© 2019

Placebos and Nocebos in Headaches

  • Dimos D. Mitsikostas
  • Fabrizio Benedetti

Part of the Headache book series (HEAD)

Table of contents

  1. Front Matter
    Pages i-ix
  2. Christian Lampl, Elisabeth Bräutigam
    Pages 1-11
  3. Andrea Negro, Paolo Martelletti
    Pages 13-25
  4. Alexandre F. M. DaSilva, Marcos Fabio DosSantos
    Pages 27-41
  5. Elisa Carlino, Lene Vase, Alessandro Piedimonte
    Pages 43-55
  6. Diletta Barbiani, Eleonora Camerone, Fabrizio Benedetti
    Pages 57-63
  7. Jakob Møller Hansen, Messoud Ashina
    Pages 65-74
  8. Christina Deligianni, Dimos D. Mitsikostas
    Pages 75-84
  9. Vanda Faria, David Borsook
    Pages 85-101
  10. Panagiotis Zis
    Pages 103-112
  11. Luana Colloca, Nathaniel Haycock
    Pages 113-124

About this book


This book discusses the role of placebos and nocebos in the treatment of headache disorders. These disorders are usually treatable, but safety and tolerability issues mean that available preventive treatments have often limited success, even in the right hands – one in five patients treated with a migraine preventive pharmaceutical agent discontinues treatment for those reasons. The nocebo effect plays a role here, with patients’ negative expectation and previous unpleasant treatment experiences creating negative belief in the treatment’s benefits and safety, which in turn limits treatment outcomes and adherence significantly. In RCTs on migraine prevention, one in 20 patients treated with a placebo discontinued treatment because of adverse events, indicating a considerable nocebo effect; the fewer potential adverse events described in the consent form, the smaller the nocebo effect. As such, physicians treating headache sufferers should acknowledge nocebo as a significant cofactor for treatment adherence and failure, and plan techniques to limit the effects, such as patient education and close follow-up. This highly informative and painstakingly presented book provides scientific insights for professionals and scholars with an interest in internal medicine, neurology and pain medicine.



migraine adherence complience treatment positive expectation for treatment negative expectation for treatment

Editors and affiliations

  • Dimos D. Mitsikostas
    • 1
  • Fabrizio Benedetti
    • 2
  1. 1.Neurology DepartmentAeginition Hospital, National and Kapodistrian University of AthensAthensGreece
  2. 2.Neuroscience DepartmentUniversity of Turin Medical SchoolTorinoItaly

About the editors

Prof Mitsikostas graduated from the Aristotele University Medical School, Thessaloniki, Greece, in 1985; he obtained his PhD degree in experimental neuropharmacology from the National & Kapodistrian University, Athens, Greece; and he certified in neurology, in 1993 (Aeginition Hospital, National & Kapodistrian University of Athens). He has pursued postdoc studies in experimental molecular pharmacology of pain at Harvard Medical School, Boston, Massachusetts, USA (1996-1998, Professor M.A. Moskowitz’s laboratory) and at the Institute of Neurology, University College London, UK (2000-2001, Professor P.J. Goadsby’s laboratory and Headache Clinic). He served at and directed the Neurology Department of the Athens Naval Hospital from 2001 until May 2016. He is an associate professor of neurology at Aeginition Hospital, heading the Unit A  and the Headache Out Patient Clinic of the 1st Neurology Department. He also teaches medical students, neurology residents and fellows. His clinical work is focused on headache, multiple sclerosis, pain and nocebo and he has lectured nationally and internationally on these topics.He continues to work on animal models for cephalic pain and multiple sclerosis, and participates in several multi-center clinical trials. He is author of more than 100 peer-reviewed papers with more than 7,000 citations (h-index 31), editor/co-editor of eight textbooks and reviewer and/or member of the advisory board of numerous peer-reviewed international medical journals. He is member of several national and international societies and Fellow in the European Academy of Neurology.  Prof Mitsikostas is currently president of the Hellenic Headache Society (2015-2018 and 2018-2021) and past president of the executive board of the European Headache Federation (2014-2016). 


Fabrizio Benedetti received his M.D. degree from the University of Turin Medical School (Italy) and was awarded the Silbert Scholarship for Psychiatry and Biobehavioral Sciences at the University of California, Los Angeles. Currently he is professor of physiology and neuroscience at the University of Turin Medical School, and director of Medicine & Physiology of Hypoxia at the Plateau Rosà Laboratories (Italy/Switzerland). He began studying placebos in the 1990s while researching pain and movement disorders. He has been invited to participate in numerous international conferences and to give lectures and is now a member of the Academy of Europe (Medicine & Physiology section) and the European Dana Alliance for the Brain. He is author of the book "Placebo Effects" (Oxford, 2nd Ed 2014) which was awarded the medical books award in 2009 by the British Medical Association.   


Bibliographic information

  • Book Title Placebos and Nocebos in Headaches
  • Editors Dimos D. Mitsikostas
    Fabrizio Benedetti
  • Series Title Headache
  • Series Abbreviated Title Headache
  • DOI
  • Copyright Information Springer Nature Switzerland AG 2019
  • Publisher Name Springer, Cham
  • eBook Packages Medicine Medicine (R0)
  • Hardcover ISBN 978-3-030-02975-3
  • eBook ISBN 978-3-030-02976-0
  • Series ISSN 2197-652X
  • Series E-ISSN 2197-6538
  • Edition Number 1
  • Number of Pages IX, 142
  • Number of Illustrations 2 b/w illustrations, 3 illustrations in colour
  • Topics Internal Medicine
    Pain Medicine
  • Buy this book on publisher's site
Industry Sectors
Health & Hospitals
Internal Medicine & Dermatology


“The intended audience is ‘physicians, neurologists, general practitioners, and headache specialists.’ … This book provides a thorough review of the scientific literature and summarizes the most salient points. The data is well integrated, and the book is very readable.” (Aliza Kumpinsky, Doody's Book Reviews, May 17, 2019)