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Open-Label Placebo: Reflections on a Research Agenda
Perspectives in Biology and Medicine
|October 9, 2018
Summary
Open-label placebos, honestly prescribed, show effectiveness without deception. Emerging theories like prediction error processing offer better explanations for placebo effects than traditional models.
Area of Science:
- Neuroscience
- Psychology
- Integrative Medicine
Background:
- Traditional placebo research often relies on deception.
- Open-label placebos (OLP) challenge this by using honestly prescribed placebo pills.
- Evidence suggests OLP can elicit therapeutic benefits.
Purpose of the Study:
- To explore the development of the OLP hypothesis.
- To review evidence supporting OLP effectiveness.
- To examine mechanistic explanations for OLP effects.
Main Methods:
- Literature review and theoretical synthesis.
- Analysis of existing evidence on OLP.
- Proposal of novel theoretical frameworks.
Main Results:
- Traditional theories (expectation, conditioning) are insufficient for OLP.
- Emerging concepts like prediction error processing (PEP), Bayesian brain, and embodied cognition provide better models.
- OLP may non-consciously perturb symptom amplification and central sensitization.
Conclusions:
- Placebo effects are neurologically encoded predictions, not solely conscious beliefs.
- PEP offers a mind-body dualism-free model for understanding OLP.
- OLP effectiveness highlights the role of predictive processing in symptom perception and improvement.
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