There’s only a weak and now discounted statistical association that was seized upon by two disgraceful anti-science politicians to create a political controversy.
Because that is what everyone (I mean, not if you are pharma) is interested in...
A 2024 study of nearly 2.5 million children initially found:
* Autism by age 10: 1.53% with prenatal exposure versus 1.33% without * ADHD: 2.87% versus 2.46%
This is the study you are referring to. I will leave it to others to judge your comment.
To spell it out: the study’s point (sorry, “Conclusions and Relevance”) is to explain away the very data GP cites?
Some personal grievance against Tylenol brand?
More graft from a competitor?
Appease their conspiracy loving dumbass base?
Destroy the scientific reputation of the US?
Trump is actually that fucking stupid?
All of the above?
https://www.cbsnews.com/news/rfk-jr-cause-of-autism-research...
They actively reject the values of intellectualism, critical thinking, and expert consensus. They instead embrace empiricism, loyalty, and the great man theory.
It’s a recipe for severe Dunning-Kruger.
These are not particularly important. The concerns are autism and ADHD.
Also don’t equate that MAHA crap with disagreement on this topic. I’m as anti MAGA as it gets but this study doesn’t do anything to assuage people’s primary concerns about this.
The desire to discuss those things is also reasonable. Though I would agree that those without credentials should probably abstain from expressing any potentially harmful opinions when healthcare is involved, the freedom to ask questions or bring up interesting digressions is fundamental.
I expect, coming form one scholarly enough to be quoting elders, you'd have a strong one. Let's have it.
surely some abuse of the drug could lead to adverse reactions?
are they just arguing for specific doses to not have negative effects? (that would be true of a lot of things we consider harmful)
Acetaminophen and dementia correlation:
https://pmc.ncbi.nlm.nih.gov/articles/PMC2877629/
https://www.sciencedirect.com/science/article/abs/pii/S01638...
Note that it's also hard on the liver. A lot fatalities due to taking after hangovers, etc: https://www.medicalnewstoday.com/articles/322813 So if you insist, maybe take some NAC.
But apparently, Ibuprofen helps counter the dementia risk:
https://www.aan.com/PressRoom/home/PressRelease/624
I am not not asserting any clever marketing here. I am merely citing public information. Noting all the above, I am confident it's perfectly safe for children and fetuses, and if posing any risk at all, applies strictly to full grown adults. No doubts about child safety have been expressed here.
Fatalities happen basically from: product stacking combination medicines people don't realize contain acetaminophen and/or multi-day accumulation exceeding max daily limit over multiple days.
Chronic drinkers have impaired acetaminophen processing so they can't handle otherwise safe doses, but fatalities still typically occur in multi-day accumulation scenarios. Their safe daily max is ~half that of a non drinker.
The effects of one round of acute drinking don't impair the liver in the same way. People are not dropping dead because they took a normal dose of acetaminophen for a hangover. Not that I'm recommending you start doing it, but it is a myth.
I find it obnoxious that NyQuil has taken over as the default brand people grab for cough syrup, for that reason. It has acetaminophen, while Robitussin or such have the other active ingredients without that risk.
The typical person doesn't read and understand active ingredients, and it's lucky if they even check dosage instructions.
Maybe I'm crazy, but I don't think killing people is an improvement.
Anecdotally, I hear about it far more in Internet comments like the parent than elsewhere. How common is it?
https://jamanetwork.com/journals/jamanetworkopen/fullarticle...
Emergency department visits ~56,000
https://pubmed.ncbi.nlm.nih.gov/16294364/
Hospitalizations ~26,000
https://pubmed.ncbi.nlm.nih.gov/16294364/
Deaths ~500 deaths/year
https://pubmed.ncbi.nlm.nih.gov/16294364/
Also, direct from FDA, for those promoting its use with alcohol: "Be aware that severe liver damage may occur if you have three or more alcoholic drinks per day while using acetaminophen." One can infer that stressing the liver prior, then again with tylenol, might be unwise. But by all means, headaches suck. I understand.
Also:
https://www.niaaa.nih.gov/health-professionals-communities/c...
But do not worry. The FDA only specifies that to qualify as risk, requires 'daily' intake of 'three or more drinks'. That is 'daily'. Therefore, it is, if you manage to survive binge drinking several cases of beer and your drinking pattern is null for day1-6, but n amount on day7, perfectly safe to take acetaminophen at will. The documentation does not refute this, therefore it is safe. Only daily drinks, three or more. Binge ok. Only official documentation good true. Inference bad false.
I stand corrected by ctoa!
And to the noble clinical researcher in the house (estearum), I much respec your authorituh. No corruption or monetary influence has ever affected the medical or research field. This I do not dispute. As a chartered researcher, you are an impervious and pure and good person. And honest too. Pharmaceutical industry applies here as well; beyond reproach -- if you're in, you're pure. The notion that they have financial incentives is schizophrenic and despicably paranoid. Anyone who thinks otherwise can have a $200 epipen stuffed in their eye, for free.
I also humbly rescind all my own experience and research. A single I "don't know much" sense from an illustrious professional medical champion was the evidence I needed to retire. Farewell and I shall never think nor speak again. All that cherry pickin really wore me out ;(
And for all:
ScienceDirect S0163834323001317 - A 2023 piece ("Association of regular use of ibuprofen and paracetamol, genetic susceptibility, and new-onset dementia in the older population") that found regular paracetamol use, but not ibuprofen, associated with higher risk of new-onset all-cause dementia, AD, and vascular dementia, independent of genetic risk. But ignore that. Acetaminophen is uncontested by good people. This = bad people https://www.sciencedirect.com/science/article/abs/pii/S01638...
*Mess due to comment throttling.
"In 2021, US poison centers received more than 80 000 cases involving an acetaminophen product.1 The National Electronic Injury Surveillance System estimated that 78 414 emergency department (ED) visits occurred annually in the US from January 1, 2006, through December 31, 2007, for overdoses of acetaminophen-containing products.2 In Canada, approximately 4500 hospitalizations occur each year because of acetaminophen overdose.3"
It doesn't tell us risk. Acetaminophen is very widely used, potentially the most widely used drug. I'm not sure what these numbers represent in terms of risk.
~80% of acetaminophen poisoning cases severe enough to end in hospital are intentional suicide attempts.
Those patients also have better outcomes though: family members know what happened, they get them to a hospital, they can take N-acetylcysteine as a timely antidote.
In the unintentional poisoning group, ~90% is from multi-day accumulation, they don't realize they've been poisoning themselves. They have a much higher rate of acute liver failure and death.
https://doi.org/10.1186/cc1475 https://doi.org/10.1016/j.cld.2013.07.001 https://doi.org/10.1097/mcg.0b013e31818a3854
"There are two distinct clinical syndromes described in literature. One is the 'garden variety', wherein the patients ingested large amounts of acetaminophen with a suicidal intent .... The other pattern is seen in chronic alcoholics who ingest smaller amounts of acetaminophen in an attempt to relieve pain ...."
"The causes of chronic pain in the accidental overdose group were toothache, chronic backache, or headache."
Also, I do not work too hard around here, especially with all the corporate aligned types that patrol the area. Folks can do their own research, while they can, before history is rewritten by LLMs and the new internet. Yeah, a lot of articles and papers are getting more difficult to find. And institutional capture is well underway with AI. Newer generations think because they can't find something, it never existed. This is HN, with a karma economy and high price on honesty. I am just leaving occasional marks in the gray zones.
Of course, one might pause for a moment to consider just how potential the alluded benefits really are with ibuprofen, and ask why doctors aren't recommending it for mental health, or as a general health product. But that might point to the peculiar fact that there is substantially more evidence suggesting risk over health benefits, and the benefits really depend on what one wants to see. There is a reason it's not marketed as a health product, but with the way it's framed, it should be, nu? I mean, potential benefits sells a lot of snake oil and lowfat yogurt. Why not advil and acetaminophen?
And by similar logic used to dismiss acetaminophen here as a health risk, eg because there's no link with autism/ADHD it's safe; why not apply the same logic to opiates? We could just say opiates do not directly cause, eg , parkinsons, or AIDS, therefore it's safe for babies. Myself, I never correlated acetaminophen with autism/ADHD, but I know it has more side-effects than listen on the bottle.
Which also answers your other question of why doctors don't recommend it: we don't actually know that it does this.
As for the rest of the ramble, you (or I) definitely don't know hardly anything that hasn't been established in clinical trials. Certainly can't just vibes-based assess a label and its completeness. It's really, really hard to know things.
The precise wording as far as safety is: "we have no substantive or high-quality evidence that the drug is unsafe."
"we have no substantive or high-quality evidence that the drug is unsafe." - (damn all the research showing it is)
--to
"we have no substantive or high-quality evidence that the drug is safe." - (damn all the research suggesting it isn't)
Well, that's as good a green light for an ad campaign as one could ask for. "we don't actually know that it does this." ain't never stopped a motivated pharmaceutical rep before. You have my official endorsement for feeding advil and acetaminophen to all. And protection from dementia is just what America needs. !Win / !Win
Maybe restless leg and depression too! And don't tell me fetuses don't get depressed there in that dark womb. We know damn well they get restless.
That's almost entirely generated by the highest quality evidence generation system we could possibly have, which is RCTs. And no, pharma reps actually aren't allowed to encourage (or even talk about) off-label uses of drugs.
I get the sense that you don't know much about this space.
The "best we have" does not mean it is good enough for the task at hand. Just saying.
Basically what I am saying is that qualifying something by saying "best we have", does not justify its using on its own..
But truly, if I am the only rascal here on HN, deviating slightly from the subject title, I will gather the tinder. Let's burn me with haste!