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REVIEW ARTICLE
Year : 2017  |  Volume : 7  |  Issue : 4  |  Page : 139-143

Minimizing nocebo effect: Pragmatic approach


1 Department of Medicine, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia
2 Department of Medical Ethics, International Medical Center, Jeddah, Saudi Arabia
3 Department of Cardiology, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia

Correspondence Address:
Majed Chamsi-Pasha
Department of Medicine, King Fahd Armed Forces Hospital, P. O. Box: 9862, Jeddah 21159
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ajm.AJM_59_17

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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.


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