Researchers in England and Scandinavia discover that medication side effects may all be in the mind. In a landmark study, researchers tested the ‘nocebo effect’ on a group of patients. The authors used common ‘Statins’ or sugar pills, finding some interesting results.
Side effects of statins
For the last 30 years, Statins have been used by doctors to lower incidences of cardiovascular disease, including strokes and heart attacks. Theses lipid-lowering medications save many patients’ lives each year but there are often complaints of debilitating side effects. One side effect being muscular aches which can occur in 10-15% of patients. Statins also cause erectile dysfunction, cognitive impairment and sleep disturbance. But what if these side effects are all in the mind?
The teams working on the 5 year Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT-LLA) have made a remarkable discovery. Over 10,000 patients were given either a statin or sugar pill. They were then asked to report what side effects they experienced. The data showed that patients not warned of side effects tended to have less of them. Conversely, when the patients did know what they were taking and were made aware of potential side effects more were reported, most notably muscle pain. This is an example of the nocebo effect.
The nocebo effect
In the bestselling book, Bad Science, Ben Goldacre describes the nocebo effect as “the opposite of placebo, where people feel bad because they are expecting to”. Is this what is happening here? Goldacre goes on to explain this phenomenon with the aid of some beautifully designed experiments. The findings often always were that a doctor’s positive reinforcement contributed to better outcomes. If the doctor told patients to expect an adverse effect then that is what the patient would report.
Should doctors, therefore, give their patients nothing but positive information? In today’s fast-paced information age this would be a difficult task. Patients have a right to know what their options are and consistently misinforming vulnerable individuals can be seen as negligent. Most health professionals are also held accountable to the internet or ‘Dr Google’ as patients become adept at self-diagnosis.
3eThe ASCOT-LLA trial challenges the medical community to rethink its values- should doctors do the utmost to protect their patient’s right to self-rule by giving them all the facts? Alternatively, should negative diagnoses be obscured in an attempt to gain better clinical outcomes?
What do you think??
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Any opinions above are the author’s alone and may not represent those of his/her affiliations. Any comment is based on the best available evidence at the time of writing. All data is based on externally validated studies unless expressed otherwise. Novel data is representative of the sample surveyed. Online recommendation is no substitute for seeing your own doctor and should not be taken as medical advice.
We have no affiliation with Ben Goldacre or ‘Bad Science’. We do like him though.
Image courtesy of Pixabay
Sources and Futher Reading
- Goldacre. B (2008), Bad Science, Harper Collins
- Sever, P., Gupta, A., Thompson, D., Whitehouse, A., Collier, T., Dahlof, B. and Poulter, N., 2016. LBOS 01-04 THE TRUE INCIDENCE OF STATIN-RELATED ADVERSE EVENTS IN HYPERTENSIVE PATIENTS REVEALED BY COMPARISON OF BLINDED AND UN-BLINDED USE OF STATIN IN THE ANGLO-SCANDINAVIAN CARDIAC OUTCOMES TRIAL (ASCOT). Journal of hypertension, 34, pp.e547-e548.http://journals.lww.com/jhypertension/Abstract/2016/09001/LBOS_01_04_THE_TRUE_INCIDENCE_OF_STATIN__RELATED.1626.aspx