In another page, we have explained the placebo effect. The nocebo effect is the negative version of the placebo effect. Placebo comes form the latin word «to please». Nocebo comes from the latin word «to harm».

The nocebo effect involves symptoms that are generated by the brain based on expectations related to a treatment. Symptoms may appear even with a sugar pill. Patients may complain of dizziness, nausea, malaise, fatigue and yes….headache! The nocebo effect may explain why some patients do not tolerate any drug, even with very small doses. Negative expectation may trigger anxiety, and symptoms may appear. Each new experience with a drug may strengthen those expectations, making the nocebo effect stronger.

Different factors may modulate expectations regarding drugs. For example, many patients have negative feelings regarding generics. It may be true that in certain individuals generics are not as good as original drugs….but for other people, the nocebo effect may be at play.

It is not always easy to distinguish true side effects from a nocebo effect, but it is important to be aware of this phenomenon. Enduring side effects for a little while during a drug trial may be the first step to success. Side effects may abate after a few days.

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