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Drug-Related Information Generates Placebo and Nocebo Responses That Modify the Drug Response

Flaten, Magne Arve Dr Psychol; Simonsen, Terje Cand Med; Olsen, Harald Dr Med

Original Articles

Objective Administration of the muscle relaxant carisoprodol and placebo was crossed with information that was agonistic or antagonistic to the effect of carisoprodol. It was investigated whether information alone induced physiological and psychological responses, and whether information modified the response to the drug.

Methods Half of the subjects received capsules containing 525 mg carisoprodol together with information that the drug acted in a specific way (Groups Relaxant/C, Stimulant/C, and No Information/C). The other half of the subjects received lactose (Groups Relaxant/L, Stimulant/L, and No Information/L). Dependent variables were blink reflexes and skin conductance responses, subjective measures of tension and sleepiness, and serum carisoprodol and meprobamate concentrations. Recordings were made between 15 and 130 minutes after administration of the capsules.

Results The Stimulant/L group reported more tension compared with the other two groups, and carisoprodol increased tension even more in the Stimulant/C group. The Relaxant/C group displayed higher levels of carisoprodol serum concentration compared with the other groups that received carisoprodol.

Conclusions Reported tension was modulated in the direction suggested by the stimulant information. The effect of carisoprodol on tension was also modulated by stimulant information. Increased carisoprodol absorption in the group that received relaxant information could be a mechanism in the placebo response.

From the Department of Psychology (M.A.F.), University of Tromso, and Department of Clinical Pharmacology (T.S.), Tromso University Hospital, Tromso, Norway; and Department of Psychiatry (H.O.), University of Oslo, Oslo, Norway.

Address reprint requests to: Magne Arve Flaten, Prof Dr Psychol, Department of Psychology, SVT, Norwegian University of Science and Technology, N. 7491 Trondheim, Norway. E-mail:

Received for publication July 7, 1998; revision received November 2, 1998.

Copyright © 1999 by American Psychosomatic Society
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