Pain and the Placebo: What We Have Learned
- 1 March 2005
- journal article
- review article
- Published by Project MUSE in Perspectives in Biology and Medicine
- Vol. 48 (2) , 248-265
- https://doi.org/10.1353/pbm.2005.0054
Abstract
Despite the recent blossoming of rigorous research into placebo mechanisms and the long-standing use of placebos in clinical trials, there remains widespread and profound misunderstanding of the placebo response among both practicing physicians and clinical researchers. This review identifies and clarifies areas of current confusion about the placebo response (including whether it exists at all), describes its phenomenology, and outlines recent advances in our knowledge of its underlying psychological and neural mechanisms. The focus of the review is the placebo analgesic response rather than placebo responses in general, because much of the best established clinical and experimental work to date has been done on this type of placebo response. In addition, this subfield of placebo research offers a specific neural circuit hypothesis capable of being integrated with equally rigorous experimental work on the psychological (including social psychological) and clinical levels. In this sense, placebo analgesia research bears all the marks of a genuine multilevel interdisciplinary research paradigm in the making, one that could serve as a model for research into other kinds of placebo responses, as well as into other kinds of mind-body responses.Keywords
This publication has 29 references indexed in Scilit:
- Conscious Expectation and Unconscious Conditioning in Analgesic, Motor, and Hormonal Placebo/Nocebo ResponsesJournal of Neuroscience, 2003
- The contribution of suggestibility and expectation to placebo analgesia phenomenon in an experimental settingPain, 2002
- Response variability to analgesics: a role for non-specific activation of endogenous opioidsPublished by Wolters Kluwer Health ,2001
- Selective opiate modulation of nociceptive processing in the human brain.Journal of Neurophysiology, 2000
- Somatotopic Activation of Opioid Systems by Target-Directed Expectations of AnalgesiaJournal of Neuroscience, 1999
- Inducing placebo respiratory depressant responses in humans via opioid receptorsEuropean Journal of Neuroscience, 1999
- Neuropharmacological Dissection of Placebo Analgesia: Expectation-Activated Opioid Systems versus Conditioning-Activated Specific SubsystemsJournal of Neuroscience, 1999
- The specific effects of prior opioid exposure on placebo analgesia and placebo respiratory depressionPain, 1998
- Potentiation of placebo analgesia by proglumideThe Lancet, 1995
- THE POWERFUL PLACEBOJAMA, 1955