Nocebo Effect: Everything You Need To Know
The nocebo effect is a little-known concept that is used in medicine, psychology, and pharmacy. It could be defined as the opposite of the famous placebo effect. It consists of a person beginning to present the possible side effects that a treatment produces just because they believe they can occur.
The truth is that, at present, there are few studies that explain this mechanism. However, it is an important part to consider in any treatment. It shows that negative expectations of a therapy can cause adverse reactions.
For this reason, when establishing a treatment, or even when conducting clinical trials, it is essential to take into account both phenomena: the placebo and the nocebo effect. In this article we explain everything you need to know about the latter.
What is the nocebo effect?
When conducting a clinical trial to test the effectiveness of a drug, most of the time two groups of people are used. One group receives the real drug, the other a placebo. Placebo is a substance without pharmacological properties, that is, without real effects.
This is done to see what the real consequences of the drug are. This process is done without the patient knowing what they are taking. Hence the so-called placebo effect: a patient begins to show benefits only because of the expectations he has of that treatment.
However, the opposite can also happen. Sometimes patients who are receiving the placebo begin to express the possible side effects of the treatment, even though they are not taking any active drugs. This is the nocebo effect.
In other words, the nocebo effect consists in that someone suffers the negative effects of a therapy only because of the expectations they had. These effects are not caused by any active ingredient, but are psychogenic. It means that they have been induced by the brain.
What causes this effect?
The nocebo effect causes the patient to suffer real symptoms and signs. For example, nausea, sleep problems, itching, and even pain may appear. What is not known is what factors definitively influence this to occur, nor is it known who are the most susceptible individuals.
A study in the journal Science points out that the price of the treatment is associated with the development of the nocebo effect and the placebo. In the same way, it seems that the dissemination of information about possible reactions is closely related to both.
What differences and similarities do the nocebo and placebo effect have?
Although, as we have mentioned, research on the nocebo effect is still scarce, there are certain characteristics that are known. For example, both effects are known to occur in the same brain areas. Similarly, they seem to have some genetic influence.
In addition, the expectations that the patient has about the drug are decisive. The truth is that for them to occur it is not strictly necessary that there is a drug, but that other types of therapies can also cause them.
Neither the nocebo effect nor the placebo are related to the action of any substance, but are derived from a psychological mechanism. What differentiates them is that the placebo is very beneficial for any therapy, while the nocebo is the opposite.
A percentage of people have been seen to drop out of clinical trials due to this nocebo effect. For this reason, it would be ideal if more investigations were launched in this regard.
The nocebo effect in clinical practice
It is clear that the nocebo effect must be taken into account before any treatment, since there are certain measures, such as giving adequate information to the patient, that can totally change their perspective and the development of this mechanism. This can alter adherence and adherence to therapy.
On the other hand, there is a responsibility of patients to adhere to official and reliable information about their drugs. Internet searches on untrusted sites contribute to psychogenic adverse reactions.
