After patients have experienced numerous treatment failures, they often exhibit a decrease in placebo response rate. This phenomenon is termed placebo sag and is frequently seen in chronic pain patients who have failed numerous therapies. Conversely, in patients who have had treatment successes, the placebo effect may be enhanced with further intervention. Over time, the placebo sag often proves particularly problematic in chronic pain patients because the overall effect of therapeutic medicines declines when the non-specific placebo component of the therapy inevitably sags.

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