[HN Gopher] A social analgesic? Acetaminophen (paracetamol) redu...
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       A social analgesic? Acetaminophen (paracetamol) reduces positive
       empathy
        
       Author : amichail
       Score  : 81 points
       Date   : 2022-05-04 17:18 UTC (5 hours ago)
        
 (HTM) web link (www.ncbi.nlm.nih.gov)
 (TXT) w3m dump (www.ncbi.nlm.nih.gov)
        
       | jpmattia wrote:
       | Psych study with n=114. Given the reproducibility crisis in
       | psychology, I'll wait for the replication.
        
         | raddan wrote:
         | Sure, do that. But also:
         | 
         | > The power analysis used a power criterion of (1 - b) = 0.80,
         | which indicated that a mean cell size of n = 54 was sufficient
         | to replicate significant effects of acetaminophen.
         | 
         | The question is not whether n=114 is "large enough" because
         | that question, by itself, does not make sense. The question is
         | whether n=114 is "large enough for the observed effect." Given
         | that the p-values for the "personal pleasure" and "empathetic
         | feelings" measures are under 0.001, the answer is "yes,"
         | potential methodological issues notwithstanding.
        
           | [deleted]
        
           | teaearlgrey_hot wrote:
           | Disagree from experience. I find it far more likely that they
           | considered how to skew the p-values low enough to where they
           | become significant. "Personal pleasure" & "Empathetic
           | feelings" do NOT sound like terms which correlate to
           | reproducibility to me.
        
             | HWR_14 wrote:
             | > "Personal pleasure" & "Empathetic feelings" do NOT sound
             | like terms which correlate to reproducibility to me.
             | 
             | All studies that use terms like that have a section that
             | explains how they are measuring it, how other studies have
             | used the same measure and how that measure itself is tested
             | for reproducibility and accuracy.
        
               | ngvrnd wrote:
               | doesn't necessarily mean they are ACTUALLY measuring
               | anything real. just sayin'
        
               | HWR_14 wrote:
               | So without training in the field, having read about the
               | specific example or anything else, you can say the entire
               | study is trash?
        
         | amelius wrote:
         | Scientist: Hey, that's odd ...
         | 
         | HN reader: I'll wait for the replication.
        
         | FastMonkey wrote:
         | All undergrads from a single university also. Just based on the
         | social development of people as they go through undergrad, I'd
         | guess that the variance in behavioural change before and after
         | treatment is fairly high whether they're treated or not.
        
           | snovv_crash wrote:
           | Just like a lot of pharma papers need a `... in mice`
           | appended to their titles, a lot of psych papers need `... in
           | undergrads` appended to theirs.
        
         | arcticbull wrote:
         | There's been a few over the years.
         | 
         | [1] 2016: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015806/
         | 
         | [2] 2015:
         | https://journals.sagepub.com/doi/abs/10.1177/095679761557036...
         | 
         | [3] 2012:
         | http://www.psychologicalscience.org/news/releases/broken-hea...
        
         | plsbenice34 wrote:
         | Seems like every time now, when I read a medical study,
         | especially psychiatry-related, I'm shocked that it could even
         | be published. I have no training in the field, so nobody would
         | take me seriously and I even doubt myself, but the study
         | designs just seem so poor
        
         | mattkrause wrote:
         | I don't think you should sneer at a triple-digit sample size
         | that's justified with a power analysis based on their previous
         | work.
         | 
         | I agree that you'd want to see replications before making any
         | major decisions--these effects are often finnicky--but this
         | seems to me like a reasonable-sized step forward.
        
           | simulate-me wrote:
           | They also had a prior justification for running this
           | experiment based on known effects of Tylenol on the brain.
        
         | madrox wrote:
         | I tend to agree. While I think the sample size is fine, the way
         | perceived positivity and perceived pleasure were measured seems
         | pretty subjective in a way I find hard to generalize.
         | 
         | The paper does seem awfully suggestive, though. Worthy of more
         | exploration for sure.
        
       | throw149102 wrote:
       | It would be interesting to see a study on whether Tylenol reduces
       | empathy in people who are sick/in chronic pain. My guess would be
       | that Tylenol increases empathy in these situations, despite the
       | general effect it has in reducing empathy. It's hard to empathize
       | with others when you're in pain yourself.
       | 
       | Brings about a good question - if you have a headache, and you
       | take Tylenol, do you become more or less empathetic? If the
       | answer is you become _more_ empathetic, that indicates that
       | instead of Tylenol being the bad guy, we should try to reduce the
       | prevalence of headaches (or pains that cause people to take
       | Tylenol) in general.
        
       | SemanticStrengh wrote:
       | Is it a pharmacologically relevant acetyl donor btw?
        
       | mabbo wrote:
       | Acetaminophen (paracetamol) is also associated with reductions in
       | 'social pain'.[0]
       | 
       | > Thus, acetaminophen reduces behavioral and neural responses
       | associated with the pain of social rejection, demonstrating
       | substantial overlap between social and physical pain.
       | 
       | It's a fascinating idea that social pain and physical pain are so
       | strongly related. That depression can be viewed as a form of
       | chronic pain, like a knee that still hurts long after the injury
       | has healed.
       | 
       | And perhaps then positive empathy has something to do with
       | literally feeling the social pain of others- blunt your ability
       | to feel social pain and you aren't as affected by it.
       | 
       | [0]https://journals.sagepub.com/doi/abs/10.1177/095679761037474..
       | .
        
         | inter_netuser wrote:
         | That's been known for a long time, possibly centuries.
         | 
         | morphine was used to treat depression as late as last century,
         | and probably remains a common folk remedy even today.
        
           | bink wrote:
           | Morphine has more effects than just killing pain, however. It
           | also provides a euphoric feeling. It's more interesting if a
           | drug that was until now only known for removing physical pain
           | can also provide relief for social pain.
        
           | colechristensen wrote:
           | Well yes, there's definitely a reason there are problems with
           | opiate addictions.
           | 
           | A differentiation between legal and illegal drugs is the
           | legal ones poison you before they make you feel particularly
           | amazing, the illegal ones poison you after. Take way too much
           | acetaminophen and you get liver failure before you feel
           | euphoria.
           | 
           | There are arguments to be made that many illegal drugs are
           | safer at effective doses but have risks of abuse not present
           | in the drugs that poison you before abuse is fun.
        
             | Terry_Roll wrote:
             | Depending on "who" you listen to Wild Lettuce is either no
             | good or its better than morphine without the addiction.
             | https://en.wikipedia.org/wiki/Lactuca_virosa
             | https://erowid.org/plants/lactuca/lactuca.shtml
             | 
             | https://en.wikipedia.org/wiki/Lactucarium#History
             | 
             | So with man made chemicals they tend to not break down as
             | easily, you see this with man made pesticides like
             | pyrethrin's yet the pyrethrin's in Chrysanthemum do break
             | down easily, organophosphates (nerve agents at the right
             | dose) are another group used to dip Sheep in, but might
             | show up in trace amounts in lanolin based Vit D3
             | supplements.
        
         | CTDOCodebases wrote:
         | Aren't emotions just thoughts with a linked physical sensation?
         | 
         | Why is it so fascinating?
        
       | photochemsyn wrote:
       | Acetaminophen is best avoided in my opinion. Long term liver
       | damage is a major issue, particularly in conjunction with
       | alcohol. There's also some evidence it's linked to cancer, and
       | why take the risk? Ibuprofen (Advil) is probably much preferable
       | in most cases, though definitely not for long-term chronic pain.
       | 
       | Long-term chronic pain is one condition where opiates actually
       | make sense, although studies demonstrate that using cannabis +
       | opiates allows the opiate dosage to be kept below the addiction
       | threshold while providing equivalent relief.
        
         | robocat wrote:
         | > There's also some evidence it's linked to cancer
         | 
         | Isn't everything? I would love to see a site that was more
         | about the relative risks of cancer. Or even better, that
         | queries us for our behaviours and then suggests where to spend
         | our efforts to improve our quality of life, based on well
         | supported research.
        
           | toast0 wrote:
           | WARNING: Reading this comment is known to the State of
           | California to cause cancer and birth defects or other
           | reproductive harm.
        
             | geocrasher wrote:
             | The moral of the story is this: Stay out of California.
             | _everything_ causes cancer there.
        
               | arcticbull wrote:
               | plane_with_red_dots.jpeg
        
       | donclark wrote:
        
         | scotty79 wrote:
         | Conservative views don't come from lack of empathy. They come
         | from anxiety about your safety.
         | 
         | You can make liberal more conservative by priming him to think
         | about his own vulnerability and death and you can make
         | conservative more liberal by priming him to think of himself as
         | invulnerable superhero
        
           | nsdfg425sf wrote:
        
           | donclark wrote:
           | Paranoid safety peeps eh?
           | 
           | I would still like to see if there is any data correlation.
        
       | [deleted]
        
       | spfzero wrote:
       | You have to suspect that the underlying reason people are taking
       | a pain reliever in the first place also makes them less
       | empathetic to others. That could even be a larger effect than the
       | one found in the study.
       | 
       | Understand that's controlled for in the OA, just mentioning
       | another aspect in real-life situations.
        
         | moron4hire wrote:
         | Are you saying that you think people who want relief from their
         | own pain are people who have reduced empathy toward others?
        
           | scotty79 wrote:
           | It might be that just being in pain yourself can lower your
           | empathy. For example your body could raise pain threshold a
           | bit so it's easier for you to suffer your pain which could
           | cause empathetic pain not to register at all.
        
       | Tylenol wrote:
       | When I can't sleep because my mind is racing, or I am anxious
       | about something, I take 1000mg of acetaminophen, the stress is
       | relieved, and within an hour I am asleep.
       | 
       | When bad things happen to me, or I'm anxious about something, I
       | take 1000mg of acetaminophen and the stress is quickly blunted.
       | 
       | Acetaminophen is a miracle drug for psychological pain, and it is
       | very safe if used occasionally in small doses (as described
       | above).
        
         | robocat wrote:
         | I take an anti-histamine. They don't usually make me drowsy,
         | but if I am wake at 3AM and feel too awake, the anti-histamine
         | is usually enough to push me back to sleep (although it isn't
         | immediate).
        
           | 37ef_ced3 wrote:
           | Antihistamines like Benadryl are anticholinergics. They are
           | harmful to the brain and everyone should avoid them. In
           | contrast acetaminophen is universally considered to be safe
           | for people with a normal liver.
        
         | maccard wrote:
         | > it is very safe if used occasionally in small doses (as
         | described above).
         | 
         | Define occasionally, and small doses. Paracetamol/acetaminophen
         | is widely considered to be dangerous for a few reasons -
         | sustained use of "safe" dosages has been shown to have a huge
         | effect on liver failure [0] - it's regularly found in other
         | painkiller, cold & flu, decongestant, and antihistamines. -
         | It's surprisingly ineffective for a large number of people for
         | lots of different kinds of pain - The dosage that can cause
         | critical liver damage is _dangerously_ close to the therapeutic
         | dose.
         | 
         | [0] https://link.springer.com/article/10.1007/s40264-012-0013-7
        
           | 37ef_ced3 wrote:
           | Commenter was explicit about dosage and pretty clear about
           | frequency. A single dose of 1,000 milligrams in a 24 hour
           | period is indeed small and universally considered to be safe
           | for people with a normal liver.
        
         | brimble wrote:
         | I use weed for both these cases--shutting my mind up so I can
         | sleep and/or dulling physical pain in case of illness so I can
         | sleep, if it doesn't rise to the level of needing/being-able-
         | to-get serious painkillers, plus (at lower doses, and far less
         | often) for reducing anxiety during waking hours.
         | 
         | Works great, wish I'd started years ago. Leaves me much better-
         | rested in the morning than other prescription sleep aids I've
         | tried. On nights when I know I'll have a nice 9ish hours
         | uninterrupted, I pair it with a little melatonin to keep me
         | from waking up completely if I stir a little after the weed's
         | worn off, and it's the best damn sleep of my life.
         | 
         | A+++++ would recommend. Screw you for lying to me, William S.
         | Sessions.
        
         | Timpy wrote:
         | I don't think 1000mg is a small dose, I'm not a doctor but that
         | seems like an extra-strength portion to me
        
           | daveoc64 wrote:
           | The standard size of a Paracetamol (as it is known in the
           | UK[0]) tablet in the UK is 500mg.
           | 
           | The normal dose is 2 tablets (i.e. 1000mg in total).
           | 
           | Wait at least 4 hours between doses.
           | 
           | Don't have more than 4 doses in a 24-hour period.
           | 
           | Paracetamol is one of the most commonly used medicines in the
           | UK.
           | 
           | [0] - https://www.nhs.uk/medicines/paracetamol-for-adults/
        
           | [deleted]
        
           | arcticbull wrote:
           | Acetaminophen has an active dose very close to the lethal
           | dose, and is the leading cause of acute liver failure in the
           | United States. While the daily limit is 4000mg, 1000mg is not
           | un-common in formulations like extra-strength Tylenol.
        
           | mattkrause wrote:
           | The "standard dosage unit" in Canada is 325 mg (for adults),
           | with extra-strength pills containing 500 or 650 mg.
           | 
           | 1000 mg is pushing the daily limit (4000 mg, but it's got a
           | halflife of ~6 hrs, so...)
        
         | User23 wrote:
         | Another drug you might want to consider is Cebocap[1]. It has a
         | very safe side-effect profile, it's safe for pregnant and
         | nursing women, and it has been clinically proven to effectively
         | treat a wide variety of ailments.
         | 
         | [1] https://www.drugs.com/imprints/forest-707-17216.html
        
       | motohagiography wrote:
       | Sounds like a hack for people with social anxiety as well.
        
         | mromanuk wrote:
         | Recently I read about using paracetamol for social anxiety.
         | There is a connection.
        
           | Broken_Hippo wrote:
           | Paracetamol and Acetaminophen are the same drug - much of the
           | world calls it Paracetamol. Different takes on the same
           | chemical name, though I can't remember the reason for the
           | difference. I looked it up some years ago when I moved from
           | the US to Europe.
        
         | bencollier49 wrote:
         | Well yes, if you're a fan of hypogonadism.
         | 
         | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5044981/
         | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5789927/
        
           | danachow wrote:
           | That's quite a leap. One of those is for ibuprofen, which has
           | virtually no similarities with acetaminophen and the first
           | one is for a xenograft model - there are tremendous problems
           | with getting carried away with that result as you seem to
           | have done.
        
           | rybosworld wrote:
           | That second link seems to suggest the effect in adults is
           | very minimal.
        
           | nrdgrrrl wrote:
        
       | midislack wrote:
       | Empathy must be stored in the liver which Tylenol also destroys.
        
       | ipnon wrote:
       | Pain is psychosomatic. A broken heart physically hurts, and a
       | broken bone will ruin your mood. A similar result was found in
       | parents with opiate abuse disorder, they were less likely to
       | notice negative emotional states when shown pictures of children
       | in various moods. I don't think this result is concerning except
       | for people who are taking NSAIDs on a daily basis for long
       | periods of time.
        
       | threads2 wrote:
       | It also reduces compensatory affirmation:
       | 
       | The Common Pain of Surrealism and Death: Acetaminophen Reduces
       | Compensatory Affirmation Following Meaning Threats
       | 
       | https://www2.psych.ubc.ca/~heine/docs/2013%20Acetaminophen%2...
       | 
       | > They ... watched a 4-min clip from the short film Rabbits,
       | created by David Lynch (2002)
       | 
       | > acetaminophen interrupts the typical compensatory responses to
       | meaning threats ...
       | 
       | > acetaminophen has more far-reaching psychological consequences
       | than previously realized
       | 
       | Though not a huge n, n=121.
        
       | pagutierrezn wrote:
       | 2016 https://news.ycombinator.com/item?id=14683173
       | 
       | 2020 https://news.ycombinator.com/item?id=25540870
        
         | dang wrote:
         | Thanks! Macroexpanded:
         | 
         |  _In study, acetaminophen makes risky moves seem less
         | dangerous_ - https://news.ycombinator.com/item?id=25540870 -
         | Dec 2020 (133 comments)
         | 
         |  _Acetaminophen reduces empathy for pain (2016)_ -
         | https://news.ycombinator.com/item?id=14683173 - July 2017 (93
         | comments)
         | 
         | Others:
         | 
         |  _Prenatal acetaminophen increases autism and ADHD risk 20%_ -
         | https://news.ycombinator.com/item?id=27362768 - June 2021 (20
         | comments)
         | 
         |  _Acetaminophen exposure in pregnancy linked to higher risk of
         | ADHD, autism: study_ -
         | https://news.ycombinator.com/item?id=21415078 - Nov 2019 (39
         | comments)
         | 
         |  _Acetaminophen use in pregnancy linked to child 's behavioral
         | problems_ - https://news.ycombinator.com/item?id=12293675 - Aug
         | 2016 (84 comments)
         | 
         |  _Acetaminophen may hinder the brain 's error-correction
         | mechanisms_ - https://news.ycombinator.com/item?id=11465452 -
         | April 2016 (56 comments)
         | 
         |  _Acetaminophen and the War on Drugs (2009)_ -
         | https://news.ycombinator.com/item?id=2211599 - Feb 2011 (58
         | comments)
        
       | geocrasher wrote:
       | This explains why some people are so stupid it hurts.
        
       | mikkergp wrote:
       | a "potent" physical painkiller .
       | 
       | Does anyone know if the word potent here is meant to be
       | scientific or emotional? It feels emotional, the dictionary
       | definition is "having great power, influence, or effect." which
       | seems weird to jump out the gate with such a subjective word for
       | an over the counter painkiller.
        
         | dvh wrote:
         | I was once taking out trash in the middle of the night and I've
         | overheard neighbor's conversation: "What's the strongest thing
         | you have here for headache and if you say Tylenol I'm gonna
         | kill you!"
        
       | dkh wrote:
       | Another study linking these. The prospect of humans in some
       | places maybe experiencing different things and making different
       | decisions than they would've because for a couple generations
       | everyone has been taking a ton of Tylenol and it reduced
       | everyone's collective empathy... that is terrifying to me.
        
       | ovulationkit wrote:
        
       | rapjr9 wrote:
       | So perhaps acetaminophen (Tylenol) is responsible for the
       | increasing political divide in the USA and in the world? People
       | literally care less about each other because their empathy is
       | being blunted. How long does the effect last? Days at least if I
       | remember previous reports correctly. There are a LOT of people
       | using acetaminophen often. If the effect lasted a week would just
       | one pill a week make you a less caring person? This seems like it
       | could be a really big deal.
        
         | HNHatesUsers wrote:
        
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