Take your health into your own hands

Take your health into your own hands

Take your health into your own hands

Placebo effect and Nocebo, the power of the mind

medications-257336_1280

Placebo effect and its opposite nocebo

The oldest and most spectacular episode of alternation, in the same person, of a placebo effect and its opposite nocebo, published in the scientific literature, is the one described in 1957 by Bruno Klopfer, a German psychologist. A gentleman named Wrigth, suffering from advanced-stage cancer, asked his attending physician to be treated with an experimental drug. After a single injection, “the tumor melted away like a snowball on a hot stove,” the doctor wrote in the medical record. A short time later, Mr. Wright, now recovered, casually read an article that discussed the ineffectiveness of that drug in tumors. Wright worsened within a few days. On examination he presented metastases. At that point the doctor injected the patient with water, telling him that he had received a new version of the drug that was effective this time. The metastases disappeared!

We do not know how Herr Wright’s story turned out, but we do know that in the last fifty years more than a hundred clinical and experimental papers have been published to try to understand what is incontrovertible: the occurrence of positive or negative effects in the physiology of a person who has been given fresh water believing it to be a drug, or who has been the subject of good or bad words. Martina Amanzio, of the Turin School of Psychology, and Fabrizio Benedetti, also from Turin, Italy, and an international authority on placebos, reviewing studies that have tested anti-hemicrania drugs, recorded that in the placebo group the frequency of adverse effects is high, which is not supposed to happen with taking inert pills; but the most intriguing part of the story is that the adverse effects are the same as with the drug tested. And that is, in studies that tested anticonvulsant drugs, the placebo group showed anorexia and memory impairment, the typical adverse effects of anticonvulsants. Thus, in studies that tested nonsteroidal anti-inflammatory drugs (the NSAIDs), the prevalent adverse effects were nausea and gastrointestinal complaints, which are typical of these drugs.

The explanation for this phenomenon lies in the expectations of people, who were (correctly) informed about the possible side effects of drugs: information and ‘expectation produced the peculiarity of the symptoms. But it is not just a matter of expectation. The first animal study to show the influence of a placebo on the immune system was that of Robert Ader, a pioneer in psychoneuroendocrinoimmunology: in 1975 he showed that rats conditioned by taking saccharin combined with a potent immunosuppressant (cyclophosphamide), even when receiving only saccharin manifested signs of immunosuppression. Thus, there are forms of conditioning that do not reach consciousness and still produce effects. This is also why there is interest in possible clinical use of the placebo effect. Benedetti showed that it is possible to produce a positive placebo effect in Parkinson’s patients by prolonging the effects of drugs with placebo pills, or in sportsmen by prolonging, by the same means, the effects of a narcotic drug. But what happens in our brain? The application of neuroimaging techniques has demonstrated the existence of a dual pathway: one for placebo and the other for nocebo. The former activates the so-called reward and pleasure circuit, the latter the anxiety circuit. The former relies on dopamine and opioid activity, the latter on cholecystokinin activity.

Expectancy reduces pain

It has been documented for a number of years that expectation-and thus the value the subject places on an impending painful event-conditions the level of intensity with which it is perceived.
For example, if a source of heat is applied to the same subject that is reported to be of a lower degree than previously applied, this expectation reduces the activation of brain areas involved in the reception and decoding of pain, and thus, although the subject has received an intense painful stimulus (50 C° heat in one hand), he or she perceives it as less intense, or, rather, as intense, as he or she expected it to be (48 C°).

By Francesco Bottaccioli

FEATURED SPECIALISTS

  • Profile picture of Dr. Antonio Varriale
    active 4 years, 7 months ago

    Aesthetic Doctors, Dentists, Basic Doctors

    • Via Grotta dell Olmo 20 - Giugliano in Campania
    phone
  • Profile picture of Dott.ssa Emanuela Costantino
    active 4 years, 7 months ago

    • Via Gallinara 2/B - Cagliari
    phone
  • Profile picture of Dott. Franco Cicerchia
    active 4 years, 7 months ago

    Ophthalmologists, Acupuncturists, Basic Doctors

    • Via Alcide de Gasperi 39 - Palestrina
    phone
  • Profile picture of Dott.ssa Francesca Vittorelli
    active 4 years, 7 months ago

    Therapist, Acupuncturists, Basic Doctors

    • Corso Andrea Palladio 134 - Vicenza
    phone
  • Profile picture of Dott.ssa Izabella Sylwia Bartosiewicz
    active 4 years, 7 months ago

    Basic Doctors, Rheumatologists

    phone

RELATED ARTICLES

Separated parents and the holiday season

The Christmas vacation season, with the array of decorations and advertising icons and all the rhetoric of family and good feelings that accompany them, can prove at times and for some a kind of emotional "trap."

Too much Caffeine?

Taken in small doses it improves concentration, while if taken in excessive doses it causes heart rate, raises blood pressure levels and induces a state of nervousness.

Holidays, Melancholy and Covid

We have said it, read it, and are experiencing it on our own skin: this year's Christmas and New Year's holidays will be different than usual because of the pandemic.

Anger, sometimes a bad counselor

How do you feel when someone insults you, verbally attacks you, or looks at you with eyes full of disapproval, contempt? When you feel threatened, judged, unappreciated and unloved? An

Holidays and Melancholy

Christmas Blues is called that state of unease, characterized by depression, anxiety, impatience, stress, insomnia, and physical and mental fatigue that accompanies the holiday season.

Let’s read aloud together

Reading aloud to a child, even a very young one, accompanying him to discover the magic of the book, the pictures, the sounds is a gift, a gift we give

Narrative medicine (preview)

Nowadays very often physicians identify patients no longer by their actual name, but by the room number in which they reside and perhaps the condition from which they suffer. It

RELATED PATHOLOGIES

Anorexia

Anorexia nervosa is an eating disorder that causes the sufferer to voluntarily deprive himself or herself of food or to consume extremely limited amounts of food that are not compatible

Bruxism

Bruxism is a condition in which you grind your teeth: it can happen, unconsciously, in a waking state or, more often, during sleep. People who clench or grind their teeth

Bulimia nervosa

Bulimia nervosa is a more widespread eating disorder than is generally believed and widely underdiagnosed, especially in its mild forms, which can go unnoticed unless those affected seek medical/psychiatric help

Parkinson’s disease

Parkinson’s disease is an aging-related neurodegenerative disorder of the central nervous system, affecting about 2.5% of people over 70 years of age, which is mainly characterized by resting tremor in

Ischemic stroke

According to the official definition of the World Health Organization (WHO), stroke corresponds to a “sudden onset of signs and/or symptoms referable to local and/or global deficits in brain function,

Senile vascular dementia

Senile vascular dementia corresponds to a process of cognitive decline that goes beyond the physiological reduction in intellectual capacity associated with aging. In most cases, vascular dementia is related to

Alzheimer’s disease

Alzheimer’s disease is the most common and severe degenerative disease of the brain, characterized by a progressive decline in cognitive functions (in particular, memory and language) associated with aging. It

Bipolar disorder

Bipolar disorder is a complex and delicate mood disorder to manage that leads sufferers to experience periods of depressed mood, characterized by symptoms similar to those of major depression, alternating

Head trauma

A head injury, also called “concussion” in medical terms, consists of the violent collision of the head against a hard surface or, conversely, of a blunt object against the cranial

Anorgasmia

Anorgasmia is the syndrome by which we refer to the difficulty in having orgasms even after normal sexual stimulation. The intensity and frequency of orgasms in women are variables that

FEATURED SPECIALISTS

  • Profile picture of Dr. Lorenzo Cerreoni
    active 4 years, 7 months ago

    Aesthetic Doctors, Basic Doctors

    • Via Macero Sauli 52 - Forlì
    phone
  • Profile picture of Dott.ssa Cinzia Maria Zurra
    active 4 years, 7 months ago

    Basic Doctors, Aesthetic Doctors, Nutritionists

    • Viale Rimembranze 5 - Triuggio
    phone
  • Profile picture of Dott.ssa Monica Calcagni
    active 4 years, 7 months ago

    Gynecologists, Aesthetic Doctors, Basic Doctors

    • Via Casilina 32 - Arce
    phone
  • Profile picture of Dr. Giuseppe Lepore
    active 4 years, 7 months ago

    Dermatologists, Basic Doctors, General Surgeons

    • 19 Via Manzoni Alessandro - Garbagnate Milanese
    phone
  • Profile picture of Studio Medico San Pellegrino
    active 4 years, 4 months ago

    Sports Doctors, Basic Doctors

    Spread the word!

    Recommend this special

    doctor to a friend

    message phone house
    visit
    video
    consulting
    WhatsApp conferences
    and webinars
NUTRITION AND DIET
 
NATURE, SPORTS, PLACES
 
CULTIVATING HEALTH
 
MENOPAUSE
 
MOM IN SHAPE
 
TRADITIONAL CHINESE MEDICINE
 
HEART SURGERY
 
MEDICINES AND MEDICAL DEVICES
 
PARENTING
 
THE CULTURE OF HEALTH
 
HEALTH UTILITIES
 
GENERAL MEDICINE
 
NATURAL MEDICINE, THERMAL
 
MIND AND BRAIN
 
NEUROVEGETATIVE DYSTONIA
 
WAYS OF BEING
 
HEALTH AND SOCIETY
 
HEALTHCARE AND PATIENTS
 
SEXUALITY
 
OLDER AGE
 
CANCERS
 
EMERGENCIES
 
NUTRITION AND DIET
 
NATURE, SPORTS, PLACES
 
CULTIVATING HEALTH
 
MENOPAUSE
 
MOM IN SHAPE
 
TRADITIONAL CHINESE MEDICINE
 
HEART SURGERY
 
MEDICINES AND MEDICAL DEVICES
 
PARENTING
 
THE CULTURE OF HEALTH
 
HEALTH UTILITIES
 
GENERAL MEDICINE
 
NATURAL MEDICINE, THERMAL
 
MIND AND BRAIN
 
NEUROVEGETATIVE DYSTONIA
 
WAYS OF BEING
 
HEALTH AND SOCIETY
 
HEALTHCARE AND PATIENTS
 
SEXUALITY
 
OLDER AGE
 
CANCERS
 
EMERGENCIES
 
DIGESTIVE SYSTEM
 
RESPIRATORY SYSTEM
 
UROGENITAL SYSTEM
 
HEART AND CIRCULATION
 
SKIN
 
INFECTIOUS DISEASES
 
EYES
 
EARS, NOSE, AND THROAT
 
BONES AND LIGAMENTS
 
ENDOCRINE SYSTEM
 
NERVOUS SYSTEM
 
DIGESTIVE SYSTEM
 
RESPIRATORY SYSTEM
 
UROGENITAL SYSTEM
 
HEART AND CIRCULATION
 
SKIN
 
INFECTIOUS DISEASES
 
EYES
 
EARS, NOSE, AND THROAT
 
BONES AND LIGAMENTS
 
ENDOCRINE SYSTEM
 
NERVOUS SYSTEM
 

your advertising
exclusively ON
MY SPECIAL DOCTOR

complete the form and you will be contacted by one of our managers