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Beware the Nocebo Effect
An article at the NY Times looks at research into the "nocebo" effect. Named after the placebo effect, it's the term for when patient expectations do harm, rather than good. "When a patient anticipates a pill’s possible side effects, he can suffer them even if the pill is fake." The article describes several instances of patients getting the placebo in a drug trial, but reporting the expected side effects of the drug, rather than the benefits or nothing at all. Quoting:
"Consider the number of people in medical trials who, though receiving placebos, stop participating because of side effects. We found that 11 percent of people in fibromyalgia drug trials who were taking fake medication dropped out of the studies because of side effects like dizziness or nausea. Other researchers reported that the discontinuation rates because of side effects in placebo groups in migraine or tension drug trials were as much as 5 percent. Discontinuation rates in trials for statins ranged from 4 percent to 26 percent. ... In one remarkable case, a participant in an antidepressant drug trial was given placebo tablets — and then swallowed 26 of them in a suicide attempt. Even though the tablets were harmless, the participant's blood pressure dropped perilously low."
No surprise here, the mind controls the body. Why wouldn't the placebo effect work both ways?
And even if I did, I wouldn't get my info about them from the freaking commercials that list off what it's for, the horrendous side effects, as it shows a happy family playing outside, and then says "ask your doctor..." WTF?
The US is the only nation that allows pharma ads, and they're really harming our society because people go to the doc and demand certain meds as a result of these commercials. Enjoy your diharrea, heart palpitations, mild depression and thoughts of suicide.
This all relates back to the article, as these nocebo effects are a result of stupid people taking advice from even more idiotic marketing people about what drugs they need, for fake diseases like restless leg syndrome, and miracle cures that don't work and just cause you to die like the numerous discontinued drugs caught up in class action lawsuits for wrongful death.
I was getting dizzy and sickly at the painkillers I never took an hour before.
I was sure I had taken them but nope, found them in my pocket about a half hour after that.
Boy I felt stupid.
I can't take anything, even supplements because I take serious side effects caused by a mental condition that was triggered by taking anti psychotic medication! stay away from head doctors they will destroy your mind folks, two years on and little progress!
I wonder if it's actually possible to commit suicide by swallowing placebos? Or is there some limit to the nocebo effect's severity that'd prevent that?
10 PRINT CHR$(205.5+RND(1)); : GOTO 10
I'm frankly not surprised that people who imagine diseases imagine side-effects from placebos.
Expectations causing harm is par for the course, isn't it?
I expected TFA to be a 5-page, thin columned piece of gosa that pops up a javascript box when your mouse hovers over any text, and with an annoying juddery div that floats up the page.
So I only read the inaccurate slashot summary, and am now posting an irrelavent comment that doesn't actually pertain to the issue at hand.
And yet, supposedly, the effectiveness of placebos is rising. What does this tell us? Human beings are becoming more pliable / suggestive, which is not a good thing.
For one, that level of pliability is probably a prelude to something really horrible, the least of which is a Justice / Legal system that will operate in "sideways mode." Not a problem until you're convicted of something you didn't do. But if you make sure you are always wealthy / powerful enough, it shouldn't ever be a problem.
I am John Hurt.
"We found that 11 percent of people in fibromyalgia drug trials who were taking fake medication dropped out of the studies because of side effects like dizziness or nausea". Aren't these also symptoms that fibromyalgia victims suffer? Could the participant merely be confusing a "side effect" with "fake pill simply not working"?
and other sexual side effects reported as positive.
W00T
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Why is anyone suprised that fibromyalgia would have such a high crock factor? That whole 'disease' smells like a scam, another invented syndrome to stick on somebody so they can claim disability. Now I know a dozen people will now feel a need to give a sob story about how they really, really have it and it really, really is a real thing. Yea, just like half of kids are now ADD or autistic or something and need to be drugged into insensibilty. Blow me. Sorry, ain't buying it.
Democrat delenda est
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"he can suffer them even if the pill is fake."
by 'them' they mean non specific symptoms, then yes.
The Kruger Dunning explains most post on
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Offer the following choice to a hypochondriac enemy at gunpoint:
"One bottle contains a completely harmless pill. The other contains a lethal pill that will first cause dry mouth, dizziness, and a rapid heartbeat before proceeding to more serious symptoms such as uncontrolled flatulence, diarrhea, and vomiting, soon followed by coma and death. Choose!"
Slide bottles containing sugar pills across the table. After they take one, put one beatific s**t-eating grin on your face and watch the show!
If one believes that advanced human evolution will include the ability to control bodily processes with one's mind, including healing and maximization of performance, then it's also quite likely possible for it to work the other way.
Happiness in intelligent people is the rarest thing I know.
Ernest Hemingway
They are so gullible that they will believe anything, even that they have upset stomachs (even when they don't). Or that Lush Rimbaugh is right. Or that celltowers are the cause of their headaches even if the tower is turned-off & the headaches are caused by other issues (like staying-up til midnight).
My AC stalker: " I personally agree with your posts most of the time, but that won't keep me from modding you troll"
Obviously we are in The Matrix, and are obviously hacking it with our minds. (Hey, the original story was that The Matrix actually ran in our own minds because they're supercomputers, so it made sense!). Anyway, we are in the Matrix, but our ability to change it is limited by a mass grouping effect. As in, because ALL our minds run it, any effect of one mind changing The Matrix is limited. Limited in fact to what we are "closest" too in terms of access, which of course is our own mind.
So maybe, if well all believed in something, we could alter our own perceived reality!
Ok, if that were true we would have found real life witches and dragons and stuff. Or maybe it is true, and there's just a good governance running in the background to keep it unnoticeable. Either way it would make for a cool story, like a much better sequel to The Matrix than the crap we were given.
Up until now, when my doctor prescribed something for me, I always looked at the datasheet the pharmacist gave me and sometimes looked the drug up on the NIH website to find out about the side effects. I am somewhat suggestible; would I be better off not looking at drug information lest I get psychosomatic side effects? I can see some potential problems, like dying due to my failing to read some other crucial parts of the datasheet.
"Imaginary solutions to real problems."
Fibromyalgia is probably best placed in the "idiophathic $disease" category; but that doesn't mean it's not real. For those not in the know, "idiopathic" is doctor-speak for "I don't know why you have these symptoms".
Wait, you mean people who suffer from fibromyalgia, a "disorder" that more often than not has no rational explanation by medical professionals, and happens disproportionately to people who tend to have some sort of other mental disorder like borderline personality disorder or who suffer from what I like to call "crazy cat lady syndrome", might be more likely to experience a negatively-skewed placebo effect? You don't say!
Some people actually think Homeopathy is NOT a completely retarded concept.
He gives a wonderful explanation of the Nocebo effect in this video of Nerdstock: 9 Lessons and Carols for Godless People, televised on BBC4, December 2009. https://www.youtube.com/watch?v=O1Q3jZw4FGs
http://www.youtube.com/watch?v=O1Q3jZw4FGs
The US is the only nation that allows pharma ads
You should travel more.
Mit der Dummheit kämpfen Götter selbst vergebens
Nocebo should be for the control group not getting any drug. That's a control too, that rarely gets included. Experimental conditions: Nothing, placebo, drug.
Hmmm. Dizziness and nausea, eh? I'll bet those affected patients probably live too close to a wind turbine. According to many people (and most of the rural news media) here in eastern Ontario (Canada), dizziness and nausea are "known" side effects of industrial wind turbines. Not to mention other symptoms like sleep disturbance and anxiety. Who needs a placebo to explain their symptoms? Proof by popular opinion! But not in my backyard, they say.
The summary just provides more typical examples of the well-known Placebo Effect. This has been known for generations.
I was expecting something along the lines of getting better even though you don't get medicine purely through believing you will.
This is just the placebo effect for unwanted effects.
"Named after the placebo effect, it's the term for when patient expectations do harm, rather than good."
With other news about Nokia selling out to a patent troll and Google patenting a 'Net-based OS, I thought this was yet another article about patents: "It's the term for when *patent* expectations do harm, rather than good." Mabye our patent system is in dire need of a cure?
NEO: I thought it wasn't real.
NEO: If you are killed in the Matrix you die here?
MORPHEUS: The body cannot live without the mind.
So, DONT tell the patient that side effects include death, OK.
your placebo is too weak.
you're in the syndrome.
Just like meta-studies which give their results in percentages of incidence in treatment and control groups, without listing the actual number of incidences in either group.
Or meta-studies that refer to other meta-studies whose results are suspiciously close to, or even below, the stated confidence interval - i.e. results which are quite close to coincidence.
"As much as 5 percent" means jack shit when your study has a 1 in 20 chance of producing false positives.
Mit der Dummheit kämpfen Götter selbst vergebens
I think it is "remarkable" that a subject in an antidepressant trial was given placebos, and attempted suicide. That seems a rather poor situation to put a depressed person in.
Inert means inert, yes.
On the other hand, "inert ingredients" means ingredients that show up in a list in a standard as being supposed to be inert when used in a specific way. Thus, YMMV.
Computer memory is just fancy paper, CPUs just fancy pens with fancy erasers; the 'net is just a fancy backyard fence.
I wonder if it bothers the people responsible for the antidepressant study that someone seeking help for depression was given placebos and tried to commit suicide. What if he chose a more effective method?
Anecdotal, and first/second person from me is third person to you, but, ...
Not sure if your 1/10 gram matches the actual amount in a placebo, but the amount of sugar in a non-placebo pill can indeed have bad effects on someone with sugar reactions, including liver and kidney function.
We know that it can have a significant effect on a diabetic person, as well, so there's no need to fuss about the amount.
When someone in the family is sick and claims sugar intolerance, does it do any good to argue whether sugar intolerance is real?
Seriously. Let the person cut back a bit on sugar, even if it means having, for instance, to make one's own biscuits because you can't get sugar free bread in the store. It's not a whole lot of trouble to go to, and home made biscuits are not particularly evil, either. Might even taste good after a bit of practice making them, adjusting the recipe, etc.
Which is on-topic here, because we too often get too involved in arguing about science when the best thing we can do for someone who is sick is just listen, express sympathy and support, and if they think of something sensible to do, encourage them to do it. (Again, for most people, cutting back on sugar is quite sensible.)
Shoot, sympathy and support are often better medicine than anything the doctor can prescribe. Can promote communication, too.
Computer memory is just fancy paper, CPUs just fancy pens with fancy erasers; the 'net is just a fancy backyard fence.
Really they don't understand the human body at all where it matters.
I know I know it's an hour long, but if you really want to know...
Hypochondria? Yeah... Slahdotter=captain obvious
For the patient to get better, they have to want to change;
"Patient has to want to change" is a shorthand/metaphor for "a patient has to accept the existence of a problem, and in order to find the cause of it so it can be treated, he or she must openly discuss the problem and the underlying issues with a trained professional".
But when I take a antibiotic, it either works or it doesn't.
Weeeell...
Elevated stress can cause an increase in production of stomach acid, which can inhibit certain antibiotics, when taken orally.
More like "thinking positive" than "believing", and weakening the effect than "not working" but you get the picture.
Mit der Dummheit kämpfen Götter selbst vergebens
Does this mean that the side effects are reported in relation to the placebo reported side effects, i.e. if 5% hurl on placebo, and 6% hurl on the med, does it get reported as a 1% hurl result?
The funniest part is that they often say "If you have been injured or killed by" such and such drug.
So if there is placebo side effects, there can now be lawsuits over taking almost nothing. Litigation paradise!
The shepherds did so well protecting the flock that the sheep no longer believed that wolves existed.
And in turn, they would have indeed committed suicide by placebo.
That would be death by placebo TREATMENT, not by placebo EFFECT.
A neutral, non-sugary, placebo pill would create the same placebo effect, but it would not trigger a high blood sugar reaction in diabetics.
And I do believe that we are talking about the effect, not the treatment here.
Cause, one could just as well choke on a placebo pill and die from a placebo treatment.
Or slip on placebo pills spilled on top of the stairs and break one's neck.
Or get run over by a truck transporting placebo pills.
Or shot by a placebo merchant who paid for the gun and bullets with money earned by providing placebo pills to various studies.
In none of those cases would the patient/victim experience the placebo effect.
Mit der Dummheit kämpfen Götter selbst vergebens
...where they cite a placebo lowering the subject's blood pressure. And blood pressure is OBjective, not SUBjective.
And yes, in this case, you are scientifically inaccurate.
All I'm saying is that the study reeks of confirmation bias.
And since when is a single sample case anything but anecdotal?
Mit der Dummheit kämpfen Götter selbst vergebens
Or maybe they were allergic to some component of the placebo - such as corn sugar (a typical ingredient). Then they'd have REAL side effects.
Bantam Dominique roosters crow a four-note song. Once you've heard it as "Happy BIRTHday" you can't NOT hear it that way
Nah, sometimes it's the opposite problem, the body can trick itself into symptoms. As for the Upset Stomach, the throwup that you had to flush down the toilet wasn't fake.
However it wasn't due to the drug, it was due to the subject/patient over stressing about tertiary factors.
My first Journal Entry ever, in 8 years! http://slashdot.org/journal/365947/aphelion-scifi-fantasy-horror-poetry-webzine
I am sorry to disagree with the experts here, but I think they got it wrong. I merely object to the name 'nocebo effect'. What this article refers to is the placebo effect, you take something, believe it is the drug, and feel the effects of the drug. The name nocebo would be much better applied to the cases where the people get the actual drug, and believe it is a placebo, which can cancel out the drug's effects. Yes this is a purely semantic distinction, but if you think about it, I think you will find it is correct. Also moderators: I am amazed at what passes for 'insightful' these days. Have a little pride and remember it suggests that you didn't already think of it yourself when you give that moderation. The first post is evidence that we need '+1 the article is stupid and this comment points that out'.
Wow, in another hundred years medicine might actually catch up with psychoanalysis and psychology at this rate.
The ASSUMPTION is that the patients experienced the effect, and it was all in their minds.
This is sloppy research. Did they check to see if the binders and fillers in the pills weren't to blame ?
How do you know that the patients weren't exposed to something else when they went to get their sugar pills ?
People need to be more skeptical of drug trials, the industry would LOVE to further damage criterion and methodologies and disclosure of adverse side effects from the constant stream of dangerous drugs it pumps out.
How many times does the FDA and big pharma have to be caught red handed screwing us over before you start to question the entire corrupt research community ?
Even more interesting (to me) is the fact that placebos tend to work even if the patient is aware that they have ingested a placebo. The placebo effect and activities of mirror neurons are still very poorly understood. I think a lot of the comments here suggesting that "the increasing effectiveness of placebo suggests that our culture is becoming more gullible/suggestible" are premature and show the bias of the people making those comments. Whether or not their conclusions are accurate, correlation does not equal causation and it could simply be that humans are developing more mirror neurons (or whatever else), giving us more--and not less--control over the power our minds have over our lives.
The parent poster was probably referring to prescription medications. Over the counter medications are usually allowed to be advertised on television in most countries. So for example, a medication you can buy over the counter will be allowed to be advertised but something that requires a doctors prescription cannot be advertised.
You should really check the links that you post more as all the youtube videos you linked to seem to be over the counter medications and not prescription medications.
http://hsionline.com/2005/02/02/placebo-pills-more-than-just-sugar/ Perhaps they should look at the content in the placebo, it isn't made of nothing.
Placebo and Nocebo are both just the 1st person indicative futures of placere and nocere.
"I will please"
"I will harm"
So they're just parallels of each other.
They take the dative for a direct object, too, in case you'd care to use them. :)
Sounds like voodoo to me.
There are four kinds of people in this world: cretins, fools, morons, and lunatics - Umberto Eco
Sounds like a severe electrolyte imbalance.
Get a bottle of dill pickles and start eating them - and drinking the brine. (With moderation - don't make yourself sick.)
See if that has any effect. If it works, great. If not, you've spent $2 and eliminated one possible cause.
Add to the list: any of a number of dietary deficiencies, such as iodine and vitamin D. Take a sport vitamin (vitamin for people who do heavy sports) for a couple of months to see if that helps.
Personally, I'm suffering because distant space aliens are taking experimental pills and transmitting their symptoms to me. I call it The Arecibo Effect.
"Even though the tablets were harmless, the participant's blood pressure dropped perilously low."
World's worst sugar crash? ;)
Indeed. It can be refactored as follows:
Depression::Somatization.
Da Blog
If drugs have to be tested against placebos, because the placebo effect is strong enough to have a significant cure rate versus not giving a placebo; then why aren't we being given placebos for things we don't have drugs for?
Star Trek transporters are just 3d printers.
> In one remarkable case, a participant in an antidepressant drug trial was given placebo tablets — and then swallowed 26 of them in a suicide attempt.
This reminds me of the James Randi talk on homeopathy: Part of the theory of homeopathy is that the more dilute the solution is the stronger it is. Randi told the hypothetical story of someone who forgot to take his "medicine" thus causing an overdose and DIED.
We are told as children: don't take drugs because if you start, you might find that you are unable to stop. And then you'll end up doing terrible things to yourself and others. So maybe some children take this to heart and then become drug addicts (particularly the born trouble-makers). The power of suggestion. http://AddictionMyth.com
... for at least one thing.
No less than a Cochrane meta-analysis has concluded acupuncture to be as effective as drugs for post operative nausea and vomiting.
http://www.ncbi.nlm.nih.gov/pubmed/19370583
...if one were to believe that fibromyalgia were a systemic inflammatory reaction to various allergies and sensitivities, one might also be able to then believe that any number of the fillers and binders used to make a 'harmless' pill could cause reactions like nausea ans dizziness. some of the more common fillers are lactose, microcrystalline cellulose, corn starch, sugars (including sucrose, mannitol, sorbitol, fructose, and dextrose), whey and yeast. these are all commonly known allergens.