Are Warnings About Drug Side Effects Actually Making Us Sick? | The Crux

Steve Silberman(@stevesilberman on Twitter) is a journalist whose articles and interviews have appeared inWired, Nature, The New Yorker, and other national publications; have been featured onThe Colbert Report;and have been nominated for National Magazine Awards andincluded in many anthologies. Steve is currently working on a book on autism and neurodiversity called NeuroTribes: Thinking Smarter About People Who ThinkDifferently (Avery Books 2013).This post originally appeared on his blog, NeuroTribes.

Photo by Flickr user Noodles and Beef

Your doctor doesnt like whats going on with your blood pressure. Youve been taking medication for it, but he wants to put you on a new drug, and youre fine with that. Then he leans in close and says in his most reassuring, man-to-man voice, I should tell you that a small number of my patients have experienced some minor sexual dysfunction on this drug. Its nothing to be ashamed of, and the good news is that this side effect is totally reversible. If you have any issues in the bedroom, dont hesitate to call, and well switch you to another type of drug called an ACE inhibitor. OK, you say, youll keep that in mind.

Three months later, your spouse is on edge. She wants to know if theres anything she can do (wink, wink) to reignite the spark in your marriage. Shes been checking out websites advertising romantic getaways. No, no, you reassure her, its not you! Its that new drug the doctor put me on, and I hate it. When you finally make the call, your doctor switches you over to a widely prescribed ACE inhibitor called Ramipril.

Now, Ramipril is just a great drug, he tells you, but a very few patients who react badly to it find they develop a persistent cough Your throat starts to itch even before you fetch the new prescription. Later in the week, youre telling your buddy at the office that you must have swallowed wrong for the second day in a row. When you type the words ACE inhibitor cough into Google, the text string auto-completes, because so many other people have run the same search, desperately sucking on herbal lozenges between breathless sips of water.

In other words, youre doomed. Cough, cough!

Photo by Flickr user Jeff and Colin

Whats going on here? Just medicine-as-usual in a world where valuable drugs have annoying side effects and conscientious health professionals do their best to protect their patients from unpleasant (and potentially litigious) surprises? Sure. But a provocative new report by Winfried Huser, Ernil Hansen, and Paul Enck in the journal of the German Medical Association suggests that the side effects of some drugs, and the discomfort of certain medical procedures, may be inadvertently intensified by doctors and nurses trying to keep patients fully informed of the consequences of their medical care. The culprit behind this phenomenon is the nocebo effect.

You can think of the nocebo effect as the evil twin of the placebo effect the bodys healing response to the act of taking a pill or receiving medical care, even if the pill itself is inert. The most familiar example of the placebo effect is what happens in trials of experimental drugs. One group of volunteers is randomly assigned to take the drug in question; another group is assigned to take placebo a fake drug designed to look just like the real one. Neither the volunteers nor the staff know which group is which. If the drug group improves significantly more than the placebo group, the drug is judged to be effective. This kind of test the double-blind, placebo-controlled trial has been the gold standard of drug development in medicine for half a century.

See the original post:
Are Warnings About Drug Side Effects Actually Making Us Sick? | The Crux