Epilepsy and Placebo: A Literature Review

Epilepsy is a widespread neurologic illness with high morbidity. Further treatments are needed to limit ongoing injury. To demonstrate effectiveness of new treatments, randomized controlled trials comparing adjuvant treatment to placebo are used. Larger placebo response limits trial sensitivity to an effective drug. Placebo also influences many other aspects of epilepsy, including intracranial electroencephalography, nocebo, device treatments, among others. Recent advances in modeling suggest that a true placebo effect in epilepsy treatment trials is possibly nil and that placebo response may be due to natural fluctuation alone, although further studies are necessary.