Is it true that doctors write prescriptions for placebo medications-‘sugar’ pills with names made to sound like legitimate medications, without telling their patients the truth?
How common is this practice? And under what circumstances is this done??
Thanks.
I’m pretty sure that would violate “informed consent.” A doctor must explain to a patient the reasons for prescribing a medication (or any treatment) and the possible negative consequences. I believe informed consent precludes a doctor from lying to a patient, which is what prescribing a placebo would amount to.
Well remember, not all placebos are “sugar pills”. The name is from a Latin word meaning “to placate” - so going by that definition, the oft-cited anecdotal reports about doctors giving antibiotics for a cold (which is viral and thus unaffected) involve placebos as well. After all, the medication in question is ineffective for the problem.
Now after clarifying that, I have to say that I do not have any knowledge of real “sugar pills” or other tablets with completely inert ingredients being prescribed,* but I can’t say that it never happens and others here might know more.
I agree with you, isthatsowrong?, but I was reading this from the FDA website-
http://www.fda.gov/fdac/features/2000/100_heal.html
"*Today, when 26-year-old Jennifer Kennedy (not her real name) from Rockville, Md., has a panic attack, she simply distracts herself with a book or crossword puzzle. But at their height, several years ago, the attacks scared her so much that she finally went to the emergency room. “I thought I was going to die from a heart attack,” says Kennedy.
She didn’t believe her doctor when he told her to “just relax” and she would feel okay, and he ended up prescribing pills. He didn’t tell her until two weeks later, after her panic attacks had subsided, that the pills were simply placebos with no active medical ingredient.*"
This is what Surreal is wondering about, I think. Clinical trials are normally blind (the patient doesn’t know if he’s getting a real treatment or a fake). This is to cancel out what’s called “the placebo effect:” a patient may get better just because he thinks he’s supposed to (and conversely, a subject who gets a sugar pill may think “oh, this won’t help me” and see no results). In these trials, which are designed to find out if the medication works, you want to identify and avoid this effect.
Actually, double-blind trials (where not only does the patient not know if the medication is real, the doctor doesn’t either - thus hopefully guaranteeing the doctor won’t somehow give away the truth and mess up the results) are common.
The reason this happens - and I’m sorry if you already know all this and I’m wasting your time, Surreal - is that control groups (the people who don’t receive the real medicine) are a very important part of a study.
Say Product X is supposed to help treat coughs. A trial is conducted, and 50% of the subjects who get the real Product X are healthy within 10 days. “Great,” one might be tempted to conclude, “it works!” Well, if there’s a control group, and 40% of them are healthy within 10 days and haven’t taken ANY medicine, we know Product X doesn’t really do much.
Hmmm. That’s really interesting. It DOES sound like a violation of informed consent. Then again, perhaps there are different rules for psychological conditions like panic attacks. If the doctor in question is a psychologist, perhaps he’s allowed to take measures like this? We’d need SDMB doctors to solve that one.
Meanwhile, the stuff I talked about is where ‘sugar pills’ and such things normally come up: in voluntary clinical trials (sometimes subjects are paid, I think).
Just to clarify here, I’m not asking about clinical trials, I’m asking about actual medical practice.
Is it common for doctors to see a patient with panic attacks / Chinese Restaurant Syndrome / PMS / Sick Building Syndrome / Chronic Fatigue Syndrome and decide that the patient is imagining it, so they prescribe a placebo and tell them it’s a powerful ‘medication’ that will heal them?
I misspoke, actually. I meant that might be what you were thinking of - that isn’t the case now that you wrote about the case above. It can’t be standard practice, and it’s definitely illegal (unless there are circumstances I don’t know about).
According to research that came out in a Harvard Medical Publication…the practice is “rather common,” and the names are pre-established?
No, not really…What am I the World Book Encyclopedia?..Like any one else I have to research my information and that required time on my part.
But my guess is that given the tendency for people to sue the medical profession and the ever increasing cost of malpractice insurance, that the
Practice would be low…and almost non-existent outside of clinical studies were patients are told that a percentage of the group will be taking a
Placebo…I doubt that the medical profession would survive the backlash were it found to be other wise.
True, I guess, although the previous post carried a rather high “WTF?” factor.
Actually it is not all that uncommon. If the doctor thinks the patient’s illness is psychosomatic he will generally call the pharmacy and tell them that they want a placebo dispensed to the patient. Each pharmacy chain has a different name for what is written on the label, but it is something medical sounding. The pharmacists don’t like it because a) they usually have to compound it themselves so it is a lot of work, and b) it is really annoying to have a hefty percentage of the patients come back to tell them how miraculous the new medicine was.
My mother figured out as a teenager that her doctor was giving her placebos for her period cramps.
This was back in the day when women who had PMS simply “weren’t comfortable being a woman.”
I think I’ll call my doctor to ask him to prescribe a stronger placebo. 
My wife is a doctor, and I have posed this question to her before. Although she says it is sometimes tempting, particularily in the case of drug-seeking behavior, she doesn’t and can’t. It is not a state law, but there are ethical guidlines that go against it, and she would also face licensing issues if she did.
That’s not to say that it doesn’t ever happen, or that it wasn’t fairly common earlier (as in the case of SnoopyFan’s mother). But I would like to see a cite for dauerbach’s assertions.
Doesn’t the common practice of prescribing antibiotics to patients with viral illnesses qualify?
Regarding anti-biotics for (say) a cold: yes, they don’t cure the illness, but they treat some of the symptoms, don’t they? That’s very different from doing nothing.
When I was in optometry school a few years ago, some older doctors liked to use sulfer-based topical antibiotics for patients with viral infections as a placebo of sorts. The drops aren’t that effective killing bacteria so there isn’t a resistance issuce, and they sting going in so patients think they are getting a medical benifit.
I’ve never done it myself. I prefer telling the patient that an anti-biotic won’t work and to go from there.
Boy, I wish there was some sort of form I could file with the AMA or somebody that says I don’t mind being given placebos. I don’t care if I’m being lied to, if it works.
Unless some of the symptoms are caused by bacteria, then antibiotics do nothing whatsoever except make the patient feel that they are being given treatment.
It seems like a tricky ethical question, doesn’t it?
I mean, if you have a condition for which no known treatment does any better than a placebo, it would seem like the sugar pills would be the most cost-effective option.
I guess it’s a discussion that’s better left to GD, though.