Increasing and dampening the nocebo response following medicine-taking: A randomised controlled trial

• Published in: Journal of psychosomatic research Vol. 150; p. 110630
• Main Authors: MacKrill, Kate, Morrison, Zara, Petrie, Keith J.
• Format: Journal Article
• Language: English
• Published: London Elsevier Inc 01.11.2021; Elsevier Science Ltd
• Subjects: Between-subjects design; Cognition; Control groups; Drugs; Lamotrigine; Media; Media coverage; Medicine; Medicine information; News; Nocebo effect; Nocebo-explanation; Nocebos; Placebo effect; Placebos; Psychiatric/Mental Health; Side effects; Media; Nocebo effect; Medicine information; Side effects; Nocebo-explanation
• ISSN: 0022-3999; 1879-1360; 1879-1360
• DOI: 10.1016/j.jpsychores.2021.110630

The nocebo effect is the adverse effects of treatment that cannot be attributed to a medicine. We investigated if we could increase or decrease nocebo responding following medicine taking. A nocebo explanation to reduce side effects was compared with a negative medication news item designed to increase side effects and a control condition. 108 healthy participants enrolled in a between-subjects study purportedly testing the effect of lamotrigine (actually placebo) on mood and cognition. Participants were randomised to watch either a video explaining the nocebo effect; a negative media item on lamotrigine, or control video prior to receiving the tablet. Side effects were assessed at 45-min and 48-h. The negative media group reported significantly more side effects (M = 0.78, SD = 1.53) than the control group (M = 0.46, SD = 1.80, p = .035) at the end of session and a greater proportion of the negative media group (33%) reported at least one side effect compared to the nocebo explanation (11%) and control group (11%, p = .020). The nocebo explanation group reported significantly fewer side effects (M = 0.38, SD = 1.16) than the control group (M = 1.37, SD = 2.98, p = .038) at the 48-h follow-up. Explaining the nocebo effect may be a beneficial addition to standard medicine information for reducing side effect reporting. Negative media coverage about a drug is likely to generate increased side effects. Future research should examine the benefit of nocebo explanation in patients starting new medicines. •The nocebo effect has a significant influence on drug side effect reporting.•This study showed the nocebo response could be manipulated after taking medicine.•Explaining the nocebo effect provides reassurance and can reduce side effects.•A brief nocebo explanation may be a beneficial addition to medicine information.