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Medicine

Tylenol May Ease Pain of Existential Distress, Social Rejection 190

Posted by timothy
from the existential-distress-is-just-a-headache dept.
Guppy writes "Does Tylenol reduce existential distress? Acetaminophen (Paracetamol) has been used to relieve mild-to-moderate physical pain for over a century, yet its actual mechanism of action continues to be debated; modern research has demonstrated an intriguing connection with the body's endocannabinoid system, raising the question of whether it may also have subtle psychological effects as well. A recent paper claims Acetaminophen can alter our response to existential challenge; previous findings have suggested that it may blunt the pain of social rejection as well."
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Tylenol May Ease Pain of Existential Distress, Social Rejection

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  • by longbot (789962) <longbottle&gmail,com> on Monday May 06, 2013 @12:51AM (#43639283) Homepage
    ....comfortably numb!
    • by hoboroadie (1726896) on Monday May 06, 2013 @12:59AM (#43639299)

      I prefer treating my cannabinoid receptors with less toxic chemicals, in case I ever want to use my liver for anything.

      • Re: (Score:3, Insightful)

        by Anonymous Coward

        Acetaminophen is basically completely safe when taken in a normal dosage (i.e. what it says on the label), except for people with certain genetic conditions that interfere with normal metabolism of the drug.

        Acetaminophen kills because it's an ingredient in so many over-the-counter and prescription drugs with different names and labels, and many people don't realize they're taking acetaminophen at all, let alone an overdose of it.

        • by Dorianny (1847922) on Monday May 06, 2013 @01:26AM (#43639385) Journal
          Most people know that taking too much Tylenol is dangerous but very few understand that McNeil, the company behind Tylenol, is just selling overpriced acetaminophen.
        • Re: (Score:3, Informative)

          by symbolset (646467) *
          The liver toxicity of Acetaminophen is used to deter opioid addiction by mixing opioids with Acetaminophen. Opioids are powerfully addictive narcotics and this practice kills about 500 Americans [nih.gov] per year.
          • I get queasy from Tylenol, maybe I don't have that immunity. All the rest of you, don't mix it with alcohol or take it for a hangover. The toxicity is cumulative. If your MD won't prescribe unadulterated opioids, get some oil of bergamot to take with it for the "grapefruit effect". It will metabolize two or three times as much therapeutic chemical and allow the proper relief without excessive toxicity.
            I have migraines, and alternate between ergotamine tartrate and hydrocodone so that neither causes problems

            • by sFurbo (1361249)

              . All the rest of you, don't mix it with alcohol or take it for a hangover. The toxicity is cumulative

              From what I gather from the literature, you are right about the hangover, but wrong about the mixing with alcohol. The blood concentration of the toxic degradation product is lowered when paracetamol is taken with alcohol, probably due to the alcohol successfully competing with cytochrome P450 in the liver, in much the same way that alcohol can be used to treat methanol poisoning (though another enzyme is competed for here).

              However, there seems to be no reason to not use inbuprofen or naproxen [sciencebasedmedicine.org]:

              All NSAIDs are hazardous, but but some have higher toxicities than others. For occasional and long-term use, products like ibuprofen and naproxen are safer and as effective as other NSAIDs.

              Except, of

              • by Guppy (12314)

                From what I gather from the literature, you are right about the hangover, but wrong about the mixing with alcohol. The blood concentration of the toxic degradation product is lowered when paracetamol is taken with alcohol, probably due to the alcohol successfully competing with cytochrome P450 in the liver, in much the same way that alcohol can be used to treat methanol poisoning (though another enzyme is competed for here).

                Stumbled upon a good review of the pharmacology of Acetaminophen-Alcohol interactions (from back in 2000). Apparently it's more complicated than I thought:
                http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2014937/ [nih.gov]

                The interactions between paracetamol and ethanol are complex and many questions remain to be answered. In animals, chronic administration of ethanol causes microsomal enzyme induction with increased toxic metabolic activation of paracetamol and enhanced hepatotoxicity. Conversely, the acute administration of ethanol inhibits the potentially toxic oxidative metabolism of paracetamol and protects against liver damage. This protective effect disappears when the ethanol is eliminated and the time interval between the intake of ethanol and paracetamol is critical.

                Although the possibility that chronic alcoholics are at increased risk of paracetamol hepatotoxicity can by no means be excluded, the available evidence does not support claims for a major toxic interaction between ethanol and paracetamol in man.

                In contrast to the findings in animals, chronic alcoholics do not produce abnormally increased amounts of the potentially toxic metabolite of paracetamol. There is only modest, short-lived induction of CYP2E1 in chronic alcoholics and it seems that other isoenzymes are primarily responsible for the metabolic activation of paracetamol in man. In keeping with the metabolic data, there is no convincing clinical evidence to support the claims that chronic alcoholics are at increased risk of liver damage either following overdosage of paracetamol or with its therapeutic use. Such evidence as exists is purely anecdotal and similar toxicity has been reported in both circumstances in patients who are not alcoholic.

                I would caution though, that while normal humans have an enormous amount of extra functional reserve in their livers, this may not be true for chronic alcohol users. Even if the absolute pharmacological toxicity is identical (or even modestly lessened), the same overdose that a non-alcoholic recovers

          • The link does not back up your claims, the 500 deaths is for ALL overdoses of Acetaminophen and it says nothing about mixing it with opioids to deter addiction. However they did do something similar during alcohol prohibition with lethal results, mixing formaldehyde (or something similar) to things such as methylated spirits, to deter alcoholics from drinking it. The practice killed thousands of people who's only crime was addiction to an illegal drug. Alcohol is also one of the very few recreational drugs
            • Re:I have become.... (Score:5, Interesting)

              by Anonymous Coward on Monday May 06, 2013 @03:16AM (#43639769)

              Sorry, but the annual death toll from mixing opioids with APAP is far higher than 500. It's just not reported as such. The financial costs of medical care for opioid addicts is far higher than that of cancer patients, as they may seek treatment for their pain several times a day from many different sources.

              [citation needed: own experience] I used to be a travelling salesman in the Western US with an opioid addict for my boss. In addition to our actual work we stopped at three clinics a day in seven states on a regular route. He had Blue Cross, and every clinic gave him a 90-day script for hydrocodone at least, sometimes Percocet or Oxycontin. God only knows what that bill was like. We did this for over a year, and hit the same clinics every 90 days. The work was lucrative of course, or it could not support this. He wasn't "taking" his medication, he was "eating" it.

              It was a fun gig, and as you might imagine morality was a situational thing. Not personally profitable though. Definitely an adventure. Never cared for the opioids myself, but the liquor flowed and we hit all the gentleman’s clubs with ready cash in hand.

              I gave up when he needed to go into rehab and wanted me to do the work with a crackhead as my boss to fill in for him. Oxy freaks are one thing, but crackheads try to kill you, usually soon. His choice of the (we all knew it) crackhead to keep up the cashflow over me who didn't have these issues was the end. I got out.

              On the way home I stopped and had a "relationship" with his wife. I'm not proud of that, but damn it was fun.

              When I got home my own wife was knocked up with somebody else's kid. Karma.

              He's dead now. Liver failure, not in any way associated with his 20 year opioid with APAP addiction so he doesn't count in that year's 500.

              /AC for good and proper reasons. Hopefully the content will override the lack of provenance.

          • Kills 500 Americans per year, you say? I think we could all do with fewer Americans. Any way we could beef up that figure?
          • The liver toxicity of Acetaminophen is used to deter opioid addiction by mixing opioids with Acetaminophen. Opioids are powerfully addictive narcotics and this practice kills about 500 Americans [nih.gov] per year.

            This isn't like spiking rubbing alcohol with methanol and other toxins. The opiods really do increase the pain relieving properties of the acetaminophen greatly. Unfortunately, the opiods are, as you say, addictive narcotics. But unlike how you interpret it, the practice actually increases narcotic addition rather than deterring it. Patients end up abusing the drugs that their own doctors gave them. Doctors don't really have that many better options for serious pain, and many don't really do a good job at p

            • by tragedy (27079)

              The opiods really do increase the pain relieving properties of the acetaminophen greatly.

              I think the point was that the opiods handle pain relief so effectively that the acetaminophen in the mix effectively does nothing except provide a health hazard.

        • Yes it's safe, but you have to understand, people generally tend to self-medicate rather than go to an actual Doctor. This leads to overdoses and over-the-top news stories. The Maximum safe daily dosage is 2000mg, but it's recommended that no more than 1500mg daily be consumed. Since this is meant for Pain relief, and the state of affairs in the United Stated is all out war on any Opium based Medication; people fall back to things such as Tylenol and tend to take more than they should.

          There have been study

      • by Zaatxe (939368)

        [...] in case I ever want to use my liver for anything.

        Like alcohol?

    • Take 36 Tylenol and see me in the morning.
      • Back in my day it was tea and two cups of Bex.
    • Is there anybody In there? Just nod if you can hear me. Is there anyone home?

      • Re:Okay (Score:5, Insightful)

        by Internetuser1248 (1787630) on Monday May 06, 2013 @02:24AM (#43639609)
        Can you stand up? I do believe it's working. Why would we want to numb existential distress? This emotion is a social corrective mechanism that tells us when society is moving in the wrong direction. The reason it is becoming more of a problem in modern times is because our society is profoundly ill and we perceive that on some level. In the same way physical pain makes one pull one's hand out of the fire, existential stress makes one reevaluate one's life and look at ways it could be made more meaningful and more fulfilling. Why don't we just make a drug to cure ambition, sexual desire and distress of the conscience while while we are at it and wreck the human race for good?
        • Sorry for the off-topic post, but as you don't make an email address public, I can't contact you any other way.

          I'm currently writing a book (non-fiction) on the topic of self-discovery using psychedelics (specifically LSD) and would like to paraphrase your comment. I'd be happy to give attribution or not, as you'd prefer.

          Specifically the context will be the discussion of negative experiences during a psychedelic trip and how it can be used as a learning experience for self-improvement; I'd like to paraphra

          • Some of the best self-discovery I've had was using ... that thing specifically that your book will focus on - but on two occasions with a particular fungus I had a good time and a bad time. The good time led me guided through an Aztec maze to meet with my spiritual guardian, the other was the most horrifying and chaotic experience of my life short of being born (and I since I don't really remember that one...). The terrible experience altered my perspective of life, what it means to "live," and how meaningl

        • by Z00L00K (682162)

          Come back after a severe anxiety attack and tell me why you didn't want to have that capped.

          • by skids (119237)

            This. Anxiety and panic aren't always beneficial and they don't always end on their own.
            Sometimes they run away with themselves in completely unproductive directions, and
            will cause you to do some pretty crazy and potentially self-damaging things. Since your
            brain has effectively been disabled, you can't just self-discipline your way out of them
            either.

            They can get so bad that you have to go the ER and have them break the feedback loop
            with a Lorazepam or whatnot.

            Not to mention the actual physical toll that c

        • Can you stand up? I do believe it's working.

          Why would we want to numb existential distress? This emotion is a social corrective mechanism that tells us when society is moving in the wrong direction. The reason it is becoming more of a problem in modern times is because our society is profoundly ill and we perceive that on some level. In the same way physical pain makes one pull one's hand out of the fire, existential stress makes one reevaluate one's life and look at ways it could be made more meaningful and more fulfilling. Why don't we just make a drug to cure ambition, sexual desire and distress of the conscience while while we are at it and wreck the human race for good?

          I have existential high blood pressure. In effect, I exist, therefore I have high blood pressure. Which really means they haven't got a clue what's actually causing it. But it's just as dangerous as the other kind, so I have it treated.

          Likewise, existential distress is not the the same thing as actual distress in response to actual situations. If you are always distressed for no concrete reason, not only are you continually miserable, you are also losing the baseline that tells you when things are objective

        • Why would we want to numb existential distress? This emotion is a social corrective mechanism that tells us when society is moving in the wrong direction. The reason it is becoming more of a problem in modern times is because our society is profoundly ill and we perceive that on some level. In the same way physical pain makes one pull one's hand out of the fire, existential stress makes one reevaluate one's life and look at ways it could be made more meaningful and more fulfilling. Why don't we just make a drug to cure ambition, sexual desire and distress of the conscience while while we are at it and wreck the human race for good?

          I can pull my hand out of a fire. I can't fix society's problems with or without crippling anxiety and depression. For that matter, no one can fix the real biggie of "existential distress", the one that puts the "existential" in the existential distress, as in the end of one's existence -- we've all heard of it: Death. The basket cases and the numb all meet the same end.

        • Ok, just a little pin prick, there'll be no more aarrrrrg, but you may feel a little sick. That's why, right there. Try not to attribute purpose and direction to anything that a society/culture does. That kind of teleological reasoning is flawed; cultures don't move with purpose towards any kind of goal, any more than species evolve towards some perfect form. Natural selection just doesn't work that way. Culture (I use culture interchangeably with society) i.e., the heterogeneous amalgamation of memes
        • Re:Okay (Score:5, Interesting)

          by Princeofcups (150855) <john@princeofcups.com> on Monday May 06, 2013 @10:07AM (#43642537) Homepage

          Why would we want to numb existential distress?

          Here's the skinny for those who think that anxiety and depression are just something that weak people complain about. These issues are a result of a physical condition. Think of it like have having diabetes, or having your legs blown off. People who succumb to extreme anxiety are some of the strongest willed people out there. They have to live with this condition day in and day out, and try to appear normal at the same time. The mechanism is easy to understand. When someone points a loaded gun at you, or in more primitive time, a tiger jumps out of the bush, your neurochemicals change. You freeze, time slows, you are ready to jump and run at a moment's notice, you are prepared to die. The same is true for harsh conditions, wartime, famine, etc. People who are naturally in a state of high stress have a better chance of survival. Life is pretty awful, but you can bear the next tragedy pretty well. Now imagine a society where we never have to deal with these things. Those that are predisposed to deal with the worst through genetics, upbringing, life events, etc., that is, who have a physically different neurochemicals, have no reason to be that way. There is no tiger, although it feels like there is. There is no war, although your brain is telling you that there is. You can't simply "suck it up" or "just get over it." It's the way that you are forced to think, and you spend your life fighting these feelings.

          Most people don't have these feelings. Lucky them. The problem is that they can't conceive of what it's like when you are constantly on alert, because any lapse means that you will die. Now therapy does help to some extent. It helps you identify triggers, and to identify when your body is telling you something that's not true. But it's tiring, and painful to deal with. Having some kind of medication to help alleviate that, and get you back to a stable level of neurochemicals is a god send. The problem with meds is that every one has side effects, so it is imperative that you find a doctor to help you find the best dosage and mix with the least side effects. And do therapy at the same time to learn to see those effects on your moods and thinking.

          So, yes, it is wonderful to have another option for anxiety when your brain is telling you to run and hide and there is nothing there. We're not talking about suppressing minor ennui or occasional blues. We're not saying to get rid of all emotions. But if taking a couple of over the counter pills with minor side effects can get a truly anxious person through a touch situation, then I'm all for that.

      • So, which one is Pink?
    • Almost forgot how that Pink Floyd song [youtube.com] is great. Back to our subject, it is remarkable how scientists will deeply analyze the slightest effects of known drugs, but, on the other hand, ignore the effects - at least as appreciable - of the everyday food, celery, carrot, parsley, rosemary etc... Instead of takings drugs, many could improve their daily by simply eating in a more balanced way, some more selected dishes.
      • by skids (119237)

        While carrots and APAP are both in common use by the populance, carrots do
        not provide instant relief from sudden onset of pain. When you burn yourself
        with hot grits, you can either stand there and think "you know, if I had eaten
        carrots instead then maybe I'd be in a better mood about burning myself with
        hot grits" Or you can take a pain reliever.

        So we need pain relievers, not just carrots.

        Carrots also do not do another thing: kill you if you eat too much, with "too
        much" being something you could get down i

    • I remember a while back about some studies that shows anxiety can often be reduced with normal antacid. Because we get butterflies in our stomach when we get anxious, and that feeling increases our anxiety, so the antacid help break the cycle.

      So it would make sense that a emotional distress causes a physical reaction that creates body pain, when then feedback on itself to create more emotional stress, and pain killers such as Tylenol may help ease those pains as well.

  • by Dorianny (1847922) on Monday May 06, 2013 @01:01AM (#43639309) Journal
    There is a more in-depth article, titled "Experiencing existential dread? Tylenol may do the trick" and dated April 16, on the medicalexpress website. http://medicalxpress.com/news/2013-04-experiencing-existential-dread-tylenol.html [medicalxpress.com]
  • "Works best when washed down with a bottle of Vodka."

  • .. McNeil Consumer Health Care, owners of the Tylenol brand.
  • by SplashMyBandit (1543257) on Monday May 06, 2013 @03:53AM (#43639875)

    In my country, New Zealand, your mates would tell you to go take a big glass of "Harden the Fuck Up", followed by a dozen pints of beer.

    "Existential Challenge" seems to amplified as a "First World Problem". If you are busy fending for your life you have two choices - get one with it (no matter how big a bitch Mother Nature is), or lay down an die. When our ancestors lamented existence it was because their lives were "nasty, brutal and short". Now, no matter how poor you are relative to your neighbour, we *all* live in luxury that far exceeds the great emperors of old. We all have far greater health care than even recent ancestors. We have great pain relief. We get bored with hundreds of channels of entertainment, income that is actually disposable on more than sustenance-level items, and the entire accumulated knowledge of all of humanity accessible through your laptop or your phone. We are granted nearly everything by our society and parents, but the one thing we have to obtain for ourselves is the correct mental attitude to appreciate it all (the accumulated achievements and struggles of our ancestors that bequeathed us such splendors of knowledge and possessions).

    In some cases drugs will help chemical abnormalities that can cause depression. In a large number of cases you don't need drugs, you need a change of perspective (like the Buddhists teach themselves to do).

    • Fending for your life is an excellent cure for existential angst. Even pretending works. I get cranky and depressed in a couple of days if I don't get enough exercise. I realise that most of the people around me consider that state normal.

  • Because the parrots eat 'em all.
  • Serious question - Every now and then I get a headache, or muscle ache, or hurt myself in some way. Regardless of the source of the pain if I take paracetamol I get no noticeable pain relief, it feels exactly like taking a placebo. Yet people around me keep taking this stuff like it actually does something.

    Does Paracetamol actually work for people here?

    • by arth1 (260657)

      Can't speak for others, but no, for me, paracetamol doesn't do anything for pain, except sometimes causing a mild headache.
      Yet doctors insist on telling me to take it, like if it hasn't ever worked for the last 45 years, it will now suddenly work.

      If I want pain gone or even reduced, I need something that ends with -ine.
      Codeine, Caffeine, Benzocaine, Buprenorphine, Moonshine, Flupirtine...

    • by Guppy (12314)

      Serious question - Every now and then I get a headache, or muscle ache, or hurt myself in some way. Regardless of the source of the pain if I take paracetamol I get no noticeable pain relief, it feels exactly like taking a placebo.

      Quite possibly -- there is always individual variation in response to substances; I would expect this to be doubly true for a pro-drug that requires further metabolism to activate. Unfortunately, I didn't find much in a quick search just now regarding variability in pain relief with acetaminophen, although there are plenty of studies examining variable responses regarding liver toxicty.

    • Every now and then I get a headache, or muscle ache, or hurt myself in some way. Regardless of the source of the pain if I take paracetamol I get no noticeable pain relief, it feels exactly like taking a placebo.

      Personally, I find that ibuprofen is a more effective over-the-counter pain reliever. It can cause people stomach problems, but I haven't experienced that personally. I think you need to already have ulcers or really take a lot of the stuff for it to mess up your stomach.

  • by guttentag (313541) on Monday May 06, 2013 @05:09AM (#43640133) Journal
    One group was forced to watch 4 minutes from The Rabbits [youtube.com] (this could very well be four minutes of watching a creepy Donny Darko-esque [youtube.com] rabbit housewife ironing in while listening to lethargic creepy music), while the other group watched an unspecified 4-minute clip from the Simpsons. The result was that the people who took Tylenol thought that a person convicted of theft or vandalism during a riot (hockey, of course, since the study was conducted in Canada) should be subjected to a punishment 23% more severe than normal if they watched the Simpsons, and 26% more severe than normal after watching the Rabbits. The people who took the placebo thought that the punishment should be 26% more severe than normal if they watched the Simpsons, and 42% more severe than normal after watching the Rabbits.

    I have to question the judgment of a researcher who would use The Simpsons as a "control," especially when he's not specifying what the clip was about. He says "all clips available upon request." That's like saying "name of the drug given to participants in the study available on request." Knowing the Simpsons, it could have been anything from "If a cow ever got the chance, it would eat you and everyone you ever cared about," to Homer driving the family to Alaska, stopping at the border and hearing, "Welcome to Alaska, here's a thousand dollars!" It could well be that the Rabbits gave the placebo group a headache. See the comments on the rabbits clip on YouTube. Top comment:

    "This is creepy as fuck."

    Other comments:

    "Something's wrong."
    "you are a madman."
    "Haunting in the most dream-like will always return to this."
    "Wow, that horrific scream made me jump."
    "It's like... they're having a normal conversation, just... not in the right order."
    "Man, D.A.R.E. would be a lot more successful if they just pointed to shit like this."

    All those people sound like they need Tylenol, or Excedrin, or something to make their head stop hurting. Since the placebo group did not have anything to make their head stop hurting, they decided to take it out on the people who rioted over a hockey game...

  • It might as well be, for if it can be healed with a pill then it rates as mental illness; if not, it's all between your ears [briandonohue.org] and get over it.
  • by colfer (619105)

    Completely expected that a pain reliever would work on mental pain. Aspirin probably works too.

  • by who_stole_my_kidneys (1956012) on Monday May 06, 2013 @02:27PM (#43645885)
    so i fail to see the importance of this.

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