Mr Hyde – The Dark Side of Placebo Effect

On May 7, 2021 the new article (co-written with Maciej Zatonski) was published at:

Science-Based Medicine

We hear very often about the benefits of auto-suggestion (a.k.a. placebos) in medicine, but much less about their risks and harms.


 When Mr A. finally reached the Emergency Department of his local hospital. “Please, please help… I swallowed all of my pills” he mumbled to the attending nurse. An empty, unlabelled medicine box dropped from his hands only seconds before he collapsed on the hospital floor. The staff immediately started the required emergency procedures. The twenty-six-year-old male appeared very pale and apathetic but was still in limited verbal contact. He managed to explain to the emergency room staff that as a clinical trial participant, he took 29 remaining tablets of an unknown experimental therapeutic investigated as a potential treatment for depression. His impulsive decision to commit suicide was soon followed by a reflection that he is not ready to die just yet. As he realised that his life might be about to end, he asked his neighbour to take him to the nearest hospital. Initial examinations revealed severe hypotension. His blood pressure was 80/40 mmHg and dropping, and his heart rate was elevated to 110 beats per minute. He was shivering and breathing rapidly. To prevent the blood pressure from falling even more, he was immediately given an intravenous infusion of 0.9% solution of sodium chloride. Over the next 4 hours, he received over 6 litres of intravenous fluids, which only partially helped to stabilise his blood pressure. The patient was still lethargic and apathetic. During the attempts to stabilise his condition, the staff has tried to learn more about the experimental treatment he was taking. It quickly turned out that he was indeed a participant of a registered clinical trial investigating new treatments for depression, however…he was in the placebo control group! In less than 15 minutes from informing Mr A about being in the placebo arm, his heart rate and blood pressure returned to normal, and he has recovered from his lethargic state. Luckily there was no permanent kidney damage caused by the administration of life-saving fluids.

Read more HERE

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