Posted by ed_uk2010 on February 17, 2015, at 19:11:43
In reply to Re: The ultimate placebo, posted by alexandra_k on February 16, 2015, at 23:57:26
Decades ago, it was common practice for doctors to prescribe placebos. The placebos were often low strength vitamin tablets labelled as something else 'Nerve tablets'. This hasn't been possible for a long time because all medicines have to be labelled with their precise ingredient - a legal requirement.
These days, a huge amount of placebo-like prescribing goes on, sometimes without even realising it, but the products involved are not actually placebos.
Common examples include:
Using acid-suppressants for vague abdominal symptoms not clearly related in any way to acid. Use of potent PPI drugs (omeprazole etc) in this manner is now extremely frequent.
Most use of antispasmodics and cough suppressants.
Rxing low doses of meds, often antidepressants, to 'relieve' a multitude of undiagnosable symptoms.
Prescribing vitamin supplements for a variety of purposes in those unlikely to be deficient.
Prescribing low doses of anti-emetics (esp. prochlorperazine) for symptoms of dizziness in older people, after investigation has been unrevealing and in the absence of any nausea/vomiting. Use of prochlorperazine for this purpose has been common and except in the very short term, is a very bad idea!
And unfortunately, a very high proportion of antibiotic prescribing in primary care.
The problem with this type of prescribing is that with the exception of the vitamin example, side effects can and do occur.... it would be better if most of the pts involved actually were being given placebos. The drugs are unlike to produce much pharmacological benefit....
poster:ed_uk2010
thread:1076696
URL: http://www.dr-bob.org/babble/20150129/msgs/1076848.html