NA - DRUG EFFECTS AND DRUG EXPECTANCY

This is a research project on how environmental contingencies can modify drug responses, through the mechanism of drug expectancy. Drug expectancy refers to the belief or expectation that symptoms should decrease or disappear after a specific treatment. Thus, a person experiencing, e.g., a toothache, expects the pain to subside after ingestion of a painkiller. Such beliefs are part of almost all treatments, and were the reason for the introduction of the double-blind method, the current gold standard, i n drug trials. There is an ambivalence in this: by excluding the role of expectations in the study of drug effects, one treats expectations as a source of error that needs to be controlled or removed. On the other hand, this implies that expectations may affect the results after drug treatment. Drug expectations may have two consequences in addition to the placebo effect: 1. They may modify the drug response. Thus, expectations of drug effects may increase the drug effect, or may even decrease the drug effect under other conditions. This latter phenomenon is known as associative drug tolerance and has been widely studied in animals. 2. Drug expectations may interact with the drug effect. This is known as active placebo and there are virtually no publish ed studies on this theme. This is not an instance where expectations increase the drug response, but rather the other way around. The drug response is thought to potentiate the placebo effect.