Letters: December 2010

December 15, 2010

Pharmacists speak out about the pros and cons of the placebo effect.

Key Points

Placebos and healing

Robert Speers, MA
BOULDER, COLO.

Context is everything

During my 31 years of pharmacy practice, I have been asked to fill capsules for the placebo effect. Each time, I did fill the prescription with the placebo, after I evaluated the patient's usage and abuse to determine that the physician's choice for placebo was the correct therapy and in the best interests of the patient. Most of these patients were abusing their prescription drugs. It worked every time, and I never had a problem with patient or family.

As a Christian pharmacist, I do not think that deception or a lie is OK unless it is in the best interests of patient care. I did not lie to the patients when counseling, as most of these prescriptions were for refills.

Students have not seen this type of patient in a practical setting and lack the first-hand knowledge to make this call. Believe me, when they see the patients who need this therapy, they will quickly change their minds.

Mark Barclay, RPh
VENICE, FLA.

Score 1 for placebo ... make that 2

In 1957, I was a brand-new pharmacist in a New York hospital. An elderly female patient of the arthritis clinic adjacent to my pharmacy had no clinical disease in reality but constantly sought treatment. The rheumatologist, the director, and I conferred and decided to give her a 2-month supply of saccharin tablets with ad lib refills to be taken 1 tid.

This went well for several months, with the patient reporting good results, until she came to my window one day, shouting, and accused us of giving her substandard medication. The previous night she had tried to commit suicide by taking the entire supply - "And look at me: I'm standing right here in front of you, and I'm alive!"

We sent her for a psych consult. I didn't know whether to laugh or to cry.

Irving Gerber, RPh
FAIR LAWN, N.J.

Correction: The Web Exclusive article "Propofol shortage leads to allergy warnings about European product" noted in the Table of Contents of the November 2010 issue stated that Fresenius Propoven (propofol) 1% contained peanut oil. It does not. The statement was taken from an inaccurate press release. The label of the European product contains the following statement: "...the product contains soybean oil and there are reports of cross allergies between soybean and peanut oil." Drug Topics regrets the error.