Reverse Placebo Effect

I wonder if there is such a thing as the reverse placebo effect, where you give someone a real drug but tell them it's a placebo that won't have any effect.The reason I'm wondering is because I have a minor but annoying condition affecting stamina for which doctors have, over the years, prescribed a number of different medicines, none of which have had any effect. But it occurred to me today that perhaps some of them did have an effect, but not a big one, but because I've become pessimistic that doctors will find something that works that my ability to detect any improvement is impaired.--Percy

I think people vary widely as to how suggestible they are. You sound somewhat like me. Every once in a while at work I accidentally get decaf instead of regular coffee, and within 15 minutes I know I made a mistake. A long time ago when I traveled regularly between college and home I would buy cokes every now and then to keep me awake. One time I could only get a Ho-Jo cola, and 15 minutes later when nothing was happening I pulled over to read the ingredients and discovered that it had no caffeine. I used to think headache pills were headache pills and didn't care what brand I pulled out of the cabinet, and it took some years before I realized that when the headache didn't go away that it was Tylenol I'd taken, which apparently has no effect on me (I used to think this was really weird, but when I finally did mention it to my doctor he said that it wasn't really that uncommon).So I feel like I have enough evidence to conclude that I know when something is having an effect on me and when it isn't, but now with my failure to find any medicine that works for my stamina condition I'm beginning to wonder if my pessimism that something will eventually work is preventing me from detecting when something does have some positive effect.I think it would be possible to study the reverse placebo effect. For example, two groups would both be given headache pills, but one would be told they were headache pills, and the other would be told they were placebos and be provided some reasonable-sounding explanation (but not the real one) for why they were telling them they were giving them placebos.Someone mentioned the difficulty in studying effects on stamina, and I agree. Stamina is affected by many factors, including how much sleep you've had, how much you've eaten, what you've eaten, what time of day you exercise, how long since the last exercise, etc. Sometimes I just have wonderful days stamina-wise, but I can never find anything to point to. I've been great with a lot of sleep and no sleep, in the morning and at night, after days of rest and with only one day of rest. The only thing that is clearly a factor is dieting. The specific foods I eat don't seem to make much difference, but any decrease in caloric intake such as occurs on a diet dramatically affects my stamina.--Percy

Advil works for me, too, as does Alleve (aka naproxen), and I have similar dentist stories.But many things do seem to work on me as well as they do on others. Morphine works great for me as a pain killer, and I can't even count as far as 10 before the sodium thiopental kicks in. Much more recently I found that propofol works great as a substitute for sodium thiopental, and is actually much better as you wake up feeling alert and refreshed instead of groggy.The frustrating thing about Tylenol is that the medical establishment is always recommending it. "If you feel any pain later, just take some Tylenol," they'll say. Interestingly, Advil is contraindicated under some circumstances (probably related to drug interaction) and can't just automatically be used as a replacement, so you have to ask what you can take instead.--Percy

I read recently how caffeine works. It blocks a certain type of receptor of a certain cell type, and the result is to make us feel more alert. These cells gradually become habituated to caffeine by developing more receptors, nullifying caffeine's effect. The cells respond to increased caffeine intake by developing yet more receptors. Caffeine will only work by keeping intake moderate, perhaps a cup or two of coffee a day.Of course, for people who never or rarely drink coffee then a cup of coffee must be a real jolt!--Percy