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Beware the Nocebo Effect

Soulskill posted more than 2 years ago | from the this-story-may-cause-itchy-palms dept.

Medicine 239

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."

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The Mind is amazing (4, Insightful)

tomhath (637240) | more than 2 years ago | (#40952559)

No surprise here, the mind controls the body. Why wouldn't the placebo effect work both ways?

Re:The Mind is amazing (0, Troll)

The Snowman (116231) | more than 2 years ago | (#40952669)

No surprise here, the mind controls the body. Why wouldn't the placebo effect work both ways?

Not just the "placebo effect" but what if the so-called "inert ingredients" weren't inert? Some placebos are sugar pills -- my body, while not diabetic, doesn't metabolize sugar well. Drinks with HFCS give me migraines, for example. A sugar placebo would certainly have side effects not even considering the mind over matter aspect of the situation. That could cause an anti-migraine pill to make the situation worse, or cause reduced kidney/liver function as my body works overtime to purge the sugar from my blood (my body isn't used to refined carbs like sugar).

Re:The Mind is amazing (0)

Anonymous Coward | more than 2 years ago | (#40952681)

what if the so-called "inert ingredients" weren't inert?

That's a pretty big "what if". Inert means inert.

Re:The Mind is amazing (0)

JoeMerchant (803320) | more than 2 years ago | (#40953659)

Often "placebo" treatment is given some palpable effect in order to convince the recipient that they are getting "the real thing." This is very much the case in medical device trials, don't know if they give placebo pills a little kick for the same reasons.

Re:The Mind is amazing (5, Insightful)

arth1 (260657) | more than 2 years ago | (#40952755)

Drinks with HFCS give me migraines, for example. A sugar placebo would certainly have side effects not even considering the mind over matter aspect of the situation.

I think you might be begging the question here - precluding a nocebo effect based on something that may very well be a nocebo effect.
Or have you been through double blind tests?

Re:The Mind is amazing (5, Interesting)

Anonymous Coward | more than 2 years ago | (#40953585)

Holy crap, a correct use of the phrase "begging the question"! You win one Internet.

Re:The Mind is amazing (1)

JoeMerchant (803320) | more than 2 years ago | (#40953671)

Drinks with HFCS give me migraines, for example. A sugar placebo would certainly have side effects not even considering the mind over matter aspect of the situation.

I think you might be begging the question here - precluding a nocebo effect based on something that may very well be a nocebo effect.
Or have you been through double blind tests?

For reference: http://yourlogicalfallacyis.com/begging-the-question [yourlogicalfallacyis.com]

Re:The Mind is amazing (0)

Anonymous Coward | more than 2 years ago | (#40953799)

For your efforts in holding back the tide of using "begging the question" as a segue, I thank you sir. May we fight on the side of right and justice 'til our dying breath.

Re:The Mind is amazing (3, Interesting)

amicusNYCL (1538833) | more than 2 years ago | (#40953103)

That could cause an anti-migraine pill to make the situation worse, or cause reduced kidney/liver function as my body works overtime to purge the sugar from my blood

Would 100mg of sugar really cause problems for your liver?

Re:The Mind is amazing (3, Insightful)

Anonymous Coward | more than 2 years ago | (#40953305)

Seriously? +4 insightful for "What if scientists haven't considered that inactive ingredients might not be inactive?" At least four people thought that was a valid, interesting point?

Dude, how much fucking sugar do you think is in a sugar pill?

Re:The Mind is amazing (5, Informative)

slew (2918) | more than 2 years ago | (#40953489)

Some placebos are sugar pills...

The good news (for you): almost no placebos in large medical trials are "sugar-filled" pills**.
The bad news (for everyone): ingredients of placebos are mostly unregulated, usually not published, and are often formulated to attempt to duplicate the known side effects of the medicine in question in a relatively benign manner.

**most actual pills, however, are sugar coated***, so in that sense almost all pills (including both real pills and placebo pills) are "sugar" pills...
***the coating of pills is often plastic phthalates (embedded with sugar and artificial colors), yet another thing to worry about when taking pills...

No humans are weird (3, Interesting)

cpu6502 (1960974) | more than 2 years ago | (#40952841)

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).

Re:No humans are weird (5, Insightful)

Anonymous Coward | more than 2 years ago | (#40953127)

or that Chiropractic treatment works. Or homeopathy, crystals, accupunture, tiger penis soup, Sea Horse balls, etc ...

And I once argued with a psychologist about their efficacy (for therapy). For the patient to get better, they have to want to change; then doesn't that make it a placebo?

"No!" blah balh blah blah.

"I see. But when I take a antibiotic, it either works or it doesn't. My belief or desire for it to work is irrelevant."

And then there are the very compelling arguments with data of the efficacy of anti-depressants.

Yeah, yeah, yeah, go ahead acuse me of being a Scientologist. But even kooks can be right sometimes for the wrong reasons. for example, Mormons. They say you can't drink alcohol.

Re:No humans are weird (2)

Alter_3d (948458) | more than 2 years ago | (#40953495)

Dammit, don't talk against chiropractors. In eleven seconds, you are going to get a reply from Dr. Looney that says that chiropractic treatments cure cancer, AIDS, ingrown nails and the Flame virus.

Re:No humans are weird (5, Insightful)

DMUTPeregrine (612791) | more than 2 years ago | (#40953543)

Psychological therapy works by using a conscious desire for change to find subconscious causes of undesired behavior and eliminate them. It is arguably psychosomatic, but not all psychosomatic effects are placebo effects.

Re:No humans are weird (2)

JoeMerchant (803320) | more than 2 years ago | (#40953703)

"I see. But when I take a antibiotic, it either works or it doesn't. My belief or desire for it to work is irrelevant."

Not entirely, as mentioned in the article, 26 placebo pills dangerously lowered the subject's blood pressure. Placebo effect can also boost or lower natural immunity, possibly to equal or greater effect than antibiotics, especially with MRSA and other drug tolerant strains.

Re:No humans are weird (2)

SydShamino (547793) | more than 2 years ago | (#40953769)

There was a recent study that showed accupucture worked. No, not Chinese accupucture; it didn't actually matter where the needled were stuck, but there was a difference if they were stuck at all. Maybe it was a placebo effect but no matter, it had an effect.

Personally my chiropractic experience was a success in that she showed me how my posture was the source of my periodic, debilitating headaches. (Muscles seized in the back of my neck.) Drastic changes to my posture (I sit strictly upright at all times) led to drastic reductions in frequency, and I know new places I can push to force the muscles to relax if they do tense up. Of course she also mucked up my jaw in an adjustment so she wasn't perfect (or even great), but for the problem I saw her for she helped.

Re:No humans are weird (0)

Anonymous Coward | more than 2 years ago | (#40953633)

Oh look, it's dude that knows how the mind works! Wow, where'd you publish your paper?

Perhaps everyone is gullible, and perhaps we give power to those things we believe in...

But obviously you've figured it out, and the world exists in the absolutes defined within your small mind.

Re:The Mind is amazing (4, Informative)

Intrepid imaginaut (1970940) | more than 2 years ago | (#40953057)

There are many examples outside the laboratory to look at in order to see the power of the mind over the body. Mothers lifting overturned vehicles to free a trapped child, a prisoner in the Nazi concentration camps whose name escapes me at the moment describing seeing men literally give up, they ate their last potato, lay down, and died for no particular medical reason. On a more upbeat note, someone like Wim Hof, who can control the temperature of his body to an incredible degree, is a living example of what we can do. Science has really only begun to probe the full extent of the control that can be achieved.

Re:The Mind is amazing (0)

Anonymous Coward | more than 2 years ago | (#40953377)

voodoo, faith healing, power of prayer, herbal, etc.
If your mind gives something power, it has power.

Too Bad I don't Take Medications... (3, Insightful)

ilikenwf (1139495) | more than 2 years ago | (#40952569)

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.

Re:Too Bad I don't Take Medications... (2, Insightful)

Anonymous Coward | more than 2 years ago | (#40952677)

Fake disease? Restless leg syndrome is a real disease. Just because many claim to have the disease, while they dont, does not make the disease fake.

Re:Too Bad I don't Take Medications... (3, Interesting)

cvtan (752695) | more than 2 years ago | (#40952985)

Have you noticed that the ads for restless leg syndrome drugs have vanished? Why is that?

Re:Too Bad I don't Take Medications... (0)

Anonymous Coward | more than 2 years ago | (#40953203)

Ads? What ads?

Re:Too Bad I don't Take Medications... (0)

Anonymous Coward | more than 2 years ago | (#40953459)

Hmm, despite what you say, my RLS hasn't also vanished... fuck you, sir.

Re:Too Bad I don't Take Medications... (2)

SydShamino (547793) | more than 2 years ago | (#40953791)

My restless legs haven't, though. Damn it's annoying as hell when I'm just trying to get to sleep and they start to ache in seconds if held still. Usually getting them really cold mitigates it enough to get to sleep, and they only bother me in the late evening.

Re:Too Bad I don't Take Medications... (2)

Shikaku (1129753) | more than 2 years ago | (#40952749)

Your outlook on medication probably causes more problems from the nocebo effect...

But you are right about the marketing at least.

Re:Too Bad I don't Take Medications... (2)

geekoid (135745) | more than 2 years ago | (#40952751)

"restless leg syndrome,"
fine, what do you call it when a persons legs don't stop moving while they sleep? It's not like there isn't volumes of actual documentation.

Re:Too Bad I don't Take Medications... (4, Funny)

cpu6502 (1960974) | more than 2 years ago | (#40952899)

"Horniness"

Re:Too Bad I don't Take Medications... (0)

Anonymous Coward | more than 2 years ago | (#40953325)

Fuck you.

Re:Too Bad I don't Take Medications... (0)

Anonymous Coward | more than 2 years ago | (#40953017)

I have restless leg syndrome but I don't take medicine for it because it's not that big of a deal. Every so often I get the uncontrollable feeling that I have to move my legs. I have to kick them, swing them, wiggle them, anything to get that sensation to go away. I have tried to hold my legs still for as long as possible and after about 30 seconds I have to move them. And you can't just keep moving them the same way. I have to change what I'm doing or the sensation comes back till I move my legs another way. It's really annoying when I'm in a car or trying to go to sleep but I only get it a couple times a month.

Re:Too Bad I don't Take Medications... (1)

somersault (912633) | more than 2 years ago | (#40953107)

I used to get it fairly regularly, but then I started eating more healthily. The couple of times I've had it this year have been after eating refined carbs/sugary stuff. Those foods cause inflammation and cause you to retain more water.

Re:Too Bad I don't Take Medications... (2)

JoeMerchant (803320) | more than 2 years ago | (#40953717)

Wheat (possibly gluten...) gives me inflammation/arthritic symptoms, eliminating it completely for several days makes the inflammation go away.

Re:Too Bad I don't Take Medications... (1)

Rob_Bryerton (606093) | more than 2 years ago | (#40953515)

A dream?

And slightly off-topic, but I think my dog has not only restless leg syndrome, but restless vocal chord syndrome (do dogs have vocal chords? They must, or they wouldn't be able to talk). You see, he tries to run and bark in his sleep sometimes. And I always figured he was chasing that damn raccoon again (who, incidentally, stole my lamb-chop) /adjusts onion on belt

Re:Too Bad I don't Take Medications... (1)

Ultra64 (318705) | more than 2 years ago | (#40953701)

What does your dog say to you?

Re:Too Bad I don't Take Medications... (1)

reub2000 (705806) | more than 2 years ago | (#40953277)

Most of their advertising is directed at doctors, so you can't go to the doctor without them trying to prescribe 2-3 drugs. Then when you experience side effects from those drugs, they'll try to prescribe more drugs to take care of the side effects.

Huh? (2, Informative)

denzacar (181829) | more than 2 years ago | (#40953299)

The US is the only nation that allows pharma ads

You [youtube.com] should [youtube.com] travel [youtube.com] more. [youtube.com]

Re:Huh? (0)

Anonymous Coward | more than 2 years ago | (#40953527)

Aren't all your examples for OTC meds?

I remember just a few days ago (1)

Anonymous Coward | more than 2 years ago | (#40952579)

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 have this problem (0)

Anonymous Coward | more than 2 years ago | (#40952581)

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!
 

last example is very interesting (2, Interesting)

Trepidity (597) | more than 2 years ago | (#40952583)

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?

Re:last example is very interesting (1)

uptownguy (215934) | more than 2 years ago | (#40952615)

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?

It can certainly lead to you hearing your neighbor's dog [imdb.com] talk to you.

Re:last example is very interesting (2)

Xaduurv (1685700) | more than 2 years ago | (#40952665)

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?

It's certainly interesting to think about. Unfortunately I'd assume the answer is yes. Like a previous commenter said, the mind controls the body. I'm reminded of cases where one person passes away in an elderly couple and the other then passes a few short years/months after. My grandmother was never the same after my grandfather died. She seemed relatively youthful before he died, but afterward she aged rapidly, and died 2 years later.

Re:last example is very interesting (1)

Xaduurv (1685700) | more than 2 years ago | (#40952673)

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?

It's certainly interesting to think about. Unfortunately I'd assume the answer is no. Like a previous commenter said, the mind controls the body. I'm reminded of cases where one person passes away in an elderly couple and the other then passes a few short years/months after. My grandmother was never the same after my grandfather died. She seemed relatively youthful before he died, but afterward she aged rapidly, and died 2 years later.

Sorry, meant to say "Unfortunately I'd assume the answer is no", as in I doubt there would be a limit to the nocebo effect.

Re:last example is very interesting (1)

R3d M3rcury (871886) | more than 2 years ago | (#40953089)

I'm not so sure. That whole survival instinct thing and all.

If I had the same meals with my spouse for 60 years and that spouse died, meals might become an unpleasant reminder of that person's death. I would start to dread meals and would probably be less inspired to eat. I'd lose weight and be less energetic which would certainly affect my general health and leave me susceptible to maladies that, in an elderly person, could be fatal.

So, no, I'm not sure that you can will yourself to die. That said, you can will yourself into situations where you can die.

Re:last example is very interesting (2)

somersault (912633) | more than 2 years ago | (#40953317)

I take it you've never had stress cause or exacerbate a health problem? I've had a few periods in my life where I've been massively stressed out and my hands and face break out in dry patches.

Relationship problems and breakups can give me feelings of physical pain (not really in short term ones, but with lines that have gone on for more than say 6 months). And still I can't imagine how horrible it would feel to lose someone after being married for 50 years. It's not so much a will to die, as an inability to cope with stress, which can lead to things like poor quality sleep and lowered immune system function, etc.. a positive attitude helps fight these things, so an "I don't care any more" attitude could be the difference between life and death..

Probably the survival instinct isn't quite so strong for those that have already raised their kids either.

Re:last example is very interesting (1)

R3d M3rcury (871886) | more than 2 years ago | (#40953857)

It's not so much a will to die, as an inability to cope with stress, which can lead to things like poor quality sleep and lowered immune system function, etc.. a positive attitude helps fight these things, so an "I don't care any more" attitude could be the difference between life and death.

Which was basically my point.

The original question was whether or not I can take a bunch of sugar-pills but believe that they are poison and, thus, die because I believe that to be true. The answer is no, you can't. No matter how much you want to die, you can't will yourself to do so.

The person I was responding to pointed out that there were plenty of cases of people who lived together for years and when one died, the other passed away shortly thereafter. As I pointed out, depression can certainly affect your ability to take proper care of yourself which can leave you more susceptible to illness and death from said illness.

Here's an analogy: If I go jogging and have a heart-attack and die, would you say that I died from jogging?

Re:last example is very interesting (1)

geekoid (135745) | more than 2 years ago | (#40952743)

no. You will notice the the nocebo* effect are non specific symptoms. They same things that tend to 'go away' when taking a placebo.

*nocebo is a stupid name. Scientists have known about this for some time. It's also a placebo effect.

Re:last example is very interesting (5, Informative)

jfengel (409917) | more than 2 years ago | (#40953025)

Nocebo is a perfectly reasonable name. "Placebo" is from a Latin root meaning "to please". "Nocebo" means "I will harm". It may sound like a silly portmanteu, but "nocebo" has roots of comparable authenticity that give rise to how the word is used today.

It would be a real stretch to make "placebo" refer to all psychosomatic effects. That would differ both from its Latin roots and from its common usage, which connotes positive effects (or at least, sought-for effects).

It is a bit late for the New York Times to be figuring this out. "Nocebo" is more recent in English than "placebo" (it only took off in the 1980s), but it's not news to science.

Re:last example is very interesting (2)

Bookwyrm (3535) | more than 2 years ago | (#40952787)

Try this reference:
    http://en.wikipedia.org/wiki/Voodoo_death [wikipedia.org]

'Psychosomatic death' is probably related to what you are thinking of.

Re:last example is very interesting (1)

Mashiki (184564) | more than 2 years ago | (#40953269)

Well, let's look at it this way. Let's take metformin [wikipedia.org] and the clinical trials(my sister was in it and is a type 1). And we use that, they used a different inert for that, because well sugar doesn't react well to type 1 diabetics. Now let's just change that, and instead they were sugar pills. And the diabetic took all the pills at once. Unless they brought their sugars back under control, it's very probable to commit suicide by high blood sugar reaction(varying effects including impairment and ketoacidosis to name a few). And in turn, they would have indeed committed suicide by placebo.

Single sample studies always are. (0)

denzacar (181829) | more than 2 years ago | (#40953599)

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.

You didn't need a study for this (1)

ericloewe (2129490) | more than 2 years ago | (#40952609)

I'm frankly not surprised that people who imagine diseases imagine side-effects from placebos.

Re:You didn't need a study for this (1)

R3d M3rcury (871886) | more than 2 years ago | (#40953109)

Didn't RTFA, so I can't say for certain. But since we're talking about the "control" group, I would assume these aren't people who are imagining that they have the disease. Otherwise, they're not much of a "control" group since they're perfectly healthy.

Noshdot (0)

Anonymous Coward | more than 2 years ago | (#40952625)

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.

Hmm (2)

lightknight (213164) | more than 2 years ago | (#40952627)

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.

Re:Hmm (1)

somersault (912633) | more than 2 years ago | (#40953161)

I wonder how the placebo effect's "potency" varies from culture to culture?

Re:Hmm (1)

Sir_Sri (199544) | more than 2 years ago | (#40953431)

I'm wondering if it's a stress response, which manifests differently in different people. For some people the idea that they're finally getting some help, or at least potentially getting it, is a huge stress reliever, which makes them better. For others the placebo isn't having the desired effect which stresses them out more, and it sort of feeds on itself making even their condition worse.

That would probably correlate to increased stress over time, but without the desire to dig through data and try and actually quantify it I'm just guessing.

Confusion? (1)

dmomo (256005) | more than 2 years ago | (#40952635)

"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"?

Re:Confusion? (1)

mycroft822 (822167) | more than 2 years ago | (#40952703)

No, fibromyalgia [wikipedia.org] is primarily just a lot of pain.

Re:Confusion? (1)

arth1 (260657) | more than 2 years ago | (#40953039)

IANAMP, but fibromyalgia is often linked to other diffuse and hard to clinically verify symptoms, much like whiplash, CFS and the newest popular diagnosis, chronic undetectable borreliosis. Which diagnosis -- if any -- a patient gets for diffuse symptoms that include pain can depend on both the doctor and what insurance companies will accept.

While there surely are people with the correct diagnosis, there are also an awful lot that have received a trashcan diagnosis like this - often more than one of them too, however statistically unlikely that is. That there's a distinct overweight of women that suffer from all of these kind of gives it away - not because women are bitchy, but simply because there's no good reason why women should get far more car crash injuries and tick bites more than men, when they drive and stay outdoor less.

In many (but note, I do not say all) cases, I think the correct diagnosis is Conversion Disorder, and yes, I do think that patients suffering from this may experience stronger nocebo effects than average.
Also note that I do not think that this makes the pains or other problems these patients experience aren't real - they most certainly are felt by those who suffer.

Re:Confusion? (0)

Anonymous Coward | more than 2 years ago | (#40953379)

Fibromyalgia isn't a diagnosable, testable disease -- it's a constellation of signs and symptoms, a set of common complaints which is a fall back for when some subset of causes has been checked and ruled out. My six years of fibromyalgia turned out to be a mild bone cancer. What do these people actually have? Were they doing anything else in their lives besides laying prone, completely idle, consuming no other foods or medications?

Remeron has a 1% chance of priapism (0)

Anonymous Coward | more than 2 years ago | (#40952637)

and other sexual side effects reported as positive.

W00T

Wow (1)

Xaduurv (1685700) | more than 2 years ago | (#40952641)

Gosh we're strange/silly creatures!

Why am I not suprised? (0, Flamebait)

jmorris42 (1458) | more than 2 years ago | (#40952643)

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.

Re:Why am I not suprised? (0)

geekoid (135745) | more than 2 years ago | (#40952717)

DOn't be stupid.

fibromyalgia is real. Are there peopel claiming it that don't have it? probably. That doesn't mean it isn't a real thing.

" just like half of kids are now ADD or autistic "
that's' wildly incorrect.

"or something "
so you really have no clue?

"need to be drugged into insensibilty"
no one is drugged into insensibility
You have exactly the same type of 'thinking' as people who think the moon landing is a hoax, and chemtrails are real.

You are a weak thinking ignorant bitch.

Re:Why am I not suprised? (0)

rmdingler (1955220) | more than 2 years ago | (#40952721)

Can I get a "hell yeah".

Re:Why am I not suprised? (1)

flaming error (1041742) | more than 2 years ago | (#40952729)

Half of kids with ADD actually makes perfect sense to me.

We didn't evolve to what we are now by maintaining a daily routine of sitting in a desk for six hours staring at a teacher, then watching tv for four more, while fattening ourselves with concentrated sugars and hyper-processed foods of trade-secret fabrication.

Our diet and lifestyle are completely foreign to our evolution, and it's no surprise we're ADD, or diabetic, or just generally mental.

Re:Why am I not suprised? (1)

cpu6502 (1960974) | more than 2 years ago | (#40952947)

Back when I was a kid "ADD" was called "boredom". So we discovered ways to not be bored:
    Like paying eraser cars inside our desk.
    Or doodling on a page.
    Or reading a book.
    Or staring at the girl's sideboob at the next desk..... ooops, no my mistake. That was just today.

Re:Why am I not suprised? (3, Informative)

LurkerXXX (667952) | more than 2 years ago | (#40952733)

Actually, most folks I know who said they have fibromyalgia have been misdiagnosed because they had non-standard symptoms for some other condition. Fibromyalgia just seems to be a catch-all for when they have some symptoms in one area and they can't figure out what else it could be.

Re:Why am I not suprised? (1)

Sir_Sri (199544) | more than 2 years ago | (#40953491)

This seems to be it, it's a guess as to something that fits some symptoms but has no known cause. Researchers and the medical community need to be clear they're talking about the same disease when they try and study it, so someone makes a mostly wild guess, sticks a name on it, and off you go. Cancer is actually a lot like that, there are probably a dozen different types of cancers (viral, environmental etc.) but they're all called cancer because they're symptomatically similar.

A few years ago there was a disease names "SARS". SARS stands for: sudden acute respiratory syndrome. As thought that conveys anything helpful.

There's definitely something wrong causing people to have various pains and so on, but no one knows specifically what it is, so they called it fibromyalgia because that makes the person who named it, and people who use the phrase sound like they have a clue (just like SARS!) even when they don't.

Re:Why am I not suprised? (0)

Anonymous Coward | more than 2 years ago | (#40952745)

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.

In other words, you know that you're wrong, but you're not going to admit it because you've chosen to emotionally invest yourself in this conclusion that you long ago reached without evidence.

In fewer words still, you're a liar.

Re:Why am I not suprised? (1, Insightful)

tomhath (637240) | more than 2 years ago | (#40952861)

Fibromyalgia isn't a disease, it's just a fancy word for muscle pain.

It really means the doctor couldn't come up with a good diagnosis but they needed to call it something to get the patient out of their office.

Re:Why am I not suprised? (1)

narcc (412956) | more than 2 years ago | (#40952911)

I'm 100% with you there.

Idiopathic $disease (0)

Anonymous Coward | more than 2 years ago | (#40952993)

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".

Re:Why am I not suprised? (1)

PPH (736903) | more than 2 years ago | (#40953267)

Fibromyalgia is real. Its really a psychological disorder, demonstrated by the fact that the standard treatment for it is some sort of mood stabilizing drug.

Its like the people who get all itchy when they see a cell phone tower. The tower might very well be inoperative (as was demonstrated by a study done in the UK). But they are driven to their symptoms by the belief that R.F. is coursing through their bodies. That doesn't make the symptoms any less real. It just makes the people suffering from them delusional.

The question is: Do we have to humor such sufferers by moving them to R.F. quiet areas or lining their homes with tin foil? Or can we just tell them to either pick up their subsidized prescription of Zoloft or live with their afflictions?

Re:Why am I not suprised? (2)

SydShamino (547793) | more than 2 years ago | (#40953881)

For my wife it was at first wondering why, with her lower back and legs in pain and numbness due to blown disk, her hands were also numb. After a few weeks on constant painkillers for her back, when those came down she found she was constantly fatigued, and with skin that felt like she had a 2nd degree sunburn over her whole body. And numb hands.

Are you proposing that, while her back was in excruciating pain, she chose to imagine that her hands were numb? Why would she go to the bother? It seems perfectly reasonable to me that nerve cells can misfire or nerve receptors can respond to the wrong or nonexistent signals, in the same way that brain cells can misfire in epileptic patients. They're all the same basic cells.

Having the treatment be a mood stabilizing drug makes sense as well, then in that they mess with the brain's ability to process nerve signals. While my wife was on it she would tell me that she felt "stupid" because she just couldn't think as quickly or as well as before. We got her off of that as soon as possible.

Re:Why am I not suprised? (1)

Anonymous Coward | more than 2 years ago | (#40953275)

Research scientists have found substantially different fMRI results for fibromyalgia patients compared to controls, so... something exists. Obviously, they don't usually do an fMRI to diagnose, who knows how many people have been misdiagnosed, and like many things, there's a whole quack industry [lose 25 pounds with just three easy tips doctors don't want you to know!], etc., but if you're going to call a bunch of people scammers and fakers, at least some of whom are in lots of pain, at least keep up with the research, yes?

One possible explanation for a stronger nocebo effect with fibromyalgia is that, if I understand it correctly, the symptoms can vary substantially day to day and over time. If a patient has some dizziness occasionally, it could be very hard to tell whether a new medication is causing a specific bout of dizziness (especially if there are multiple variables at play). If (not a real example) you have a group of people who have dizziness in approximately one out of four days, and then give them a placebo which they think can result in dizziness, then about one in four of them will experience dizziness on the day they start the drug. If they decide that the chance the dizziness might be caused by the drug is greater than the benefit of remaining in the clinical trial (and if they're on a placebo, they're probably not experiencing any benefits from the drug), then they're going to drop out.

Stress can also cause interesting symptoms in many people (clammy hands, racing heart, nausea; think stage fright), so some nocebo effects could be due to nervousness about trying a new medication. Others may be partly due to reporting bias (i.e. the non-placebo example of erectile dysfunction given in the article: if you didn't know erectile dysfunction could be caused by the drug, and you happened to have a few experiences of that sort, would you really want to mention it to the doctor, either for embarrassment or for don't-think-it's-relevant reasons?) or perception/selection bias (if you're on the alert for, say, itchy legs, you're going to notice/remember any itches more than you normally would and it's more likely to seem greater than normal).

But also, the brain is weird. And the blood pressure plummeting one is extra-weird.

Re:Why am I not suprised? (0)

Anonymous Coward | more than 2 years ago | (#40953829)

There's also strange things possible with conditioned responses. A study was done involving lab mice where they were given water with a substance that made them sick combined with another stimulus (flavoring, I think it was). After conditioning, when just the flavoring was present, clean water started making them sick. If I remember correctly, that particular study nearly killed the mice because the chemical used to make them ill also slightly suppressed their immune system, and the immune suppression was then being caused by the conditioned response alone.

I suspect other minor things could also be causing random symptoms. Like soap residue on dishes, drinking slightly dirty water, eating slightly spoiled food, or varying exposure to some air borne allergens. Or a person with dental problems could experience wildly varying symptoms from their most recent meal and assume discomfort was caused by a medication instead.

People just aren't very good at identifying cause and effect. I doubt the placebo effect deserves all the credit.

well (1)

geekoid (135745) | more than 2 years ago | (#40952671)

"he can suffer them even if the pill is fake."
by 'them' they mean non specific symptoms, then yes.

The Perfect Murder! (0)

Anonymous Coward | more than 2 years ago | (#40952697)

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!

The Math Is Simple (2)

rmdingler (1955220) | more than 2 years ago | (#40952785)

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.

The Matrix (0)

Anonymous Coward | more than 2 years ago | (#40952859)

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.

Is ignorance bliss? (1)

jcohen (131471) | more than 2 years ago | (#40952875)

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.

Re:Is ignorance bliss? (1)

SomeJoel (1061138) | more than 2 years ago | (#40953175)

I suggest looking at the data sheet, but paying close attention to the % of people experiencing the side effects. I'm pretty sure they have to report even very low incidence rates of side effects. If only a handful of test subjects got a particular side effect, then I'm pretty sure you can convince yourself that you're not *that* unlucky. Compare it to some other event with similar odds. Make sure the event you compare it to is a positive one though, like winning the lottery, lest you start a chain reaction of psychosomatic pitfalls.

Stop the presses! (1)

Anonymous Coward | more than 2 years ago | (#40952995)

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!

#homo (-1)

Anonymous Coward | more than 2 years ago | (#40953055)

No surprise (1)

simplexion (1142447) | more than 2 years ago | (#40953129)

Some people actually think Homeopathy is NOT a completely retarded concept.

No mention of Ben Goldacre? (1)

fugspit (632645) | more than 2 years ago | (#40953151)

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 [youtube.com]

Re:No mention of Ben Goldacre? (1)

fugspit (632645) | more than 2 years ago | (#40953189)

Gosh, there it is in related links. That'll teach me to search for him by name and not by the name of the book he wrote.

Nocebo (0)

Anonymous Coward | more than 2 years ago | (#40953315)

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.

Wind turbines! (1)

ve3oat (884827) | more than 2 years ago | (#40953369)

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.

Why do they need a new word? (0)

Anonymous Coward | more than 2 years ago | (#40953453)

The summary just provides more typical examples of the well-known Placebo Effect. This has been known for generations.

Nocebo? (0)

Anonymous Coward | more than 2 years ago | (#40953485)

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.

Misread the summary (1)

aNonnyMouseCowered (2693969) | more than 2 years ago | (#40953493)

"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?

The matrix (1)

bug1 (96678) | more than 2 years ago | (#40953513)

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.

when all the smiles are out of town (0)

Anonymous Coward | more than 2 years ago | (#40953533)

your placebo is too weak.
you're in the syndrome.

Remarkable Antidepressant Placebo (1)

TwineLogic (1679802) | more than 2 years ago | (#40953705)

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.

Re:Remarkable Antidepressant Placebo (0)

Anonymous Coward | more than 2 years ago | (#40953795)

you make it sound like some crazy doctor switched his medecine in his back ... the guy willingly signed up for a drug trial with absolutely no qualitative guarantee about the drug

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