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Comment by arkades | Hacker News Reader

This article does not show any evidence of a nocebo effect. It shows increased reporting following publicity - without distinguishing whether the result was increased incidence of perceived harm, or just increased /reporting/ of perceived harm (for instance, if patients would not have previously attributed those somatic symptoms to their medication.)

Crap study, just an excuse for a publication.

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This is also my take on this paper. It records an increase in reported side effects, which is not the same thing as an actual increase in side effects. Patients may have been experiencing these side effects anyway, but either didn’t report them, or didn’t associate them with the intervention.

Knowing these side effects are associated with the intervention would likely be enough for Confirmation Bias to increase the reported instance.

agree that it's crap study, but even worse than that it's an attempt to discredit symptom reporting in general

while talking extensively about the nocebo effect, it ignores the fact that without media coverage a patient may experience side effects but not connect that effect with the switch from one drug to another, or may think they're imagining the effect, etc

Absolutely. My long-term partner was in this exact situation: She did experience some fairly mild side-effects, complained about them to me, but didn't consider that the medication switch might be the cause until she saw others complaining, checked, and realised the symptoms had begun at the time she'd changed meds. She had simply assumed that she wouldn't have been switched to the generic if it wasn't identical, and thus initially assumed that any symptoms she was experiencing must be caused by something else; the exact opposite of what the study claimed, despite the fact that she will have been counted in that study as evidence of a nocebo effect.

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