Nocebo and Lessebo Effects

[Petr75]

2020
University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada; The Ottawa Hospital Research Institute, Ottawa, ON, Canada; Division of Neurology, Department of Medicine, The Ottawa Hospital
Nocebo and Lessebo Effects
https://pubmed.ncbi.nlm.nih.gov/32563285/

Abstract

The power of placebos is commonly associated with the placebo effect. In contrast, detrimental effects related to the use of a placebo are little studied and less well recognized. This chapter covers the nocebo and lessebo effects defined, respectively, as expectation of harm in the form of adverse events in a placebo arm and reduction of therapeutic benefit due to the uncertainty of being allocated to placebo. The lessebo effect is a more recent concept and has been described only in depression, schizophrenia and Parkinson's disease. The nocebo response was evaluated in many neurological diseases, including epilepsy, multiple sclerosis, Parkinson's disease, Alzheimer's disease, restless leg syndrome, among others. Meta-analyses of randomized controlled trials in these conditions reveal a significant variability of the magnitude of the nocebo response and that factors related to study design, study participants or neurological disease can be associated with a nocebo response, although with the opposing findings across conditions. The knowledge about neurobiological mechanisms of the nocebo effect is poor for neurological diseases, and most of the information has been generated in pain. Functional neuroimaging suggests the existence of a distinct network for the anticipation and the experience of a hyperalgesia nocebo response. Different types of neurotransmitters have been involved, including cholecystokinin, dopamine and opioids. Recognizing the potential impact of nocebo and lessebo effects, mitigating strategies are in development with application to clinical research and clinical practice, such as a contextualized informed consent process, alternative study designs and enhancement of patient-physician communication.

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2020
Maximizing Placebo Response in Neurological Clinical Practice
https://pubmed.ncbi.nlm.nih.gov/32563294/

[NHE]

2020
University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada; The Ottawa Hospital Research Institute, Ottawa, ON, Canada; Division of Neurology, Department of Medicine, The Ottawa Hospital
Nocebo and Lessebo Effects
https://pubmed.ncbi.nlm.nih.gov/32563285/

https://fastereft.com/blog/fastereft-ex ... bo-effect/

The Nocebo Effect

The opposite to the placebo effect, the nocebo effect causes the patient to experience symptoms that have no connection to the treatment. For example, a patient given a harmless substance, but told that it can cause side-effects may experience the side-effects even though the information was false. The nocebo effect is the mind’s great ability to produce symptoms without any physical cause.

The Lessebo Effect

The lessebo effect occurs when patients believe that they are receiving the placebo instead of the real treatment; and their negative expectations lead to the failure of the real treatment. In other words, although they have received the real treatment, they believe they’ve received the placebo, and this belief results in the treatment not working for them, while it works in a control group.

This shows that the mind can cause both negative and positive effects on the body – regardless of whether or not the medical treatment is real or not.