The Obecalp Nitty-Gritty
- 45% of doctors who responded to a survey said they’ve given placebos to patients. That number certainly seems high, but sometimes patients don’t want to hear what you’re saying–namely, that no drug will help them. Giving antibiotics for a viral illness would almost count as a placebo, if they didn’t have the associated side effects and risks. I’ve certainly wanted to write for “Obecalp 1 tab PO BID” (’placebo’ backwards) but I find it totally unethical and undermining of the doctor-patient trusting relationship. (Then again, patients don’t always seem so keen on the whole trusting relationship either, but that’s why we’re professionals.)
- Linkage shout-out to Maggie Mahar’s Health Beat Blog, which has been around for awhile but I never gave proper… props to. Maggie wrote the outstanding Money-Driven Medicine (Amazon) and has her background in business writing. (The aforementioned book provides a lot of evidence for the problems of our health care system and perverse incentives within it.) Lately she’s been investigating the ICU Checklist for Central Line Place program that was stupidly halted and providing frequent updates about what she’s learning. One of my new favorite blogs in the last six months.
- Illinois’ state-wide smoking ban seems to be going over fairly well. Being at home lately, I’m proud my own hometown finally decided to adopt a smoking ban (better late than never, OP!) and our bustling urban metropolis of Kansas City is being forced to put it on the ballot. I for one am much less likely to go out where bars allow smoking.
No need to write for Obecalp.
There’s Cebocap!
http://www.walgreens.com/images/drug/0100456070701.jpg
The blue (#1) ones are *extra* potent.
They aren’t cheap. 35 cents/capsule AWP.
My concern would be around the side effects. I wasn’t able to find PI for Cebocap, but in reviewing the PI for various other Obecalp preparations, I found the following:
Sleeplessness
Hypersomnolence
Constipation
Diarrhea
Hypertension
Hypotension
Bradycardia
Tachycardia
This stuff seems *really* dangerous.
E
I do love that one of the reasons cited was “to get the patient to stop complaining.” I don’t know how often I’d prescribe a placebo without the patient’s knowledge, but often patients will ask about this supplement or that home remedy and if it doesn’t sound harmful (ex- cranberry juice for UTI, not enough evidence yet) then I say hey, why not, it certainly can’t hurt. Also, don’t we prescribe things “without sufficient evidence” all the time? Is that really so different from a blatant placebo?
That list of side effects is awesome. It’s kind of like the PDR, where they publish every side effect mentioned in the clinical trial of a drug, so even if 1 patient of 10,000 had a headache it gets published and ends up on the commercial.
Hi Tiny Shrink et al.
I’m a health/medicine reporter doing a quick piece for the LA Times on the placebo study published in the Gen Arch of Int Med. (BTW, authors are keen to point out that THEY did not use the term placebo in the survey, but rather a broad definition of what wd constitute a placebo–an intervention with no demonstrated therapeutic benefit–and not just a sugar pill either.) Most docs who acknowledged prescribing such interventions say they did so againstthe backdrop of some level of belief in the power of mind-body connection.
I’d love to reflect the thoughts of physicians, or those in training. But I do have to have quotes and do have to use names. Would you be willing to call me and talk about it? Many thanks!
Melissa Healy
Staff Writer
The Los Angeles Times/Health
202-824-8388
[...] quick bits: Thanks to the LA Times for the mention about the placebo study (and very cool that the reporter found me via my [...]