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CC BY-NC-ND 4.0 · Avicenna J Med 2017; 07(04): 139-143
DOI: 10.4103/ajm.AJM_59_17
REVIEW ARTICLE

Minimizing nocebo effect: Pragmatic approach

Majed Chamsi Pasha
Department of Medicine, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia
,
Mohammed Ali Albar
Department of Medical Ethics, International Medical Center, Jeddah, Saudi Arabia
,
Hassan Chamsi Pasha
Department of Cardiology, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia
› Author Affiliations Financial support and sponsorship Nil.
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Abstract

The nocebo effect, the inverse of the placebo effect, is a well-established phenomenon, yet under-appreciated. It refers to nonpharmacological, harmful, or undesirable effects occurring after active or inactive therapy. The frequency of adverse events can dramatically increase by informing patients about the possible side effects of the treatment, and by negative expectations on the part of the patient. Patients who were told that they might experience sexual side effects after treatment with β-blocker drugs reported these symptoms between three and four times more often than patients in a control group who were not informed about these symptoms. Nocebo effect has been reported in several neurological diseases such as migraine, epilepsy, multiple sclerosis, Parkinson's disease and neuropathic pain, and in patients with depression. The investigation of the biological and theoretical underpinning of the nocebo phenomenon is at an early stage, and more research is required. Physicians need to be aware of the influence of nocebo phenomenon and be able to recognize it and minimize its effects.

Keywords

Drugs - medical ethics - nocebo - placebo - treatment


Publication History

Article published online:
09 August 2021

© 2017. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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