Placebo and Pain Chapter 14. How Placebo Responses are Formed: From Bench to Bedside

The observation that cognitive factors, such as beliefs, expectations and prior experiences, not only modulate the perception of pain but also the therapeutic benefit and adverse effects of pharmacologic treatments is not new. However, to date, the contribution of cognitive factors to pharmacotherapy is still poorly understood and far from being systematically exploited to maximize treatment outcome. This chapter gives an overview on the contribution of placebo and nocebo mechanisms to the outcome of analgesic treatments, insights into the neurobiologic mechanisms by which both factors combine or interact, and discusses implications for clinical care and the design of clinical studies.