Placebo vs “Nocebo”: Deal or No Deal?


Harnessing the placebo effect: the need for translational research

Luana Colloca and Franklin G. Miller
Philos Trans R Soc Lond B Biol Sci
2011 Jun 27;366(1572):1922-30
PubMed Central: PMC3130404

Researchers from the US National Center for Complementary and Alternative Medicine and National Institutes of Health provide guidance for research to guide clinicians in applying new knowledge about the placebo effect. Considering that “effects following the administration of a placebo can be due to the general psychosocial context around the therapy,” the authors review contemporary placebo and “nocebo” theories along with best evidence and clinician attitudes and patient behaviors toward placebos, and proposals to bridge the gap between mechanism-based research and clinical practice.

The article would have been even more useful if the authors had provided a clear definition of nocebo up front, beyond “placebo adverse effects” and “opposite expectations and outcomes [compared to placebo effect]”. The definition on Wikipedia is a marvel of internal contradiction: “In medicine, a nocebo (Latin for “I shall harm”) is a harmless substance that creates harmful effects in a patient who takes it.”

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