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Comment by watwut

9 hours ago

It is not false. It does nothing. Head hurts, you take paracetamol ... head still hurts. The belly hurts, you take paracetamol ... nothing change.

When I took ibuprofen it did actually made an actual real change.

"I took it and it didn't work so it's a fake placebo drug" - wow, your scientific method is flawless, have you considered a career at the US Department of Health?

I have a counter-study with size n=1: I did all my recovery from tonsilectomy on paracetamol and definitely noticed it working. That was however on the maximum safe dose.

(one of the major problems with paracetamol is that the effective dose is only a few multiples away from the dose which starts to cause liver damage! It is by a long way the most dangerous OTC drug)

You're partially right compared to placebo only about 5% of people are painfree over the effect of a placebo when taking paracetamol.

Paracetamol got it's start as replacing the more effective but much more dangerous and withdrawn drug Phenacetin.

Why don't people notice that it's such a small benefit over nothing? Well because placebo effect is quite good for pain and pain is usually transitory anywhere..if you have a tension headache you're probably going to aim to relax. Turn away from the screen or even have some caffeine and those are more effective than paracetamol!

  • Where did you pull this 5% from? There are gazillions of studies showing higher or lower efficacies for different kinds of pain. Along with the inaccuracies about Phenacetin (whose MOA is metabolising into paracetamol).

    • You will indeed find various figures for various pain types all are far worse than ibuprofen.

      Here is an example from the Cochrane library

      > For the IHS preferred outcome of being pain free at two hours the NNT for paracetamol 1000 mg compared with placebo was 22 (95% confidence interval (CI) 15 to 40) in eight studies (5890 participants; high quality evidence), with no significant difference from placebo at one hour.

      A NNT of 22 means that in absolute terms 1/22 people met the positive endpoint criteria more than placebo. This figure is usually quoted as 20% for placebo and 25% for paracetamol giving NNT of 20.

      The NNT of 22 gives 1/22= 4.5%.

      https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...

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