BehindTheMedspeak: Can Tylenol ease the pain of heartbreak?

Long story short, from Gary Stix's September 2010 Scientific American article: In a laboratory setting employing brain imaging, individuals who took Tylenol "... appeared to experience fewer feelings of rejection than those who received a placebo...."

Here's the article.

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Feeling the Pain of Rejection? Try Taking a Tylenol

What is a fate as bad as death? Many contemporary and ancient societies considered banishment at least equal. After all, in the past, estrangement from family or friends, along with the corresponding exile away from the campfire or town gates, meant literally getting thrown to the wolves. Not surprisingly, our brains are wired with circuitry so that we can scrupulously avoid such fates, whether that means expulsion to the desert as in the Biblical tale of Hagar and Ishmael or the heartbreak of not getting that long-awaited invitation to the high school prom. The neurological wiring that makes us feel pain, new research suggests, also means that a common painkiller could ease the sting.

One brain area in question resides about an inch behind your forehead. Called the anterior cingulate cortex, it serves as one of the brain’s control centers for that “why me?” feeling when you get picked last for the dodgeball game. It also happens to be the same circuitry that induces the emotional component of pain, that desperate feeling provoked by the throbbing of a toothache. Evolution may have piggybacked brain functions that regulate social interaction on top of a more primal pain system. The way we speak (“I’m crushed”) even hints at just such a connection.

Research from the 1970s in rodents on the overlapping functions of this brain circuitry showed that opiates tended to quell not only painful stimuli but also the tiny squeaks that signal distress. C. Nathan DeWall, a social psychologist at the University of Kentucky who has researched the neurobiology of rejection for nearly 10 years, wondered whether an extraordinarily simple step to tone down these double-duty pain circuits might work in the human brain, which has evolved to master playground politics and other complex behaviors. Instead of dosing subjects with Vicodin, he and colleagues simply handed out acetaminophen (Tylenol) or a placebo to 62 volunteers. “We didn’t have to use fancy drugs; we didn’t have to get prescriptions,” he says. “All we had to do was find a drug that was safe and effective in alleviating the type of pain that we’re interested in.”

In one part of the study, published in the July Psychological Science, participants reported feelings of rejection on questionnaires. In another part, they played a computer game in which they were progressively excluded from a virtual ball-passing group as time elapsed. Brain imaging revealed that the Tylenol-gobbling group appeared to experience fewer feelings of rejection than those who received a placebo did. “I believe this study reports some of the best evidence that the systems that mediate our reactions to rejection evolved out of systems that signal the potential for physical harm,” says Kevin Ochsner, head of Columbia University’s social cognitive neuroscience lab.

One study does not a combo headache and heartache drug make. “That’s a question I get a lot: Should I take some acetaminophen before opening the letter from a potential employer?” DeWall comments. “It’s a little too early to make a call for widespread use.”

If validated, acetaminophen may become an invaluable research tool in seeking the neural underpinnings of not only exclusion but other mental processes related to social behavior. In one unpublished study, DeWall and his associates have found that subjects’ moral judgments change after receiving acetaminophen. They become less wracked by indecision when facing the classic moral dilemma in which one person must be sacrificed to save many; they reject out of hand what they perceive to be a ludicrous choice. If acetaminophen really does assist in resolving internal emotional conflict, it might help socially awkward individuals who become distraught when confronted by more routine moral choices. An ability to induce subtle shifts in perspective may give entirely new meaning to the Tylenol slogan of “Feel better.”

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The abstract of DeWall et al's Psychological Science paper follows.

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Pain, whether caused by physical injury or social rejection, is an inevitable part of life. These two types of pain—physical and social—may rely on some of the same behavioral and neural mechanisms that register pain-related affect. To the extent that these pain processes overlap, acetaminophen, a physical pain suppressant that acts through central (rather than peripheral) neural mechanisms, may also reduce behavioral and neural responses to social rejection. In two experiments, participants took acetaminophen or placebo daily for 3 weeks. Doses of acetaminophen reduced reports of social pain on a daily basis (Experiment 1). We used functional magnetic resonance imaging to measure participants’ brain activity (Experiment 2), and found that acetaminophen reduced neural responses to social rejection in brain regions previously associated with distress caused by social pain and the affective component of physical pain (dorsal anterior cingulate cortex, anterior insula). Thus, acetaminophen reduces behavioral and neural responses associated with the pain of social rejection, demonstrating substantial overlap between social and physical pain.

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You want the full monty?

Here's a link to the full text — tables, figures, references and the rest — of the study.