Beta-blockers, Statins, AF, and the Nocebo Effect

Our brains can easily fool us. No experienced doctor would deny the power of the placebo effect. Today I want to discuss the nocebo effect, which occurs when negative expectations of something causes it to have a more negative effect than it otherwise would. Drugs can exert a strong nocebo effect. If your brain thinks you will have a side effect, you may actually get that effect. Nocebo brain trickery is relevant to statins. That’s why I used this wording in my last post: (Note the italics) The actual frequency of muscle symptoms is hotly debated. Randomized controlled trials (in which patients don’t know whether they are taking the statin or placebo) report very small increases in muscle complaints—about a 1-2% increase. Observational studies, however, reveal higher rates of statin muscle complaints–in the range of 10-20%. The nocebo effect is also relevant to beta-blockers. Beta-blockers, which are drugs that blunt the effect of adrenaline, carry enormous baggage about side effects. People think they will gain weight, be fatigued, or get short-winded when taking these drugs. Men think they will become impotent. The evidence, however, does not support these perceptions. Similar to muscle complaints and statins, our brains may be tricking us. An elegant study from a famous group of British researchers strongly suggests that most side effects from beta-blockers stem from the nocebo effect. The authors did a systematic review of blinded trials that used beta-bl...
Source: Dr John M - Category: Cardiology Authors: Source Type: blogs