Evidence map›Paper›PMID 38577951›Full record

Trial reportThe international journal of neuropsychopharmacology2024

Placebo Effects Are Small on Average in the 7.5% CO2 Inhalational Model of Generalized Anxiety.

Nathan T M Huneke, Cosmina Cross, Harry A Fagan, Laura Molteni, Naomi Phillips, Matthew Garner, David S Baldwin

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in The international journal of neuropsychopharmacology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
  2. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 2 countries.

Nathan T M HunekeSouthern Health National Health Service Foundation Trust, Southampton, UK.ORCID 0000-0001-5981-6707
Cosmina CrossSouthern Health National Health Service Foundation Trust, Southampton, UK.
Harry A FaganSouthern Health National Health Service Foundation Trust, Southampton, UK.
Laura MolteniClinical and Experimental Sciences, Faculty of Medicine, University of Southampton, UK.
Naomi PhillipsSolent National Health Service Trust, Southampton, UK.
Matthew GarnerCenter for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, UK.
David S BaldwinUniversity Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
National Health Service · GBUniversity of Southampton · GB

Funding

Medical Research Council MR/T000902/1
6 · The paper itself

Abstract

backgroundAnxiety disorders are highly prevalent and socio-economically costly. Novel pharmacological treatments for these disorders are needed because many patients do not respond to current agents or experience unwanted side effects. However, a barrier to treatment development is the variable and large placebo response rate seen in trials of novel anxiolytics. Despite this, the mechanisms that drive placebo responses in anxiety disorders have been little investigated, possibly due to low availability of convenient experimental paradigms. We aimed to develop and test a novel protocol for inducing placebo anxiolysis in the 7.5% CO2 inhalational model of generalized anxiety in healthy volunteers.

methodsFollowing a baseline 20-minute CO2 challenge, 32 healthy volunteers were administered a placebo intranasal spray labelled as either the anxiolytic "lorazepam" or "saline." Following this, participants surreptitiously underwent a 20-minute inhalation of normal air. Post-conditioning, a second dose of the placebo was administered, after which participants completed another CO2 challenge.

resultsParticipants administered sham "lorazepam" reported significant positive expectations of reduced anxiety (P = .001), but there was no group-level placebo effect on anxiety following CO2 challenge post-conditioning (Ps > .350). Surprisingly, we found many participants exhibited unexpected worsening of anxiety, despite positive expectations.

conclusionsContrary to our hypothesis, our novel paradigm did not induce a placebo response, on average. It is possible that effects of 7.5% CO2 inhalation on prefrontal cortex function or behavior in line with a Bayesian predictive coding framework attenuated the effect of expectations on subsequent placebo response. Future studies are needed to explore these possibilities.

Indexed as

Anti-Anxiety AgentsAnxietyCarbon DioxidePlacebo EffectAdministration, InhalationAdultDouble-Blind MethodFemaleHumansLorazepamMaleYoung AdultAnti-Anxiety AgentsCarbon DioxideLorazepamanxietyAnxiety disordersplacebo effectplacebo response

Identifiers

PMID38577951
PMCPMC11059817
OpenAlexW4393991872

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.