Question 1

What is the difference between placebo and nocebo?

Fabrizio Benedetti · Accepted Answer

Whereas a placebo effect is related to positive effects, the nocebo effects are attributable to negative expectations, which, in turn, lead to clinical worsening.

https://pubmed.ncbi.nlm.nih.gov/23899563/

Question 2

What are some clever uses of the placebo effect?

Fabrizio Benedetti · Accepted Answer

Some possible implications are represented by the administration of placebos interspersed among real treatments, according to a paradigm such as “drug-drug-drug-placebo-drug-drug-placebo-drug-etc.” In the long run, this may lead to a reduction of drug intake.

https://physoc.onlinelibrary.wiley.com/doi/full/10.1113/JP271322

Question 3

Does your research suggest that we shouldn't be rejecting complementary medicine such as homeopathy and ancient healing techniques due to their lack of scientific evidence?

Fabrizio Benedetti · Accepted Answer

No, our research is only aimed at better understanding the psychological component of any treatment, be it pharmacological or not. Complementary and alternative medicine is outside mainstream medicine because, as far as we know today, they lack rigorous scientific evidence.

Question 4

Does more frequent dosing increase the placebo effect?

Fabrizio Benedetti · Accepted Answer

Learning is important. If a drug is given several days in a row and then replaced with a placebo, the placebo effect is usually huge. By contrast, if a placebo is given for the first time, the placebo effect is smaller, or it does not occur at all.

https://www.nature.com/news/parkinson-s-patients-trained-to-respond-to-placebos-1.19341

Question 5

Does everyone respond to placebos?

Fabrizio Benedetti · Accepted Answer

There are people responding to placebos and people who do not. It is not clear why this happens, but personality traits, genetic factors, and social factors may play an important role. This is a future challenge for placebo research.

Question 6

Is healing from placebos all in your mind?

Fabrizio Benedetti · Accepted Answer

Not exactly. There are many physiological and biochemical effects both in the brain and in the whole body, such as the release of endorphins and endocannabinoids.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3055515/

Question 7

Are all diseases equally placebo-responsive?

Fabrizio Benedetti · Accepted Answer

Whenever psychological factors are involved, such as in pain, motor performance, anxiety, depression, the placebo effect is important. Conversely, placebos cannot kill the bacteria of pneumonia, nor can they prevent pregnancy, nor can they stop cancer growth.

Question 8

Could the placebo effect be just regression to the mean?

Fabrizio Benedetti · Accepted Answer

The very definition of placebo effect is that it is a true psychobiological effect. Regression to the mean may play a role, sometimes important, but it has nothing to do with the real psychological placebo effect.

Question 9

What is the placebo effect, and why does it happen?

Fabrizio Benedetti · Accepted Answer

The placebo effect is the positive effect (clinical improvement) following the administration of an inert treatment (the placebo) with no specific therapeutic properties (water, flour, etc.). What matters is not so much the inert treatment but rather the psychosocial context around the patient, which induces positive expectations of benefit. In other words, a placebo is the whole ritual of the therapeutic act, which is made of many psychological and social factors. 
https://www.youtube.com/watch?v=ZHeF7rYz7uY

Question 10

Is it attention and nurturance from a health practitioner, i.e., a healing relationship that may account for a large part of the placebo effect?

Fabrizio Benedetti · Accepted Answer

Yes, the social encounter between the therapist and the patient plays a crucial role. Any word, behaviour, the attitude of the therapist may potentially influence the therapeutic outcome and the course of a disease.

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