title: The placebo response in medicine: minimize, maximize or personalize?
abstract: Our understanding of the mechanisms mediating or moderating the placebo response to medicines has grown substantially over the past decade and offers the opportunity to capitalize on its benefits in future drug development as well as in clinical practice. In this article, we discuss three strategies that could be used to modulate the placebo response, depending on which stage of the drug development process they are applied. In clinical trials the placebo effect should be minimized to optimize drug-placebo differences, thus ensuring that the efficacy of the investigational drug can be truly evaluated. Once the drug is approved and in clinical use, placebo effects should be maximized by harnessing patients' expectations and learning mechanisms to improve treatment outcomes. Finally, personalizing placebo responses - which involves considering an individual's genetic predisposition, personality, past medical history and treatment experience - could also maximize therapeutic outcomes.
authors: Department of Internal Medicine VI, University Hospital Tübingen, 72076 Tübingen, Germany. paul.enck@uni-tuebingen.de
authors: Paul
authors: P
authors: Enck
authors: Ulrike
authors: U
authors: Bingel
authors: Manfred
authors: M
authors: Schedlowski
authors: Winfried
authors: W
authors: Rief
mesh_terms: D002986:Clinical Trials as Topic; D015195:Drug Design; D055808:Drug Discovery; D006801:Humans; D010817:Physician-Patient Relations; D015990:Placebo Effect; D057285:Precision Medicine; D016896:Treatment Outcome