Nocebo Effect
The phenomenon in which negative expectations about a treatment lead to worsening of symptoms or emergence of adverse effects, mediated by anticipatory anxiety and classical conditioning. Nocebo effects are clinically significant in drug therapy, contributing to non-adherence and treatment discontinuation. They are observed when patients are informed of potential side effects or switched from branded to generic medications.
示例
- Statin myalgia: significantly higher incidence in open-label vs. blinded statin studies (nocebo contribution)
- Generic drug switching: increased adverse event reports despite pharmacokinetic bioequivalence
- COVID-19 vaccine trials: 35% of placebo recipients reported systemic side effects (fatigue, headache)
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The phenomenon in which negative expectations about a treatment lead to worsening of symptoms or emergence of adverse effects, mediated by anticipatory anxiety and classical conditioning. Nocebo effects are clinically …