TY - JOUR

T1 - Placebo and nocebo in the treatment of migraine

T2 - How much does real world effectiveness depend on contextual effects?

AU - Basedau, Hauke

AU - Ornello, Raffaele

AU - Matteis, Eleonora De

AU - Davaasuren, Bolortsetseg

AU - Kadyrova, Begimai

AU - Vuralli, Doga

AU - Bozhenko, Myroslav

AU - Azizova, Ilaha

AU - Bitsadze, Natia

AU - Eralieva, Elnura

AU - Ashina, Messoud

AU - Mitsikostas, Dimos

AU - Puledda, Francesca

N1 - Publisher Copyright: © International Headache Society 2023.

PY - 2023

Y1 - 2023

N2 - Purpose: Treatments in medicine impact individuals beyond their intended effects, due to phenomena such as the placebo and nocebo effects. The placebo effect arises from the positive expectation of a treatment being beneficial, while the nocebo effect stems from the negative expectation of a treatment causing harm. Both in real-world practice and clinical trials, treatments can lead to outcomes unrelated to their intended mechanism of action, which we categorize as placebo and nocebo responses. These responses, combined with the inherent fluctuation in a condition's natural progression, regression to the mean, and random comorbidities, make up a significant part of the therapeutic experience. Particularly in pain management, placebo and nocebo effects play a substantial role. By addressing modifiable contextual factors such as patient expectations, lifestyle choices, and the therapeutic relationship, healthcare providers can enhance the effectiveness of migraine treatments, paving the way for a more comprehensive, individualized approach to patient care. We must also consider non-modifiable factors like personal experiences, beliefs, and information from social media and the internet. Conclusion: This review offers a summary of our current understanding of the placebo and nocebo effects in migraine management.

AB - Purpose: Treatments in medicine impact individuals beyond their intended effects, due to phenomena such as the placebo and nocebo effects. The placebo effect arises from the positive expectation of a treatment being beneficial, while the nocebo effect stems from the negative expectation of a treatment causing harm. Both in real-world practice and clinical trials, treatments can lead to outcomes unrelated to their intended mechanism of action, which we categorize as placebo and nocebo responses. These responses, combined with the inherent fluctuation in a condition's natural progression, regression to the mean, and random comorbidities, make up a significant part of the therapeutic experience. Particularly in pain management, placebo and nocebo effects play a substantial role. By addressing modifiable contextual factors such as patient expectations, lifestyle choices, and the therapeutic relationship, healthcare providers can enhance the effectiveness of migraine treatments, paving the way for a more comprehensive, individualized approach to patient care. We must also consider non-modifiable factors like personal experiences, beliefs, and information from social media and the internet. Conclusion: This review offers a summary of our current understanding of the placebo and nocebo effects in migraine management.

KW - contextual effects

KW - headache

KW - Migraine

KW - nocebo

KW - placebo

U2 - 10.1177/03331024231218392

DO - 10.1177/03331024231218392

M3 - Review

C2 - 38041833

AN - SCOPUS:85178349258

VL - 43

SP - 1

EP - 12

JO - Cephalalgia

JF - Cephalalgia

SN - 0800-1952

IS - 12

ER -