Worrying about taking medications is causing real harm to people

But it is a problem. It is estimated that up to half of patients prescribed statins stop taking statins or reduce their doses because they feel unwell. Because statins are now cheap and widely prescribed (I take them myself), resistance increases the risk of heart attack or stroke in the population. Nocebo causes serious damage.

It has been recognized for a long time. Walter Kennedy, a British physician, coined the word in 1961 as the placebo “evil twin” (“I will hurt” in Latin, rather than “I will satisfy”). More recently, researchers have proposed the term “drucebo” for responses that are not considered direct side effects of taking medications.

I don’t think I can imagine nocebo spreading. One of the reasons people refuse to receive the COVID-19 vaccination is fear of serious adverse reactions such as loss of fertility or heart attacks. No matter how doctors and public health officials try to reassure them, the concern remains.

Many people who did not get the COVID-19 vaccine, and instead were injected with dummy substances, experienced ill effects. AP

Clinical trials of COVID-19 vaccines have confirmed previous evidence of nocebo responses: many people who did not get the vaccine, and instead were injected with placebos, experienced ill effects. A research study published last month found that 35 percent of people receiving a placebo for the first trial dose had adverse reactions elsewhere in their body.

It follows that many of the symptoms that people complained about were due to nocebo. I felt a little sick after one of the COVID-19 hits, but now I wonder if it was a side effect of the drug, or just because I was expecting it: I was surrounded by friends and colleagues telling me how they felt, and whether they needed to lie down.

This condition is exacerbated by the febrile state of the media and social media. to be fair to passHer stories about the side effects of statins are more balanced than the headlines, but she knows how to appeal to her elderly readers. The bad news, including reasons for concern about drugs, is compelling.

Then there is the outpouring of insight, information, flamboyant opinions, and deliberate deception that flows through social media and private message groups. There are a lot of people out there who like to scare others about side effects and it can become a self-fulfilling prophecy.

Behind all this lies a complex medical problem – doctors are obligated to fully inform patients of the risks as well as the benefits of drugs, and not to harm them. But if the act of telling patients about all possible side effects is likely to lead to negative reactions, what should they do?

Especially with nervous patients, some tend to skip the warnings and rely on the leaflets that come with the pills (which I haven’t read before). Kaptchuk, who studies the effects of placebo and nocebo, denounces such tactics: “Telling them the slightest is completely unethical, destroys informed consent and is deceptive,” he said.

He has another suggestion: Doctors should briefly explain the possible side effects of the drugs but add that people also have similar reactions through nocebo. He calls this “putting speed bumps” to prevent patients from being overwhelmed with information, and to keep them informed better, not worse.

It would be a lot easier if our bodies produced clear information, rather than vague aches and pains that might be an illness, side effect, or nocebo. But we weren’t built that way, and medical science will take more time to produce an accurate signal.

Until then, public health is at risk from nocebo. We have more to fear than fear itself, but it is still painful.

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