In the footsteps of the Nobel Laureate

Nobel Prize in Medicine in 2008 It was received by Dan Arieli, who gave two groups of volunteers the same placebo. He told the first group that he was giving them an analgesic at a price of $ 2.5 per tablet, and the second – at 10 cents. Of course, the first one worked better.

Now the same work was repeated exactly the opposite, showing that the drug, which patients consider more expensive, enhances the manifestation of the nocebo effect – imaginary hyperalgesia.

The strength of side effects was associated with the price of drugs

Natalia Pelezneva, Naked Science

Researchers from Germany concluded that patients experience more intense side effects if they believe they are taking a more expensive drug. Scientists associate this phenomenon with the nocebo effect – the "reverse side" of the placebo effect. Nocebo drugs do not have a real pharmacological effect, but cause a negative reaction in the patient.

It is known that the more expensive a patient considers a dummy medicine, the more pronounced the positive effect of placebo on the body. A new study has shown that the opposite is also true.

Article by Tinnermann et al. Interactions between brain and spinal cord mediate value effects in nocebo hyperalgesia is published in the journal Science.

49 people took part in the work. They believed that they were testing a cream that softens the manifestations of atopic dermatitis: itching and peeling of the skin. The participants were divided into two groups of 24 and 25 people, respectively. For the experiment, we developed the design of two packages: "cheap" orange and "expensive" blue. The design was chosen taking into account the opinions of a focus group of 66 people. Then a "cheap" cream was applied to the forearm of each participant from the first group, and the second group received an "expensive" one. Also, all participants were given a portion of a "neutral" cream on their hands, with which they had to compare the result. In fact, the same cream containing no active substances was put in all three types of packages.

People were told that the ointment increases sensitivity to pain. This common side effect of drugs is called "hyperalgesia". To check the sensitivity level, the participants' hands were exposed to "flashes" of relatively high temperature (up to 45 °C). Those who received the "expensive" drug, on average, estimated the level of sensitivity to pain significantly higher. Also, the pain from the effects of the "expensive" cream noticeably increased during the procedure, and the effect of the "cheap" cream was felt almost the same all the time.

Drawing from an article in Science

During the tests, the scientists conducted an fMRI examination of the participants. It confirmed the difference in perception. Researchers associate this phenomenon with the activity of some areas of the prefrontal cortex, as well as the central gray matter (Periaqueductal gray).

Scientists hope that the results of the study will help reduce the level of manifestations of the nocebo effect in patients.

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