Medicine and Health

How side effects can improve treatment efficacy: a randomized trial

L. A. Schenk, T. Fadai, et al.

This study by Lieven A. Schenk, Tahmine Fadai, and Christian Büchel explores how mild side effects can positively influence treatment outcomes by altering expectations. Participants experiencing nasal sprays believed to contain fentanyl reported reduced pain when side effects were involved, suggesting that expectations play a pivotal role in pain perception. The research reveals intriguing insights into the brain's pain modulation mechanisms.

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Abstract

This study investigated whether and how side effects can trigger positive treatment expectations and enhance treatment outcomes. 77 healthy participants received nasal sprays (capsaicin for side effects or saline) believing they contained fentanyl before thermal pain. Results showed that nasal sprays with side effects led to lower pain, dependent on beliefs about side effects' relation to treatment outcome and treatment expectations. fMRI data indicated involvement of the descending pain modulatory system (anterior cingulate cortex and periaqueductal gray). Mild side effects can signal effective treatment, influencing expectations and outcomes via the descending pain modulatory system. This has implications for clinical practice and clinical trial design.

Publisher

medRxiv

Published On

Nov 22, 2023

Authors

Lieven A. Schenk, Tahmine Fadai, Christian Büchel

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