Drug-Set Interaction: Psychological and Physiological Effects of Epinephrine Under Differential Expectations

To determine whether physiologic responses to a drug could be changed by expec-tation, and what role placebo effect might play, 14 medical students were given either epinephrine or placebo. Measurements of subjective response and response of plasma free fatty acids, blood glucose, and heart rate were made, Stimulant expectation was engendered by suggestion of epinephrine-like effects, and sedative expectation by suggestion of barbiturate-like effects. Of 8 drug subjects, 8 had a greater FFA response under stimulant expectations, and 7 had greater subjective, blood glucose, and heart rate responses. In 6 placebo subjects, there was no dis-cernible effect of expectation in any measure. THE QUESTION of how expectations (i.e. set) can influence the action of drugs is one which is currently receiving a great deal of attention on a number of differ-ent fronts.1"8 One model of drug-set interaction implies that when subjects have well-defined and appropriate ex-pectations concerning intended drug ac-