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...Pain study, which was led by Italian neuroscientist Martina Amanzio, reviewed 73 clinical trials conducted between 1988 and 2007. All the previously published trials pitted potential antimigraine medications against sugar pills. The medications included nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen (Advil); triptans, which include Imitrex; and anticonvulsant drugs like Topamax. Those three categories of drugs carry different adverse effects: NSAIDs, for instance, often cause stomach problems; anticonvulsants can cause paresthesia (tingling) and memory impairment. Interestingly, patients who took sugar pills tended to report nocebo problems consistent with whatever drug they thought they might have swallowed...

Author: /time Magazine | Title: The Flip Side of Placebos: The Nocebo Effect | 10/13/2009 | See Source »

...work in clinical trials, it is the sugar pill, along with its close cousin, the sham treatment. The placebo, as such inert and cost-free remedies are known, can relieve depression as effectively as Prozac, ease discomfort as effectively as acupuncture, and reduce as much disability and back pain as a widely used vertebral surgery that costs...

Author: /time Magazine | Title: The Flip Side of Placebos: The Nocebo Effect | 10/13/2009 | See Source »

...been known, but the mechanism behind them is still largely a scientific mystery. The standard explanation is that we are just fooling ourselves. In Latin, placebo means "I shall please," which suggests that the placebo effect is just a fleeting mind trick - that the mere suggestion of pharmacologically induced pain relief humors the body into temporary recovery. In trials, every drug response is in fact assumed to be at least partially due to the placebo effect. But the confounding thing about the benefits of the placebo is that the effect is often not beneficial...

Author: /time Magazine | Title: The Flip Side of Placebos: The Nocebo Effect | 10/13/2009 | See Source »

...nocebo effect. (The term nocebo is also from Latin, this time from the infinitive nocere, "to do harm.") A nocebo response occurs when the suggestion of a negative effect of an intervention leads to an actual negative outcome. When doctors tell patients that a medical procedure will be extremely painful, for example, they tend to experience significantly more pain than patients who weren't similarly warned. And in double-blind clinical trials of antidepressants, even those participants receiving a sugar pill report side effects like gastrointestinal discomfort if investigators have warned them at the outset that those effects are likely...

Author: /time Magazine | Title: The Flip Side of Placebos: The Nocebo Effect | 10/13/2009 | See Source »

...possible that the nocebo response is easily explained: in the antidepressant trials, maybe some patients - given that they already tended toward depression and anxiety - worried so much about the doctor's cautions that their stomach released enough acids to cause pain. That would make sense except that the range of possible nocebo responses stretches far beyond stomachache (in extreme cases, ailing patients who are mistakenly informed that they have only a few months to live will die within their given time frame, even though postmortem investigations show that there was no physiological explanation for early death). In a new paper...

Author: /time Magazine | Title: The Flip Side of Placebos: The Nocebo Effect | 10/13/2009 | See Source »

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