, work environment, social support), patient characteristics (age, sex, genetics, general health conditions, personality, well-being), illness features and previous therapeutic experience, self-management, and treatment setting (physician's attitude and attention, illness behavior). Such variables may be therapeutic or countertherapeutic, and are unlikely to be simply additive. In certain patients their interactive combination may lead to clinical improvement, whereas in other cases it may produce no effect, and, in a third group, it may lead to worsening of the condition. Maximizing patients' expectations does not necessarily result in sustained effects and, in due course, may actually lead to worsening of the condition (violation of expectations). In this paper, we outline a multifactorial conceptual model that may have implications for the design of clinical trials as well as for clinical practice, with special reference to psychopharmacology and psychotherapy. The effects of drug treatment may be potentiated by specific nonpharmacological treatment strategies, and this synergism may disclose significant differences against placebo. Medical outcomes may be unsatisfactory not because technical interventions are missing, but because our conceptual models and thinking are inadequate.

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Open-Label Placebos Improve Symptoms in Allergic Rhinitis: A Randomized Controlled Trial

Cited by 88 publications

References 9 publications

Open label placebo: can honestly prescribed placebos evoke meaningful therapeutic benefits?

Open label placebo: can honestly prescribed placebos evoke meaningful therapeutic benefits?

Placebos Without Deception: Outcomes, Mechanisms, and Ethics

The Clinical Inadequacy of the Placebo Model and the Development of an Alternative Conceptual Framework

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