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Expectations impact drug efficacy

Article-Expectations impact drug efficacy

Oxford, England — A new study suggests that a patient’s expectations of a drug’s effects influence its therapeutic efficacy as well as the brain’s pain-related pathways that are activated during treatment, HealthDay News reports.

In their study, researchers at Oxford University exposed healthy participants to pain-provoking heat and gave them remifentanil, an opioid. Some participants were told that the drug would have no effect, some that it would lessen their pain, and the rest that it would increase their pain. The researchers used functional magnetic resonance imaging (fMRI) to record brain activity in members of the three groups.

The researchers found that individuals who expected pain relief experienced twice as much as people who were told to expect none. Those who were told that the drug would aggravate their pain described their pain as unchanged. As for the fMRI results, subjects who expected positive results from the remifentanil showed brain activity in the endogenous pain modulatory system; those with negative expectations about the drug showed more activity in the hippocampus.

“We propose that it may be necessary to integrate patients’ beliefs and expectations into drug-treatment regimes alongside traditional considerations in order to optimize treatment outcomes,” the authors wrote.

The study appears in the Feb. 16 issue of Science Translational Medicine.

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