Related Experiment Video
Updated: Jul 13, 2025
How to Study Placebo Responses in Motion Sickness with a Rotation Chair Paradigm in Healthy Participants
Published on: December 14, 2014
Placebo and nocebo effects and mechanisms associated with pharmacological interventions: an umbrella review
Elisa Frisaldi1, Aziz Shaibani2,3, Fabrizio Benedetti4
1Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy elisa.frisaldi@unito.it.
Objectives:
This review aimed to summarise the existing knowledge about placebo and nocebo effects associated with pharmacological interventions and their mechanisms.
Design:
Umbrella review, adopting the Assessment of Multiple Systematic Reviews 2 tool for critical appraisal.
Data Sources:
MEDLINE/PubMed, Scopus, Web of Science, PsycINFO, Cochrane Central Register of Controlled Trial were searched in September 2022, without any time restriction, for systematic reviews, narrative reviews, original articles. Results were summarised through narrative synthesis, tables, 95% CI.
Outcome Measures:
Mechanisms underlying placebo/nocebo effects and/or their effect sizes.
Results:
The databases search identified 372 studies, for a total of 158 312 participants, comprising 41 systematic reviews, 312 narrative reviews and 19 original articles. Seventy-three per cent of the examined systematic reviews were of high quality.Our findings revealed that mechanisms underlying placebo and/or nocebo effects have been characterised, at least in part, for: pain, non-noxious somatic sensation, Parkinson's disease, migraine, sleep disorders, intellectual disability, depression, anxiety, dementia, addiction, gynaecological disorders, attention-deficit hyperactivity disorder, immune and endocrine systems, cardiovascular and respiratory systems, gastrointestinal disorders, skin diseases, influenza and related vaccines, oncology, obesity, physical and cognitive performance. Their magnitude ranged from 0.08 to 2.01 (95% CI 0.37 to 0.89) for placebo effects and from 0.32 to 0.90 (95% CI 0.24 to 1.00) for nocebo effects.
Conclusions:
This study provides a valuable tool for clinicians and researchers, identifying both results ready for clinical practice and gaps to address in the near future.
Funding:
Università Cattolica del Sacro Cuore, Milan, Italy with the 'Finanziamento Ponte 2022' grant.
Prospero Registration Number:
CRD42023392281.
Related Concept Videos
01:54The Placebo Effect
02:07Blind Procedures
01:27Effects of Chemicals: Overview
01:21Pharmacodynamics: Overview and Principles
Most drugs' effects result from their interactions with drug receptors or targets within the body. These interactions trigger specific responses at the cellular or systemic level. Drug receptors can be found on the surfaces of cells or...
01:30Combined Effects of Drugs: Antagonism
The most common type is receptor antagonism, where one drug acts as an antagonist to block the effects of another drug by...
01:14Agonism and Antagonism: Quantification
To quantify these effects, researchers use a dose-response curve, which provides valuable information about the potency and efficacy of a drug. Potency refers to...