Nonspecific medication side effects and the nocebo phenomenon.

By A. Barsky, Ralph Saintfort, M. Rogers, J. Borus. Journal of the American Medical Association (JAMA), 2002

777 citations recorded by the source corpus.

Patients taking active medications frequently experience adverse, nonspecific side effects that are not a direct result of the specific pharmacological action of the drug. Although this phenomenon is common, distressing, and costly, it is rarely studied and poorly understood. The nocebo phenomenon, in which placebos produce adverse side effects, offers some insight into nonspecific side effect reporting. We performed a focused review of the literature, which identified several factors that appear to be associated with the nocebo phenomenon and/or reporting of nonspecific side effects while taking active medication: the patient's expectations of adverse effects at the outset of treatment; a process of conditioning in which the patient learns from prior experiences to associate medication-taking with somatic symptoms; certain psychological characteristics such as anxiety, depression, and the tendency to somatize; and situational and contextual factors. Physicians and other health care personnel can attempt to ameliorate nonspecific side effects to active medications by identifying in advance those patients most at risk for developing them and by using a collaborative relationship with the patient to explain and help the patient to understand and tolerate these bothersome but nonharmful symptoms.

Subfields: Cognitive Neuroscience, Psychiatry and Mental health

View Paper: https://www.semanticscholar.org/paper/858d029465d6e13082f0078b37d480d70540b083

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Citations in the corpus

Patients presenting with somatic complaints: epidemiology, psychiatric co‐morbidity and management (2003, background): “Discontinuation rates may be higher because of a heightened sensitivity to somatic side effects – a ‘nocebo’ effect (Barsky et al., 2002) – as well a causal attribution that is somatic and rejects anything suggesting a psychological etiology (‘my symptoms are physical; they are not in my head’).”
Role of pharmacist counseling in preventing adverse drug events after hospitalization. (2006, background): “(%) Emergency department visit or readmission 28/92 (30) 25/84 (30) .”
Interpretation of the evidence for the efficacy and safety of statin therapy. (2016, background): “studies may be biased by differences in the reporting and detection of health outcomes between the patients who are taking it and those who are not.(139,145,146)”
A side effect resource to capture phenotypic effects of drugs (2010, background): “Those side effects are either associated with the underlying disease, or are a result of the nocebo effect: patients who expect certain side effects are more likely to experience these effects (Barsky et al , 2002).”
Neurobiological Mechanisms of the Placebo Effect (2005, background): “The mandates of informed consent actually require disclosure of the possible time course of likely change in target symptoms as well as the nature and scope of all potential side effects (Barsky et al., 2002), further prohibiting such a control group.”