Chamsi-Pasha Majed, Albar Mohammed Ali, Chamsi-Pasha Hassan
Department of Medicine, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia.
Department of Medical Ethics, International Medical Center, Jeddah, Saudi Arabia.
Avicenna J Med. 2017 Oct-Dec;7(4):139-143. doi: 10.4103/ajm.AJM_59_17.
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.
反安慰剂效应是安慰剂效应的对立面，是一种已被充分证实但却未得到充分重视的现象。它指的是在进行主动或非主动治疗后出现的非药理学的、有害的或不良的效应。告知患者治疗可能产生的副作用以及患者的负面预期会显著增加不良事件的发生率。被告知使用β受体阻滞剂药物治疗后可能出现性副作用的患者报告这些症状的频率比未被告知这些症状的对照组患者高出三到四倍。在偏头痛、癫痫、多发性硬化症、帕金森病和神经性疼痛等几种神经系统疾病以及抑郁症患者中都报告过反安慰剂效应。对反安慰剂现象的生物学和理论基础的研究尚处于早期阶段，需要更多的研究。医生需要意识到反安慰剂现象的影响，并能够识别它并将其影响降至最低。
