Cited by 323Pain Management and Placebo EffectPain Mechanisms and TreatmentsPsychosomatic Disorders and Their Treatments

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Neuro-Bio-Behavioral Mechanisms of Placebo and Nocebo Responses: Implications for Clinical Trials and Clinical Practice

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Schedlowski, Manfred, Enck, Paul, Rief, Winfried, Bingel, Ulrike·2015·Pharmacological Reviews

DOI 10.1124/pr.114.009423

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Abstract

The placebo effect has often been considered a nuisance in basic and particularly clinical research. This view has gradually changed in recent years due to deeper insight into the neuro-bio-behavioral mechanisms steering both the placebo and nocebo responses, the evil twin of placebo. For the neuroscientist, placebo and nocebo responses have evolved as indispensable tools to understand brain mechanisms that link cognitive and emotional factors with symptom perception as well as peripheral physiologic systems and end organ functioning. For the clinical investigator, better understanding of the mechanisms driving placebo and nocebo responses allow the control of these responses and thereby help to more precisely define the efficacy of a specific pharmacological intervention. Finally, in the clinical context, the systematic exploitation of these mechanisms will help to maximize placebo responses and minimize nocebo responses for the patient's benefit. In this review, we summarize and critically examine the neuro-bio-behavioral mechanisms underlying placebo and nocebo responses that are currently known in terms of different diseases and physiologic systems. We subsequently elaborate on the consequences of this knowledge for pharmacological treatments of patients and the implications for pharmacological research, the training of healthcare professionals, and for the health care system and future research strategies on placebo and nocebo responses.

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Self-citation

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1 of the 431 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

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Sorted by citations

Placebo and Nocebo Effects
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See all 323

Authors: Schedlowski, M., Enck, P., Rief, W., & Bingel, U.
Affiliations: Philipps University of Marburg (DE)
ORCID: Schedlowski, Manfred
Enck, Paul
Rief, Winfried
Bingel, Ulrike
Venue: Pharmacological Reviews
Publisher: Elsevier BV
Published: 2015-07
Volume: 67
Issue: 3
Pages: 697-730
ISSN: 0031-6997 (ISSN-L)
DOI: 10.1124/pr.114.009423
OpenAlex: W2180491479
Cited by: 323
References: 431
Citations by year: 2026: 19 · 2025: 30 · 2024: 23 · 2023: 17 · 2022: 32 · 2021: 32 · 2020: 44 · 2019: 38 · 2018: 29 · 2017: 24 · 2016: 29 · 2015: 5
FWCI: 2.88
Type: journal article
Language: en
Open access: green
doi.org
Licence: cc-by
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Pharmacological Reviews (publishedVersion)
PubMed (publishedVersion)
German Medical Science (German Research Foundation) (publishedVersion, cc-by)
German Medical Science (German Research Foundation) (cc-by)
Topics: Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Keywords: placebo effect, nocebo effect, symptom perception, neural mechanisms, cognitive and emotional factors, end-organ function, health professions education, clinical trials, health care system
MeSH terms: Animals, Brain, Clinical Trials as Topic, Cognition, Humans, Placebo Effect, Biomedical Research, Nocebo Effect

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Neuro-Bio-Behavioral Mechanisms of Placebo and Nocebo Responses: Implications for Clinical Trials and Clinical Practice

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