Cited by 67Neurotransmitter Receptor Influence on BehaviorPain Management and Placebo EffectTreatment of Major Depression

Rethinking psychopharmacotherapy: the role of treatment context and brain plasticity in antidepressant and antipsychotic interventions.

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Rief, W., Barsky, A.J., Bingel, U., Doering, B.K., Schwarting, R., Wöhr, M., Schweiger, U.·2016·Neuroscience & Biobehavioral Reviews

Abstract

Emerging evidence indicates that treatment context profoundly affects psychopharmacological interventions. We review the evidence for the interaction between drug application and the context in which the drug is given both in human and animal research. We found evidence for this interaction in the placebo response in clinical trials, in our evolving knowledge of pharmacological and environmental effects on neural plasticity, and in animal studies analyzing environmental influences on psychotropic drug effects. Experimental placebo research has revealed neurobiological trajectories of mechanisms such as patients' treatment expectations and prior treatment experiences. Animal research confirmed that "enriched environments" support positive drug effects, while unfavorable environments (low sensory stimulation, low rates of social contacts) can even reverse the intended treatment outcome. Finally we provide recommendations for context conditions under which psychotropic drugs should be applied. Drug action should be steered by positive expectations, physical activity, and helpful social and physical environmental stimulation. Future drug trials should focus on fully controlling and optimizing such drug×environment interactions to improve trial sensitivity and treatment outcome.

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Authors
Rief, W., Barsky, A. J., Bingel, U., Doering, B. K., Schwarting, R., Wöhr, M., & Schweiger, U.
Affiliations
  • Philipps University of Marburg (DE)
  • Brigham and Women's Hospital (US)
  • Essen University Hospital (DE)
  • University of Lübeck (DE)
Corresponding author
Rief, W.
Venue
Neuroscience & Biobehavioral Reviews
Publisher
Elsevier BV
Published
2016-01
Volume
60
Pages
51-64
ISSN
0149-7634 (ISSN-L)
OpenAlex
W2172892932
Cited by
67
References
171
Citations by year
2026: 3 · 2025: 9 · 2024: 7 · 2023: 7 · 2022: 3 · 2021: 4 · 2020: 7 · 2019: 7 · 2018: 7 · 2017: 10 · 2016: 3
FWCI
0.79
Type
journal article
Language
en
Open access
Locations
  • Neuroscience & Biobehavioral Reviews (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Keywords
treatment context, antidepressants, antipsychotic drugs, placebo response, neuroplasticity, environmental enrichment, social stimulation, treatment expectations, prior treatment experience, physical activity, clinical trial design
MeSH terms
Animals, Antidepressive Agents, Mental Disorders, Brain, Environment, Humans, Neuronal Plasticity, Antipsychotic Agents

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