Tylenol Relieves Angst?

I ran across this interesting AMA MorningRounds article about how acetaminophen may relieve existential dread. The video above gives you a quick summary. The study was published in the April 11, 2013 issue of Psychological Science [1].

I think this is intriguing. I also think it’s important to point out that acetaminophen toxicity, either accidental from consuming too many acetaminophen-opioid combinations or from deliberate overdose in suicide attempts, is important to remember [2]. I see a fair number of those as a psychiatric consultant in the general hospital. Maybe you should exercise a little dread about taking too many Tylenol tablets?

I got it. Why not look at a funny video, rather than something surreal or disturbing, as a more constructive way to deal with angst?

1. Randles, D., et al. (2013). “The Common Pain of Surrealism and Death: Acetaminophen Reduces Compensatory Affirmation Following Meaning Threats.” Psychological Science.
The meaning-maintenance model posits that any violation of expectations leads to an affective experience that motivates compensatory affirmation. We explore whether the neural mechanism that responds to meaning threats can be inhibited by acetaminophen, in the same way that acetaminophen inhibits physical pain or the distress caused by social rejection. In two studies, participants received either acetaminophen or a placebo and were provided with either an unsettling experience or a control experience. In Study 1, participants wrote about either their death or a control topic. In Study 2, participants watched either a surrealist film clip or a control film clip. In both studies, participants in the meaning-threat condition who had taken a placebo showed typical compensatory affirmations by becoming more punitive toward lawbreakers, whereas those who had taken acetaminophen, and those in the control conditions, did not.

2. Manthripragada, A. D., et al. (2011). “Characterization of acetaminophen overdose-related emergency department visits and hospitalizations in the United States.” Pharmacoepidemiology and Drug Safety 20(8): 819-826.
Purpose To estimate the number of acetaminophen overdose-related emergency department (ED) visits and hospitalizations in the United States, characterize these by intentionality, age, and gender, and compare the strengths and limitations of the utilized databases. Methods We used data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) and the National Electronic Injury Surveillance System (NEISS) to estimate the number of relevant ED visits in the United States between 2000 and 2007, and the National Hospital Discharge Survey (NHDS) to estimate the number of relevant hospitalizations in the United States between 1991 and 2006. National estimates and their standard errors were calculated using information provided in each database. We used the standard United States population in 2000 to calculate age-adjusted rates. Results We estimate an annual average of 44 348 (NHAMCS, 2000–2007) or 78 414 (NEISS, 2006–2007) acetaminophen overdose-related ED visits and 33 520 (NHDS, 2000–2006) hospitalizations. For 2000–2006 we calculated an age-adjusted rate of 13.9 acetaminophen overdose-related hospitalizations per 100 000 US population, with the highest rate (15.7) occurring from 2005 to 2006. Between 1991 and 2006, there was no decrease noted in hospitalizations for intentional or unintentional overdoses. The majority of overdoses reported in NEISS (69.8%) and NHDS (74.2%) were classified as intentional (suicides or suicidal gestures), whereas in NHAMCS, intentionality was evenly distributed. Conclusions Our results suggest that acetaminophen overdose, both intentional and unintentional, remains a significant public health concern. With an understanding of their methodological characteristics and limitations, these national databases can be useful tools to characterize acetaminophen overdose-related ED visits and hospitalizations. Published in 2011 by John Wiley & Sons, Ltd.