Abstract
Rationale
The active placebo hypothesis states that placebo effects are potentiated when an active drug is administered.
Objective
This hypothesis was tested in an experiment where information about the effect of a drug was combined with administration of an active drug or placebo.
Methods
Information that a drug acted as a relaxant, a stimulant, or as a placebo was crossed with oral administration of a relaxant drug (700 mg carisoprodol), a stimulant drug (400 mg caffeine) or placebo (lactose) in healthy volunteers (n=94). Dependent variables were subjective and physiological measures of arousal, as well as serum carisoprodol and caffeine levels. Data were collected from 15 to 280 min after administration of drug or placebo.
Results
Caffeine increased alertness, systolic and diastolic blood pressure, startle blink reflexes, and skin conductance responses. Subjects were calmer after carisoprodol, and heart rate was increased. There was a positive correlation between increased arousal and carisoprodol levels when stimulant information had been provided. However, this was only seen when carisoprodol levels were very low. There was no evidence that caffeine modulated the placebo response.
Conclusions
Active placebo responses were seen only transiently when carisoprodol levels were low, and only in the subjective arousal data. Caffeine did not support active placebo responses. The overall findings did not favour the active placebo hypothesis.
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Acknowledgements
The study was approved by the Committee for Medical Research Ethics in Health Region V in Norway (project number 21/97), and was supported by The Council for Psychiatric Health (project number 97/1060) and the Norwegian Science Foundation (project numbers 122709/320 and 115012/320). The authors thank the staff at the Department of Clinical Research at the University Hospital of North Norway for their assistance.
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Flaten, M.A., Simonsen, T., Zahlsen, K. et al. Stimulant and relaxant drugs combined with stimulant and relaxant information: a study of active placebo. Psychopharmacology 176, 426–434 (2004). https://doi.org/10.1007/s00213-004-1886-7
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DOI: https://doi.org/10.1007/s00213-004-1886-7