Aim: comprehensive analysis of the neurobiological, psychopharmacological, and behavioral mechanisms underlying the digital nocebo effect induced by media misinformation.

An integrative review of scientific literature was conducted using PubMed, Scopus, Web of Science, and Google Scholar databases. Publications from the last decade concerning the nocebo effect, cyberchondria, neurobiology of pain, and the impact of social media on pharmacotherapy efficacy were systematically analyzed.

The digital nocebo effect is proven to be not merely a psychological phenomenon, but a complex neurobiological response initiated by media-induced stress. The pathogenetic basis involves hyperactivation of the hypothalamic-pituitary-adrenal axis and the cholecystokinin system, leading to central nocebo hyperalgesia, as well as the suppression of endogenous opioid and dopaminergic transmission. On a psychopharmacological level, cyberchondria and doomscrolling cause somatic amplification and persistent autonomic shifts. These can objectively alter the pharmacokinetics and pharmacodynamics of drugs (particularly statins and psychotropic medications), forming nocebo-induced therapeutic resistance.

Medical misinformation in the digital environment directly interferes with patients’ physiological processes, catastrophically reducing compliance and the effectiveness of evidence-based medicine. Overcoming this phenomenon requires abandoning paternalism, implementing predictive screening (Q-No questionnaire), applying "prebunking" communication strategies, and integrating medical media literacy principles into daily clinical practice.