Do you know the difference between the nocebo effect and the placebo effect?  This interesting distinction is illustrated by “You Can’t Always Get What You Want: The Influence of Choice on Nocebo and Placebo Responding,” published in the June issue of the Annuals of Behavioral Medicine and discussed in a Wall Street Journal article, “Giving Patients’ Some Choice May Boost Drugs’ Effectiveness: side effects may be limited, too, study finds,” published on 7-11-16.

The study compared two groups, one offered their choice of two medications and the other which as assigned one of the medications.  Here is the kicker-  both “medications” were inert – placebos- but the choice group reported significantly better response and less side effects.  The group assigned to take a “medication” experienced the nocebo effect- negative responses to an inert “drug.”

mhconcierge’s take: When collaborating with prescribers, it is helpful to be aware of both the placebo effect and the nocebo effect, and to help respond to the bothersome nocebo effect.  Patients with negative expectations, including the experience of not having a choice about medication, are more likely to have a lack of benefit and more side effects, according the emerging body of research about the nocebo effect.

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