When I was in high school, I was plagued with serious Acne on my face and body just like any other teenager. After going through countless medications and climbing up the ladder of seriousness I was left with the final option, Roacutane.
Roacutane is a very serious acne medication that comes equipped with two pages of side effects. These side effects range from from skin peeling, hair loss, depression and even suicide. These were some serious side effects but my dermatologist assured me that most people don’t get these at all. After careful consideration and my acne getting progressively worse, I dove into the deep end and went on the medication.
After going on the medication I found myself gaining a lot of these symptoms. Most noticeably increased hair grown on my face. As most Indian girls, I have been “blessed” with a lot of body hair. But I found this increase in hair not on my head but on the sides of my face. I was convinced that it was the medication slowly turning me into a werewolf with each pill I took. I went to the dermatologist and she lowered my dose. The “effect” went away. However, even after I stopped the medications, the hair remained the same.
Fast tracked 6 years, I am sitting in my psychology lecture learning about nocebos. A nocebo is basically the opposite of a placebo effect where an individual believes and expects negative effects to occur to the body and/or mind because they have been subjected to a form of treatment. And then it clicked. The hair never grew, it was always that way and still is. Because I read the two page long list of side effects and I was on the medication I was literally “seeking” these side effects within me.
Nocebo’s are super powerful. Just to give you an idea, it can be elicited through the way information or procedure is phrased or even simply by changing a medication or process.
Studies have shown that when a procedure is described as painful compared to uncomfortable, patients will experience significantly more pain purely because the procedure was described as painful. Even more interestingly, patients report symptom presence differently when information is phrased in a positive manner – “60% of people do not experience symptoms” compared to a negative manner – “40% of people do experience symptoms”. Those that were told the information in a positive frame, hardly experienced symptoms, however those told in a negative frame, experienced symptoms much more frequently, despite the fact that the chance of experiencing the symptoms was the same for both. This was because the negative framing was presented in a way that the patient was included in the statistic, leading the patient to think they will be affected by the symptoms, eventually falling into the nocebo effect.
As humans we don’t particularly like or welcome change. Once we are used to something and feel comfortable, we like to keep it that way. So it isn’t that surprising that when medications are changed, physicians and pharmacists see a surge in side effects supposedly caused by the new drug. There have been many cases such as these instances.
In New Zealand, a better and improved drug with the same active ingredient but one different filler ingredient caused social outrage among patients and pharmacists because they were all getting these side effects. The funny thing about this was that New Zealand was the only country out of approximately 30 that had a surge of these side effects due to the nocebo effect. Hardly anyone from the other countries reported any side effects from the new drug.
So given all this, the next time you guys take a new medication, it may be wise to not read the list of side effects that come with it.