Allergic to Skepticism

Over the summer, I made the trip to visit Akusai, Magus, the Fianceé and Wikinite, along with an assortment of other Hoosiers. The trip was a blast–as any such gathering would be–but that’s not why I’m dredging it up several months later. No, the reason for the resurrection comes from something Akusai was talking about at the event–namely, his allergies.

I’ve recently developed several such allergies. I remember most of my life that I would get a cold or two in spring or summer. At some point, my body decided that wasn’t enough, so toward the end of high school, I started getting all those classic allergy symptoms at various times of the year, and always around cats.

I’ve never gone to an allergist; instead, I self-medicated. I experimented first with Benadryl antihistamines, and it only took a few weeks for me to realize that the reason I was falling asleep much earlier than usual was because of the whole “MAY CAUSE DROWSINESS” thing. I switched over to Claritin (loratadine) and its generic counterparts, and I haven’t looked back since.

So, when Akusai brought up his allergy problems, I chimed in that Claritin really helped mine. He (and he can correct me if I get this wrong) replied that it didn’t work for him, and that his allergist said it didn’t really work for anyone. I was taken a little aback, skeptic though I am–had I really fallen prey to Doggerel #70? I know I’m not immune to the placebo effect or other fallacies of thought, but this one surprised me a little. So, I resolved that I would do some research into the medicine and find out what kind of clinical evidence supported its efficacy.

And then, I didn’t do much else. I pulled up some articles on my iPhone at one point, but never really got around to reading them. I kept using the Claritin as necessary, mainly because I still had these bottles of it, and resolving to look into the literature eventually.

Eventually was within the last week, as it turns out. My fianceé, you see, has been using Zyrtec (cetirizine hydrochloride), and has been trying to convince me to give it a shot. I didn’t want to run into the same trap that I’d apparently hit with Claritin, so I decided to do some research. In the meantime, I bought a trial pack of the Zyrtec.

I also completely exasperated my fianceé by launching into full-on skeptic mode in the medicine aisle, explaining that I wanted to do the research, and that I wasn’t going to believe it worked just based on her self-reported experience. We also got into a bit of back-and-forth over whether or not the brand name mattered; clearly both bottles contain the same chemical (it says so on the label); why would one affect me differently? Apparently, I failed the “being skeptical without coming across as a dick” test. I’d like to work on that, but apparently the threshold is a lot lower than I suspected.

Anyway, when I got home, I pulled up PubMed and searched for combinations of “loratadine,” “cetirizine hydrochloride,” and “allergy.” I read and skimmed a lot of abstracts, which covered an awful lot of terms that I didn’t understand, but at the end of it I was pretty well satisfied that both loratadine and cetirizine had been shown to be significantly more effective than placebo in controlled trials. Moreover, at least some of the abstracts suggested that the latter was more effective than the former, which has inspired me to continue at least trying Zyrtec. And by “Zyrtec,” I mean “generic cetirizine hydrochloride,” because I still haven’t been convinced that there’s a difference. My next big step is to see an allergist (now that I have insurance), so I can get a better idea of what exactly I’m allergic to.

The point of this meatspace anecdote is as a reminder that it’s easy, even for skeptics, to be fooled. I don’t (and I’d say, I can’t) really turn off that skeptical impulse, much to my fianceé’s consternation, but through laziness and assumptions, I can delay it, and I should be more careful about that. True, I can’t go researching each and every thing I do or consume or think about, but I can at least do the legwork when it’s my money and my health on the line. All told, that research didn’t take long, and while the details of the studies were well beyond my ability to comprehend, the conclusions were straightforward.

The other point is one I’m going to be working on in meatspace a bit more. As skeptics, we tend to be harsh and blunt because, I think, we recognize the value in that unvarnished truth (and because we like to argue). We understand that the only idea worth believing is one that’s been through an unrelenting gauntlet of harsh trials and uncompromising questions. We have a specialized vocabulary to describe all the ways that people can be fooled and can fool themselves, and we use it regularly.

Most people, however, are not as steeped in the skeptical movement as we are. Launching into a skeptical examination with all guns blazing, talking about the worthlessness of anecdotal evidence and the placebo effect and mistaking correlation for causation is all well and good in blog comments and TAM conversations, but it seems to come across as hostile to non-skeptics. I think it’s important to rein in those finely-honed skeptical impulses when we’re in meatspace dialogues, lest we come across as condescending know-it-alls.

Conversely, though, we also need to educate (and it’s difficult to educate peers without seeming like a condescending know-it-all) so that we can have these kinds of discussions, and so that other people understand why we are so focused on this harsh evaluation of ideas, beliefs, and claims. There is value in skepticism for everyone–except perhaps the woo merchants, frauds, and charlatans–and we have a responsibility to communicate and promote that. If we did it more often and more effectively, we’d have a lot less to worry about with regard to tone and civility.

5 Responses to Allergic to Skepticism

  1. Techskeptic says:

    clearly both bottles contain the same chemical (it says so on the label); why would one affect me differently? Becuase its possible that there are other ingredients besides the main one that improve performance. Further its possible that the manufacturing method, creating differnt solubilities of the hydrochoride (they are all hydrochlorides) in your stomach.I'm not saying that these differences do in fact exist between generic and brand name, its just a possiblity

  2. Doubting Tom says:

    And the first part of that is what I speculated on when I was talking with my fianceé, that there might be differences in the non-active ingredients or the way it's manufactured that do have an effect. And, of course, different people react differently to different drugs, so there are a lot of variables (which I admittedly glossed over a bit in the post, but brought up in the conversation). In any case, if I notice a difference on the generics, I'll switch back. If I don't notice a difference, then the brand name isn't worth the extra 50% of the cost.

  3. Techskeptic says:

    very few people find that the brand helps. I doubt you will.

  4. Akusai says:

    If I don't notice a difference, then the brand name isn't worth the extra 50% of the cost.An Zyrtec ain't cheap to begin with.Funny that I got this whole train moving without even realizing it. I hope Zyrtec works for you!

  5. Navi says:

    heh, I have an anecdote. no clue with Zyrtec, but I've noticed now that the Depakote ER has a generic, it doesn't seem as effective on my husband, and I've been bugging him to get a 'dispense as written.' Along with advice as to whether or not other medications would help.

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