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Nocebo in headache.
Curr Opin Neurol. 2016 06; 29(3):331-6.CO

Abstract

PURPOSE OF REVIEW

This article addresses nocebo in headache. Nocebo is the antipode of placebo and refers to adverse events a person manifests after receiving placebo.

RECENT FINDINGS

In randomized trials for migraine prevention meta-analyses revealed that eight out of 20 patients treated with placebo experienced any adverse event. More importantly, one out of 20 patients treated with placebo withdrew treatment because of adverse events. The adverse events in placebo groups mirrored the adverse events expected of the active medication studied, confirming that pretrial suggestions induce the adverse events in placebo-treated patients. Nocebo was higher in preventive treatments than in symptomatic ones. Among preventive migraine treatments botulin toxin A showed the lowest nocebo. Generally, the safer a drug was the less nocebo was induced. Nocebo was similar in trials for tension-type headache. To predict and prevent nocebo consequences a 4-item self-fulfilled questionnaire (Q-No) has been developed, with 72% specificity and 67% sensitivity.

SUMMARY

Although nocebo remains largely unknown in the medical community, it limits adherence and treatment outcomes significantly in preventive treatments for migraine and tension-type headache. The Q-No questionnaire may help in predicting nocebo, whereas individualized strategies are needed to prevent nocebo consequences.

Authors+Show Affiliations

Department of Neurology, Athens Naval Hospital, Athens, Greece.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

26926672

Citation

Mitsikostas, Dimos D.. "Nocebo in Headache." Current Opinion in Neurology, vol. 29, no. 3, 2016, pp. 331-6.
Mitsikostas DD. Nocebo in headache. Curr Opin Neurol. 2016;29(3):331-6.
Mitsikostas, D. D. (2016). Nocebo in headache. Current Opinion in Neurology, 29(3), 331-6. https://doi.org/10.1097/WCO.0000000000000313
Mitsikostas DD. Nocebo in Headache. Curr Opin Neurol. 2016;29(3):331-6. PubMed PMID: 26926672.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nocebo in headache. A1 - Mitsikostas,Dimos D, PY - 2016/3/2/entrez PY - 2016/3/2/pubmed PY - 2018/1/10/medline SP - 331 EP - 6 JF - Current opinion in neurology JO - Curr. Opin. Neurol. VL - 29 IS - 3 N2 - PURPOSE OF REVIEW: This article addresses nocebo in headache. Nocebo is the antipode of placebo and refers to adverse events a person manifests after receiving placebo. RECENT FINDINGS: In randomized trials for migraine prevention meta-analyses revealed that eight out of 20 patients treated with placebo experienced any adverse event. More importantly, one out of 20 patients treated with placebo withdrew treatment because of adverse events. The adverse events in placebo groups mirrored the adverse events expected of the active medication studied, confirming that pretrial suggestions induce the adverse events in placebo-treated patients. Nocebo was higher in preventive treatments than in symptomatic ones. Among preventive migraine treatments botulin toxin A showed the lowest nocebo. Generally, the safer a drug was the less nocebo was induced. Nocebo was similar in trials for tension-type headache. To predict and prevent nocebo consequences a 4-item self-fulfilled questionnaire (Q-No) has been developed, with 72% specificity and 67% sensitivity. SUMMARY: Although nocebo remains largely unknown in the medical community, it limits adherence and treatment outcomes significantly in preventive treatments for migraine and tension-type headache. The Q-No questionnaire may help in predicting nocebo, whereas individualized strategies are needed to prevent nocebo consequences. SN - 1473-6551 UR - https://www.unboundmedicine.com/medline/citation/26926672/Nocebo_in_headache_ L2 - http://dx.doi.org/10.1097/WCO.0000000000000313 DB - PRIME DP - Unbound Medicine ER -