Evidence from
pain research shows that the effectiveness of active pharmacological treatments can be enhanced by placebo effects. The "open
drug administration" is superior to "hidden
drug administration." In a randomized controlled trial, we aimed to show that the targeted use of placebo effects increases the efficacy of an
antihistamine (
dimetindene) infusion in participants with
atopic dermatitis. We openly infused
dimetindene (
drug) in full sight with information (intervention group 1: OPEN-DRUG+INST), openly infused
drug with an additional classical conditioning learning experience (intervention group 2: OPEN-
DRUG+INST+COND) or infused
drug without any information or sight (i.e., hidden administration (control group 1: HIDDEN-
DRUG)). Control group 2 received a placebo infusion (saline) declared as
dimetindene and also experienced the conditioning experience (
PLAC+INST+COND). Itch was experimentally induced with
histamine via a skin prick test. Outcome was assessed at the subjective (primary end point: experimental itch intensity, numeric rating scale), and objective level (secondary end point: wheal size, mm2 ). Experimental-induced itch intensity decreased in all groups but at different rates (P < 0.001). The groups with the open administration, whether it was
dimetindene or placebo, had significantly stronger reductions in itch compared to the HIDDEN-
DRUG group (OPEN-
DRUG+INST+COND: P < 0.001; OPEN-DRUG+INST: P = 0.009; and
PLAC+INST+COND: P < 0.001). Additional
drug conditioning mediated via expectation led to a stronger reduction of
itching (P = 0.001). Results on wheal size were similar (P = 0.048), however, no significant difference between the HIDDEN-
DRUG group and the
PLAC+INST+COND group (P = 0.967) was found. We conclude that specifically generated targeted placebo effects can significantly increase the action of a
drug (
dimetindene) and should be used in clinical practice.