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Nathan Huneke

@nathanhuneke.bsky.social
259 followers 540 following 51 posts

NIHR Academic Clinical Lecturer in General Adult Psychiatry at the University of Southampton Placebo Effects | Affective and Anxiety Disorders nathanhuneke.netlify.app

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Nathan Huneke @nathanhuneke.bsky.social · 31/07/2026
Placebo effects are only part of the story. Our new review argues that antidepressant trial outcomes are also influenced by diagnostic uncertainty, illness trajectory, measurement variability, and functional unblinding, with important implications for drug development. doi.org/10.1176/appi...
doi.org
Determinants of Nonspecific Response to Treatment in Randomized Controlled Trials of Major Depressive Disorder: A Narrative Review | American Journal of Psychiatry
The design, conduct, and interpretation of double-blind randomized placebo-controlled clinical trials in major depressive disorder (MDD) are complicated by determinants of nonspecific response to trea...
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Nathan Huneke @nathanhuneke.bsky.social · 13/05/2026
We might finally get chaos under Ed Miliband
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Nathan Huneke @nathanhuneke.bsky.social · 11/03/2026
I’m guest editing a new BMC Psychiatry Collection on #placebo and #nocebo effects in psychiatry. We’re looking for work on expectancy mechanisms, communication, and implications for clinical practice + trials. Details: link.springer.com/collections/... @sfb-trr-289.bsky.social
link.springer.com
Placebo and nocebo effects in psychiatry
BMC Psychiatry is calling for submissions to our Collection, Placebo and nocebo effects in psychiatry. Clinical outcomes in psychiatry are influenced not only ...
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British Association for Psychopharmacology @bapsych.bsky.social · 20/01/2026
We are accepting proposals for symposia from BAP members for the #BAP2027 Summer Meeting which will be held in Newcastle. Deadline 6th March. For more information and to submit a proposal go to
bap.org.uk
The British Association for Psychopharmacology | 2027 Summer Meeting – Newcastle
The British Association for Psychopharmacology (BAP) promotes research and education in psychopharmacology, and brings together people in academia, health services, and industry
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British Association for Psychopharmacology @bapsych.bsky.social · 19/01/2026
REGISTER NOW for #BAP2026 Summer Meeting in Birmingham, 19th - 22nd July. For more information and to register go to
bap.org.uk
The British Association for Psychopharmacology | 2026 Summer Meeting – Birmingham
The British Association for Psychopharmacology (BAP) promotes research and education in psychopharmacology, and brings together people in academia, health services, and industry
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Nathan Huneke @nathanhuneke.bsky.social · 07/11/2025
It was a real privilege to be invited to present on treatment-resistance in anxiety disorders at the Psychiatry Masterclass 2025 at the Conrad Dubai. Many thanks to the organising and scientific committees for inviting me! It was great to be there with such excellent speakers!
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Nathan Huneke @nathanhuneke.bsky.social · 25/10/2025
Excellent @liviaasan.bsky.social, well done!
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Nathan Huneke @nathanhuneke.bsky.social · 25/10/2025
Our new Insights article out now in European Neuropsychopharmacology We argue that poor control conditions in digital therapeutics trials risk misleading efficacy claims. Let’s raise the bar for DTx trial design. 🔗 authors.elsevier.com/a/1l-8p,L21E... @ecnp.eu #DTx #MentalHealth #ClinicalTrials
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Nathan Huneke @nathanhuneke.bsky.social · 14/10/2025
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Nathan Huneke @nathanhuneke.bsky.social · 14/10/2025
It was great to present on placebo and nocebo effects in depressive and anxiety disorders in an educational update session at the ECNP Congress. Many thanks to the educational committee for inviting me! @ecnp.eu
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The Power of Expectations @sfb-trr-289.bsky.social · 08/10/2025
🎥 Two new #SFB289 #webinars are uploaded on our YouTube channel! 🎥 In September 2025, @nathanhuneke.bsky.social presented his work on placebo effects in psychiatric disorders: youtu.be/Z1pyhXSV5RE
youtu.be
Webinar: Nathan Huneke - Toward improved understanding of placebo effects in psychiatric disorders
YouTube video by SFB-TRR 289 "Treatment Expectation"
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Nathan Huneke @nathanhuneke.bsky.social · 02/10/2025
Great to collaborate on this with @hvansteenbergen.bsky.social! We found evidence that endogenous opioids mediate attentional broadening after receiving rewards.
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Nathan Huneke @nathanhuneke.bsky.social · 03/09/2025
Really enjoyed the opportunity to present at the SFB289 webinar!
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Nathan Huneke @nathanhuneke.bsky.social · 22/08/2025
Great to be part of this
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Michael Browning @mikebrowning.bsky.social · 30/06/2025
Our new study published in TheLancetPsych! We found that pramipexole augmentation substantially reduced depressive symptoms in patients with treatment-resistant depression over 48 weeks of treatment. This is an important advance in how we treat depression! 1/6 www.thelancet.com/journals/lan...
thelancet.com
Pramipexole augmentation for the acute phase of treatment-resistant, unipolar depression: a placebo-controlled, double-blind, randomised trial in the UK
In this trial involving participants with treatment-resistant depression, pramipexole augmentation of antidepressant treatment, at a target dose of 2·5 mg, demonstrated a reduction in symptoms relativ...
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Erick Turner @eturnermd1.bsky.social · 28/05/2025
Timely article!
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Nathan Huneke @nathanhuneke.bsky.social · 16/04/2025
Editorial accompanies jamanetwork.com/journals/jam...
jamanetwork.com
Negative Effects During Placebo Treatment
This study compares premature study termination rates in placebo groups of high-quality randomized clinical trials across 9 major psychiatric disorders, focusing on total dropouts, dropouts due to adv...
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Nathan Huneke @nathanhuneke.bsky.social · 16/04/2025
Our thoughts on missing data, statistics and placebo effects in psychiatric trials. Thanks Samuele Cortese and Marco Solmi! jamanetwork.com/journals/jam...
jamanetwork.com
Understanding Placebo Mechanisms to Reduce Attrition in Psychiatric Trials
Placebo responses in psychiatric trials are clinically significant and variable.1 When placebo response is large, the assay sensitivity of a clinical trial can be impacted, meaning that it can potenti...
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Nathan Huneke @nathanhuneke.bsky.social · 11/04/2025
Very important initiative!
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Nathan Huneke @nathanhuneke.bsky.social · 12/03/2025
Our new review in JAMA Psychiatry: "Expectancy Effects, Failure of Blinding Integrity, and Placebo Response in Trials of Treatments for Psychiatric Disorders" jamanetwork.com/journals/jam... Thanks to co-first author Guil Fusetto-Veronesi; and to Samuele Cortese, David Baldwin, Matt Garner 🧵👇
jamanetwork.com
Expectancy Effects, Blinding Integrity, and Placebo Response in Psychiatric Disorders
This narrative review discusses the impact of expectancy effects and functional unblinding on treatment responses in randomized clinical trials of treatments in psychiatry.
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Nathan Huneke @nathanhuneke.bsky.social · 12/03/2025
Check out the paper and let us know what you think! jamanetwork.com/journals/jam...
jamanetwork.com
Expectancy Effects, Blinding Integrity, and Placebo Response in Psychiatric Disorders
This narrative review discusses the impact of expectancy effects and functional unblinding on treatment responses in randomized clinical trials of treatments in psychiatry.
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Nathan Huneke @nathanhuneke.bsky.social · 12/03/2025
3. We should develop readouts that are resistant to expectation effects (e.g. psychophysics, network connectivity). Experimental medicine models appear resistant to expectation effects, & could be used to develop such readouts academic.oup.com/ijnp/article... journals.sagepub.com/doi/abs/10.1...
academic.oup.com
Placebo Effects Are Small on Average in the 7.5% CO2 Inhalational Model of Generalized Anxiety
AbstractBackground. Anxiety disorders are highly prevalent and socio-economically costly. Novel pharmacological treatments for these disorders are needed b
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Nathan Huneke @nathanhuneke.bsky.social · 12/03/2025
2. Statistical methods to 'account for' or 'correct for' expectation effects in RCTs exist but need testing and validating. Gathering data as in recommendation 1 would allow us to do this.
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Nathan Huneke @nathanhuneke.bsky.social · 12/03/2025
We make the following recommendations: 1. We should systematically record blinding integrity for patients and for clinician raters, and if it fails, why. This would allow us to explore the above question.
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Nathan Huneke @nathanhuneke.bsky.social · 12/03/2025
If blinding fails in active arms in RCTs w/ larger drug-placebo separation, that might be OK, as an effective treatment might unblinds patients/raters. BUT, if blinding failure in placebo arms drives the difference (maybe through 'disappointment'/'know'-cebo/'lessebo') then that would be a concern.
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Nathan Huneke @nathanhuneke.bsky.social · 12/03/2025
Our recent work shows blinding integrity is rarely measured in psychiatric RCT's. Yet, signals suggest a potential relationship between functional unblinding and greater drug-placebo separation - perhaps due to lower placebo effect onlinelibrary.wiley.com/doi/full/10.... jaacap.org/article/S089...
onlinelibrary.wiley.com
The relationship between blinding integrity and medication efficacy in randomised‐controlled trials in patients with anxiety disorders: A systematic review and meta‐analysis
Background Blinding is thought to minimise expectancy effects and biases in double-blind randomised-controlled trials (RCTs). However, whether blinding integrity should be assessed and reported rema...
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Nathan Huneke @nathanhuneke.bsky.social · 12/03/2025
i.e. higher expectations = higher treatment efficacy. Treatment effects are larger in open-label trials compared with the same treatment given double-blind. Despite this, effect of functional unblinding on estimates of efficacy has been little explored, partly due to lack of data
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Nathan Huneke @nathanhuneke.bsky.social · 12/03/2025
'Response to treatment' results from 3 broad effects: non-specific effects, placebo-specific effects (expectations, associative learning, maybe unblinding effects...), and the improvement specifically attributable to the treatment itself. These effects appear to be additive:
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Nathan Huneke @nathanhuneke.bsky.social · 12/03/2025
In this narrative review we discuss how expectancy effects and functional unblinding can impact treatment and placebo responses in RCT's treatments in psychiatry. We finish with recommendations for the field. Here is a summary:
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Nathan Huneke @nathanhuneke.bsky.social · 12/03/2025
Our new review in JAMA Psychiatry: "Expectancy Effects, Failure of Blinding Integrity, and Placebo Response in Trials of Treatments for Psychiatric Disorders" jamanetwork.com/journals/jam... Thanks to co-first author Guil Fusetto-Veronesi; and to Samuele Cortese, David Baldwin, Matt Garner 🧵👇
jamanetwork.com
Expectancy Effects, Blinding Integrity, and Placebo Response in Psychiatric Disorders
This narrative review discusses the impact of expectancy effects and functional unblinding on treatment responses in randomized clinical trials of treatments in psychiatry.
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Livia Asan @liviaasan.bsky.social · 07/03/2025
🧠 Help Us Understand Pain Perception in FND! 🧠 Looking for volunteers with & without #FND for a study in London @kingsioppn.bsky.social. Single lab visit testing pain perception with electrical stimulation. Interested? Please message me: Livia.Asan@kcl.ac.uk ✉️ Thanks for sharing!
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Nathan Huneke @nathanhuneke.bsky.social · 11/03/2025
Of course!
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Masud Husain @masudhusain.bsky.social · 06/03/2025
Why academia is sleepwalking into self-destruction. My editorial @brain1878.bsky.social If you agree with the sentiments please repost. It's important for all our sakes to stop the madness academic.oup.com/brain/articl...
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Stefan Marciniak @profmarciniak.bsky.social · 02/03/2025
#Pubmed problems being reported Please say if it’s working for you, your country and search engine (perhaps retweet for larger sample size 🤷‍♂️ fine for me, UK & Safari
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Nathan Huneke @nathanhuneke.bsky.social · 02/03/2025
Fine for me
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Nathan Huneke @nathanhuneke.bsky.social · 02/03/2025
Still working for me
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Nathan Huneke @nathanhuneke.bsky.social · 22/11/2024
@actaneuropsych.bsky.social
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Nathan Huneke @nathanhuneke.bsky.social · 22/11/2024
Overall we found placebo effect size in this patient group is large. We also identified some important moderators to consider when designing RCTs for gambling disorder. Given the large placebo effect size, we should also consider how to leverage this in the clinic. @sotonpsychology.bsky.social
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Nathan Huneke @nathanhuneke.bsky.social · 22/11/2024
Nocebo response was more or less zero for RCTs of supplements, and higher for RCTs of medications. Expectation effects? Due to little data, we cannot draw any firm conclusions.
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Nathan Huneke @nathanhuneke.bsky.social · 22/11/2024
Active treatment and placebo response were correlated for most outcomes; but not for quality of life. I find this very interesting - would we see greater drug/placebo separation if quality of life was our main outcome for RCTs in psychiatry?? 🤔
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Nathan Huneke @nathanhuneke.bsky.social · 22/11/2024
As with many psychiatric conditions, we found placebo effect size has increased over time in gambling disorder. Absence of company sponsorship and if the active medication was a nutritional supplement (such as NAC) were also associated with increased placebo response.
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Nathan Huneke @nathanhuneke.bsky.social · 22/11/2024
Placebo effect size in gambling disorder is large [1.18 (95%CI 0.91–1.46)] - among the largest seen in psychiatry buff.ly/3OltvLj. Interestingly, when outcome measure was quality of life, placebo effect size was smaller [0.63 (0.42-0.83)].
buff.ly
Placebo effects in randomized trials of pharmacological and neurostimulation interventions for mental disorders: An umbrella review - Molecular Psychiatry
Molecular Psychiatry - Placebo effects in randomized trials of pharmacological and neurostimulation interventions for mental disorders: An umbrella review
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Nathan Huneke @nathanhuneke.bsky.social · 22/11/2024
Pleased to be able to share our meta-analysis exploring placebo and nocebo response in gambling disorder, out now in Acta Neuropsychiatrica. This is the first meta-analysis of placebo response in RCTs for gambling disorder. buff.ly/3V8dnk3
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Joe Pierre, MD @psychunseen.bsky.social · 17/11/2024
New starter pack: Mental Health Professionals For facts/expertise, but not individual clinical advice! Just getting started... will add more as time goes by... bsky.app/starter-pack...
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Nathan Huneke @nathanhuneke.bsky.social · 18/11/2024
Would love to be added to this - thank you!
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University of Southampton @unisouthampton.bsky.social · 04/10/2024
Huge congratulations to all the nominees and winners at last night’s #VCAwards2024 🏆✨ Held at St Mary’s Stadium, it was an inspiring evening recognising the dedication and talent across our University. #WeAreUoS
All the award winners are standing on stage with the Vice-Chancellor, smiling and holding their trophies. They are dressed in colourful, formal attire.A group of award winners are gathered around a large illuminated star, smiling and holding certificates. Some have their hands raised in celebration. They are dressed in formal attire, with a mix of suits and dresses. A banner with the University of Southampton logo is visible in the background.A woman seated at a table decorated with flowers smiles and claps during the VC Awards, while others around her also applaud.A group of seven people pose around large blue letters spelling UoS at St Mary's Football Stadium. The stadium seats and a screen displaying "Celebrating Success" are visible in the background.
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Nathan Huneke @nathanhuneke.bsky.social · 26/10/2024
Is there a way to search for starter packs?
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Nathan Huneke @nathanhuneke.bsky.social · 18/10/2024
Trying bluesky again. Which feeds should I follow?
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Nathan Huneke @nathanhuneke.bsky.social · 26/04/2024
Further work is needed to explore these possibilities. Either way, it seems the CO2 model is resistant to placebo effects, which is useful to know in itself! Check out the paper for a full discussion!
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