Placebo Interventions for Nausea: a Systematic Review

Quinn, Veronica F.; Colagiuri, Ben

doi:10.1007/s12160-014-9670-3

Cited by 34 publications

(28 citation statements)

References 65 publications

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“…As such, the current review draws attention not only to the need for further research examining additivity in pain, but also for other health-related outcomes. In particular, examining additivity in outcomes with notably strong placebo effects, such as nausea (Quinn & Colagiuri, 2014) or sleep disturbance (Yeung, Sharpe, Glozier, Hackett, & Colagiuri, 2018) may prove to be particularly consequential for the interpretation of RCTs in these conditions.…”

Section: Concluding Remarks and Future Directionsmentioning

confidence: 99%

Placebo and Active Treatment Additivity in Placebo Analgesia: Research to Date and Future Directions

Coleshill

Sharpe

Colloca

et al. 2018

International Review of Neurobiology

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Placebo analgesia is a robust experimental and clinical phenomenon. While our understanding of the mechanisms of placebo analgesia has developed rapidly, some central questions remain unanswered. Among the important questions is how placebo anal-gesia interacts with active analgesic effects. It is an assumption underlying double-blind randomized placebo-controlled trials (RCTs) that the true effect of a treatment can be determined by examining the effect of the active treatment arm and subtracting the response in the placebo group (“the assumption of additivity”). However, despite the importance of this assumption for the interpretation of RCTs, it has rarely been formally examined. This article reviews the assumption of additivity in placebo analgesia by examining studies employing factorial designs manipulating both the receipt of an active analgesic and instructions about the treatment being delivered. In reviewing the literature, we identified seven studies that allowed a test of additivity. Of these, four found evidence against additivity, while the remaining three studies found results consistent with additivity. While the limited available data are somewhat mixed, the evidence suggests that at least under some conditions the assumption of additivity does not hold in placebo analgesia. The concordance between mechanisms of the active analgesic and placebo analgesia may influence whether additivity occurs or not. However, more research using factorial designs is needed to disentangle the relationship between placebo analgesia and the active effect of analgesic treatments.

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Section: Concluding Remarks and Future Directionsmentioning

confidence: 99%

Placebo and Active Treatment Additivity in Placebo Analgesia: Research to Date and Future Directions

Coleshill

Sharpe

Colloca

et al. 2018

International Review of Neurobiology

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“…58 These efforts are complemented by field studies on nausea resulting from going on a naval cruise and clinical work in cancer patients suffering from nausea in the context of chemotherapy. Laboratory findings in healthy individuals support that nausea symptoms can be improved with placebo interventions that are based on the principles of Pavlovian conditioning, a manipulation of expectancies (typically by verbal instructions) or a combination of both.…”

Section: Nauseamentioning

confidence: 99%

Placebo effects and their determinants in gastrointestinal disorders

Elsenbruch

Enck²

2015

Nat Rev Gastroenterol Hepatol

150

112

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Placebo effects in clinical trials have sparked an interest in the placebo phenomenon, both in randomized controlled trials (RCTs) and in experimental gastroenterology. RCTs have demonstrated similar short-term and long-term placebo response rates in gastrointestinal compared to other medical diagnoses. Most mediators and moderators of placebo effects in gastrointestinal diseases are also of similar type and size to other medical diagnoses and not specific for gastrointestinal diagnoses. Other characteristics such as an increase in the placebo response over time and the placebo-enhancing effects of unbalanced randomization were not seen, at least in IBS. Experimental placebo and nocebo studies underscore the 'power' of expectancies and conditioning processes in shaping gastrointestinal symptoms not only at the level of self-reports, but also within the brain and along the brain-gut axis. Brain imaging studies have redressed earlier criticism that placebo effects might merely reflect a response bias. These findings raise hope that sophisticated trials and experiments designed to boost positive expectations and minimize negative expectations could pave the way for a practical and ethically sound use of placebo knowledge in daily practice. Rather than focusing on a 'personalized' choice of drugs based on biomarkers or genes, it might be the doctor-patient communication that needs to be tailored.

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“…This way the cognitive and emotional mediated withdrawal phenomenon symptoms can be suppressed. There is also evidence, that this approach is a very successful way to inhibit the development of nocebo nausea (Colagiuri & Zachariae, 2010; Quinn & Colagiuri, 2015). …”

Section: Requirements For a Clinical Application Of Placebo Effectsmentioning

confidence: 99%

Clinical Use of Placebo Effects in Patients With Pain Disorders

Klinger

Stuhlreyer

Schwartz

et al. 2018

International Review of Neurobiology

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The analgesic placebo effect is well documented by numerous studies. Many important influencing factors, however, are yet to be discovered. In the arena of placebo effects and clinical implications, expectancies play a central role. Expectancies are shaped by processes of classical and social learning as well as verbal instructions and are strongly related to emotional factors. Expectancies trigger a cascade of endogenous opioids and nonopioids, which alter the experience of pain. For clinical application it is important to know, that placebo research yields ethical possibilities to use placebo effects without deception and without using placebos. Since placebo effects contribute to responses to active anal-gesics, it is feasible to enhance patients’ benefits from pain treatments by increasing the additional placebo effect. There are several possibilities to use the placebo effects via shaping and adapting information about analgesic medication and via associating medication intake with a positive context. A positive patient–clinician communication atmosphere is very important to generate clinically meaningful placebo effects in pain medicine.

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Placebo Interventions for Nausea: a Systematic Review

Abstract: These findings suggest that placebo interventions can alter nausea and that these may serve as a useful way of reducing the burden of nausea in practice.

Cited by 34 publications

References 65 publications

Placebo and Active Treatment Additivity in Placebo Analgesia: Research to Date and Future Directions

Placebo and Active Treatment Additivity in Placebo Analgesia: Research to Date and Future Directions

Placebo effects and their determinants in gastrointestinal disorders

Clinical Use of Placebo Effects in Patients With Pain Disorders

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