AccScience Publishing / JCBP / Online First / DOI: 10.36922/JCBP025360069
PERSPECTIVE ARTICLE

Complementary action of nocebo and placebo effects

Claude F. Touzet1*
Show Less
1 Department of Neuroscience, Faculty of Biology, Aix Marseille University, Marseille, France
Received: 4 September 2025 | Revised: 15 November 2025 | Accepted: 8 December 2025 | Published online: 23 December 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

The placebo effect exists and is accounted for by regulatory agencies, which require new medications to demonstrate efficacy beyond a placebo. The person-dependent nature of the placebo effect has made it challenging for practitioners trained solely in allopathic medicine—often focused on the suppression of symptoms without accounting for the uniqueness of patients—to fully grasp its significance. Advances in cognitive science have shed light on how memories are stored and how they interact with an individual’s interpretation of the world situation, effectively generating the placebo effect as a byproduct of this processing. Neuroscience further reveals how cortical maps involved in cognition interact with lower-level neural networks responsible for homeostatic regulatory loops, enabling an “idea” to produce physiological changes. In the context of optimization theory, the placebo effect can be understood as a straightforward hill-climbing strategy. Conversely, the nocebo effect is just the opposite strategy. However, both effects can be harnessed therapeutically to promote positive outcomes. Although this may seem counterintuitive regarding the nocebo effect, it can nevertheless prove valuable, particularly for patients who do not respond to a placebo.

Keywords
Placebo
Nocebo
Homeostasis
Artificial neural networks
Optimization tool
Funding
None.
Conflict of interest
The author declares no conflict of interest.
References
  1. Häuser W, Hansen E, Enck P. Nocebo phenomena in medicine: Their relevance in everyday clinical practice. Dtsch Arztebl Int. 2012;109(26):459-465. doi: 10.3238/arztebl.2012.0459

 

  1. Colloca L, Barsky AJ. Placebo and nocebo effects. N Engl J Med. 2020;382(6):554-561. doi: 10.1056/nejmra1907805

 

  1. Kroenke K. A practical and evidence-based approach to common symptoms: A narrative review. Ann Intern Med. 2014;161(8):579-586. doi: 10.7326/M14-0461

 

  1. Berne RM, Levy MN. Physiology. 6th ed. United States: Mosby; 2004.

 

  1. Modell H, Cliff W, Michael J, McFarland J, Wenderoth MP, Wright A. A physiologist’s view of homeostasis. Adv Physiol Educ. 2015;39(4):259-266. doi: 10.1152/advan.00107.2015

 

  1. Cannon WB. Organization for physiological homeostasis. Physiol Rev. 1929;9(3):399-431. doi: 10.1152/physrev.1929.9.3.399

 

  1. Cannon WB. The Wisdom of the Body. New York: W.W. Norton and Company; 1932.

 

  1. Morrison SF, Nakamura K. Central mechanisms for thermoregulation. Annu Rev Physiol. 2019;81:285-308. doi: 10.1146/annurev-physiol-020518-114546

 

  1. Zimmerman CA, Leib DE, Knight ZA. Neural circuits underlying thirst and fluid homeostasis. Nat Rev Neurosci. 2017;18(8):459-469. doi: 10.1038/nrn.2017.71

 

  1. Guyenet PG. The sympathetic control of blood pressure. Nat Rev Neurosci. 2006;7(5):335-346. doi: 10.1038/nrn1902

 

  1. Nattie E, Li A. Central chemoreceptors: Locations and functions. Compr Physiol. 2012;2(1):221-254. doi: 10.1002/cphy.c100083

 

  1. Hebb DO. The Organization of Behavior: A Neuropsychological Theory. Hoboken: Wiley; 1949.

 

  1. Kandel ER, Schwartz JH, Jessell TM, Siegelbaum SA, Hudspeth AJ, editors. Principles of Neural Science. 5th ed. United States: McGraw-Hill; 2013.

 

  1. Weisstein EW. Attractor. MathWorld--A Wolfram Web Resource; 2020. Available from: https://mathworld.wolfram. com/attractor.html [Last accessed on 2025 Dec 11].

 

  1. Vanderbilt D, Louie SG. A Monte Carlo simulated annealing approach to optimization over continuous variables. J Comput Phys. 1984;56(2):259-271. doi: 10.1016/0021-9991(84)90096-8

 

  1. LeCun Y, Boser B, Denker JS, et al. Backpropagation applied to handwritten zip code recognition. Neural Comput. 1989;1(4):541-551. doi: 10.1162/neco.1989.1.4.541

 

  1. Watkins CJCH, Dayan P. Q-learning. Mach Learn. 1992;8(3-4):279-292. doi: 10.1007/BF00992698

 

  1. LeCun Y, Bengio Y, Hinton G. Deep learning. Nature. 2015;521(7553):436-444. doi: 10.1038/nature14539

 

  1. Moerman DE, Jonas WB. Deconstructing the placebo effect and finding the meaning response. Ann Intern Med. 2002;136(6):471-476. doi: 10.7326/0003-4819-136-6-200203190-00011

 

  1. Waber RL, Shiv B, Carmon Z, Ariely D. Commercial features of placebo and therapeutic efficacy. JAMA. 2008;299(9):1016-1017. doi: 10.1001/jama.299.9.1016

 

  1. Ventola CL. Direct-to-consumer pharmaceutical advertising: Therapeutic or toxic? P T. 2011;36(10):669-684.

 

  1. Gallistel CR. The Organization of Learning. United States: MIT Press; 1990. 23. Buzsáki G. The Brain From Inside Out. Oxford: Oxford University Press; 2019.

 

  1. Herculano-Houzel S. The human brain in numbers: A linearly scaled-up primate brain. Front Hum Neurosci. 2009;3:31. doi: 10.3389/neuro.09.031.2009

 

  1. Markram H, Lübke J, Frotscher M, Sakmann B. Regulation of synaptic efficacy by coincidence of postsynaptic APs and EPSPs. Science. 1997;275(5297):213-215. doi: 10.1126/science.275.5297.213

 

  1. Beecher HK. The powerful placebo. JAMA. 1955;159(17):1602-1606. doi: 10.1001/jama.1955.02960340022006

 

  1. Kohonen T. Self-Organizing Maps. 3rd ed. Germany: Springer; 2001.

 

  1. Russell SJ, Norvig P. Artificial Intelligence: A Modern Approach. 4th ed. United Kingdom: Pearson; 2021.

 

  1. Kirkpatrick S, Gelatt CD Jr., Vecchi MP. Optimization by simulated annealing. Science. 1983;220(4598):671-680. doi: 10.1126/science.220.4598.671

 

  1. Jonas WB. The homeopathic therapeutic relationship: The role of the consultation in healing. Homeopathy. 2012;101(1):4-7. doi: 10.1016/j.homp.2011.10.002

 

  1. Hahnemann S. The Homoeopathic Medical Doctrine, or “Organon of the Healing Art”. Dublin: W.F. Wakeman; 1833.

 

  1. Hahnemann S. Organon of the Healing Art. 6th ed. England: W. Headland; 1921.

 

  1. Kent JT. Lectures on Homoeopathic Philosophy. Uttar Pradesh: B. Jain Publishers; 2004.

 

  1. Soni A, Ali SA, Das A, Dey S. Kent’s twelve observations: A doctrinal legacy of Hahnemann for clinical prognosis. Int J Hom Sci. 2025;9(3):501-506. doi: 10.33545/26164485.2025.v9.i3.H.1699

 

  1. Ullman RW, Reichenberg-Ullman J. The Patient’s Guide to Homeopathic Medicine. Amsterdam: Picnic Point Press; 1994.

 

  1. Lok Sabha Unstarred Question No. 1768. Ministry of AYUSH; 2022. Available from: https://sansad.in/getFile/annex/257/ AU1768.pdf?source=pqars [Last accessed on 2025 Dec 11].

 

  1. Lok Sabha Unstarred Question No. 1887. Ministry of Health and Family Welfare; 2019. Available from: https://sansad.in/getFile/loksabhaquestions/annex/182/au1887_xrgu06. pdf?source=pqals [Last accessed on 2025 Dec 11].

 

  1. Nesse RM. How is Darwinian medicine useful? West J Med. 2001;174(5):358-360. doi: 10.1136/ewjm.174.5.358

 

  1. Evans SS, Repasky EA, Fisher DT. Fever and the thermal regulation of immunity: The immune system feels the heat. Nat Rev Immunol. 2015;15(6):335-349. doi: 10.1038/nri3843

 

  1. Wall PD. Pain: The Science of Suffering. Weidenfeld and Nicolson; 1999.

 

  1. Dantzer R. Cytokine-induced sickness behavior: Mechanisms and implications. Ann N Y Acad Sci. 2001;933(1):222-234. doi: 10.1111/j.1749-6632.2001.tb05827.x

 

  1. Kang H, Miksche MS, Ellingsen DM. Association between personality traits and placebo effects: A preregistered systematic review and meta-analysis. Pain. 2023;164(3):494-508. doi: 10.1097/j.pain.0000000000002738

 

  1. Camerone EM, Tosi G, Romano D, et al. The role of pain expectancy and its confidence in placebo hypoalgesia and nocebo hyperalgesia. Pain. 2023;164(4):834-845. doi: 10.1097/j.pain.0000000000002760

 

  1. Patterson DR, Jensen MP. Hypnosis and clinical pain. Psychol Bull. 2003;129(4):495-521. doi: 10.1037/0033-2909.129.4.495

 

  1. Yerzhan A, Ayazbekova A, Lavage DR, Chelly JE. The use of medical hypnosis to prevent and treat acute and chronic pain: A systematic review and meta-analysis. J Clin Med. 2025;14(13):4661. doi: 10.3390/jcm14134661

 

  1. Colloca L, Miller FG. The nocebo effect and its relevance for clinical practice. Psychosom Med. 2011;73(7):598-603. doi: 10.1097/PSY.0b013e3182294a50

 

  1. Finniss DG, Kaptchuk TJ, Miller F, Benedetti F. Biological, clinical, and ethical advances of placebo effects. Lancet. 2010;375(9715):686-695. doi: 10.1016/S0140-6736(09)61706-2

 

  1. Foddy B. A duty to deceive: Placebos in clinical practice. Am J Bioeth. 2009;9(12):4-12. doi: 10.1080/15265160903318350

 

  1. Hróbjartsson A, Gøtzsche PC. Placebo interventions for all clinical conditions. Cochrane Database Syst Rev. 2010;2010(1):CD003974. doi: 10.1002/14651858.CD003974.pub3

 

  1. Van der Hulst AE, Klip H, Brand PL. Risk of developing asthma in young children with atopic eczema: A systematic review. J Allergy Clin Immunol. 2007;120(3):565-569. doi: 10.1016/j.jaci.2007.05.027
Share
Back to top
Journal of Clinical and Basic Psychosomatics, Electronic ISSN: 2972-4414 Print ISSN: 3060-8562, Published by AccScience Publishing