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Cited by 784Pain Management and Placebo EffectPsychosomatic Disorders and Their TreatmentsPharmacovigilance and Adverse Drug Reactions

The DOI matches its Crossref record; 69 of the 69 references it cites were found in a registry or an index.

Nonspecific Medication Side Effects and the Nocebo Phenomenon

Open access
Barsky, Arthur J.·2002·JAMA
DOI 10.1001/jama.287.5.622
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Abstract

Patients taking active medications frequently experience adverse, nonspecific side effects that are not a direct result of the specific pharmacological action of the drug. Although this phenomenon is common, distressing, and costly, it is rarely studied and poorly understood. The nocebo phenomenon, in which placebos produce adverse side effects, offers some insight into nonspecific side effect reporting. We performed a focused review of the literature, which identified several factors that appear to be associated with the nocebo phenomenon and/or reporting of nonspecific side effects while taking active medication: the patient's expectations of adverse effects at the outset of treatment; a process of conditioning in which the patient learns from prior experiences to associate medication-taking with somatic symptoms; certain psychological characteristics such as anxiety, depression, and the tendency to somatize; and situational and contextual factors. Physicians and other health care personnel can attempt to ameliorate nonspecific side effects to active medications by identifying in advance those patients most at risk for developing them and by using a collaborative relationship with the patient to explain and help the patient to understand and tolerate these bothersome but nonharmful symptoms.

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Crossref · 10.1001/jama.287.5.622

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Metadata

Authors
Barsky, A. J.
Affiliations
Brigham and Women's Hospital (US)
Corresponding author
Barsky, Arthur J.
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2002-02-06
Volume
287
Issue
5
Pages
622
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.287.5.622
OpenAlex
W2030711540
Cited by
784
References
69
Citations by year
2026: 19 · 2025: 36 · 2024: 23 · 2023: 34 · 2022: 54 · 2021: 49 · 2020: 47 · 2019: 53 · 2018: 45 · 2017: 42 · 2016: 39 · 2015: 33 · 2014: 31 · 2013: 27 · 2012: 31
FWCI
12.69
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
Keywords
nocebo effect, adverse drug reactions, placebo effect, patient expectations, conditioning, anxiety, depression, somatization, patient-physician communication, risk factors
MeSH terms
Attitude to Health, Drug Therapy, Humans, Negativism, Placebos, Risk Factors, Effect Modifier, Epidemiologic, Placebo Effect, Drug-Related Side Effects and Adverse Reactions

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