Foreword by Prof. Wolfgang GrisoldPlacebo and recently the term nocebo are often used in situations where uncertain effects, possibly the effect of the mind works, and have been often disregarded as scientifical activities. All of us working with patients are implicitly using the concept of placebo, and sometimes the negative prediction, the nocebo. As members of the health profession, we are part of placebo effect, and investigations have shown that also in regular approved and effective drugs a percentage of placebo effect can be calculated. The awareness of these important effects are important. The perception of placebo effect can in several instances be blocked or denied by cultural practices, and for neurology, it is important to spread and enhance the global perception. |
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Fabrizio Benedetti,
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Toward a pharmacology and toxicology of words.
Fabrizio Benedetti, MD, MAE
Modern medicine and neurology have progressed in parallel with the advancement of biochemistry, anatomy, and physiology. By using the tools of modern medicine and neurology, today the physician and the neurologist can treat and prevent a number of diseases through pharmacology, genetics, and physical interventions, including surgery. In addition to this materia medica, the patient’s mind, cognitions and emotions play a central part as well in any therapeutic outcome. Placebo effects are at the very heart of these issues and, maybe paradoxically, they can be approached by using the same biochemical, cellular, and physiological tools of the materia medica, which represents an epochal transition from general concepts such as suggestibility and power of mind to a true physiology and biology.
Placebo effects remind us of the old tenet that patients must be both cured and cared for, and they teach us that these complex issues can today be investigated by using a physiological and neuroscientific approach. The intricate psychological factors involved can be approached through biochemistry, anatomy, and physiology, thus eliminating the old dichotomy between biology and psychology. This is both a biomedical and a philosophical enterprise that is changing the way we approach and interpret medicine, neurology, and human biology.
In the first case, curing the disease only is not sufficient, and care of the patient is of tantamount importance. In the second case, the philosophical debate about the mind-body interaction can find some important answers.
Fabrizio Benedetti, MD, is professor of neurophysiology at the University of Turin Medical School, Turin, Italy, and professor of medicine, physiology, and neuroscience for the Innovative Clinical Training, Trials and Healthcare Initiative (ICTHI), Zermatt, Switzerland. He has been nominated member of The Academy of Europe and of the European Dana Alliance for the Brain. He is author of the book Placebo Effects (Oxford University Press, 3rd Edition, 2020), which received the Medical Book Award of the British Medical Association in 2009. In 2012, he received the Seymour Solomon Award of the American Headache Society, in 2015 the William S. Kroger Award of Behavioral Medicine from the American Society of Clinical Hypnosis, in 2023 the Lifetime Achievement Award by the Society for Interdisciplinary Placebo Studies.
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World Neurology | Jan-Feb 2024, Volume 39, No. 1
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