Cpnhelp.org

Uh, notice that one of the main things they are prescribing as a "placebo" is antibioticsi for viral colds. But... it's not like anybody is actually testing to make sure the cold is viral; they're just assuming it, or at most going on some weak indications, like the color of mucus or the length of time the infection has lasted. And for that matter, even a viral cold, in someone who has Cpni (which is a substantial fraction of the population), is likely to be followed by a reactivation of that Cpn -- which is something that antibiotics really help with. So for my money, this is a case of the patients actually knowing better than the doctors what helps them, not a case of the placebo effect. That's not to say that giving antibiotics as doctors do today -- grudgingly, and for a short time -- is the best option; really what would be best would be to test for Cpn (well, if there were good tests) and treat it fully.

And... of course you don't tell the patient that you're giving something as a placebo; that would be silly. It would defeat the whole purpose of the placebo; you might as well just not prescribe it at all.

But what is wrong here is the fundamental assumption that doctors generally know what they are doing, and do things for good reasons -- instead of being engaged, as they really are, in a effort to fix an extremely complicated and poorly-understood system (the human body), and to do so in an economically sensible fashion.

Here's another case of a doctor who gives placebos:

... B12 is a WONDERFUL placebo. Pretty ruby color (heap powerful color), inoccuous, not terribly expensive. But mildly painful to administer (that's important-- you need SOME kind of a price shamanistically to expect a reward). Has powerful and subtle vitamin effects. And now, not one, but two positive papers. And of course, more in the psych literature for people with low or even lowish levels. So the doc who's giving it more than half believes it's doing good things he can't prove. Geez, I should reprint the papers on B12 for tiredness to give to my patients that I'm treating for chronic fatigue with B12. Tell me why not?

That's from an article by Steven B. Harris, M.D., describing why he prescribes B12 as a placebo. But again, we at cpnhelp have other ideas on why B12 helps, which have nothing to do with the placebo effect.

It only makes sense to get all outraged over doctors doing something unscientific if you believe they are really being scientifically rigorous in the first place. They aren't; there's some science in the business, but it's mostly an art.

I had an infectious disease doc once tell me he could give me a placebo but make me think it would help and it would help me!!!!  Then he said if I got well, then I was very intellegent to believe it.  Weird!  No sense at all.  Needless to say, I never went back to him.

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FMSi/CFS 1995. tinnitusi, ibsi, sinusitis, EBVi, NACi 2400mg, valtrex, cortef, armour, doxy, azith, flagyli, calcium pyruvate, vita c 10,000 daily, etc. 

I think givinig a placebo does more harm then good. If you really have a infection then givinig a placebo just delays the real treatment and we all know how progressive cpni is.

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Fibro, CFSi,  Myco, CPNi, Wheldon protocol, Zithro 250mg M/W/F/S, Doxyi 100mg 2x day, NACi 1200mg 2x day,  Flagyli pulses 400 mg 3x day

The thing is, they're giving antibioticsi as so-called placebos. There's a fair chance they're actually helping people, but just are too stone-headed to realize it.

Ironic, isn't it?

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The difference between what we do and what we are capable of doing would suffice to solve most of the world’s problems. Mohandas Gandhi

What an outrage that they are ignorant enough to think antibioticsi are a placebo. A good experiment has placebos that really are neutral.

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Combined Antibiotic Protocol minocycline, azithromycin, metronidazolei for muscle pain, insomnia, interstitial cystitisi, sinus, disphonia, dry eyes, stiff neck, veins, thyroid, TMJ.

These aren't researchers doing experiments that the article is talking about; they are working doctors, prescribing placebos just to make patients feel better via the placebo effect. Or so they think... even when what they prescribe actually might be doing good.

I don't think there's anything outrageous here; prescribing placebos, when one doesn't know anything better to do, is dubious since it might discourage the patient from finding a better doctor; but it can help the patient. The placebo effect isn't just about deceiving people; in many cases people actually show objective improvements when they are prescribed a placebo. That's why experimenters do double-blind, placebo-controlled studies in the first place: to distinguish the help that people might be getting from the active drug, from the very real help that even a placebo often provides. In any case, patients who have been prescribed a placebo can ask the doctor what can be expected from it, or can search the Internet to find out; it's no big secret.

Norman,

hello,

I believe Steven Harris M.D. is the son of Nick Harris who owns and runs Igenex.I guess that tells us something.

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diagnosed MSi Jan.2000 ,  chronic neurological lyme disease Nov.2002.

doxyi 100 mg. 1BID. roxyi.150 mg.? BID,adding rifampin soon, pulsed tinii. every 3 weeks, as of oct.17/08, no rifampin as yet, just doxy and 1 gram daily of IV ceftriaxone, soon to

The guy I quoted is not the Lyme doctor Steve Harris. This Steve Harris is a geriatrician who does resuscitation research.

Relieved to hear it.

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diagnosed MSi Jan.2000 ,  chronic neurological lyme disease Nov.2002.

doxyi 100 mg. 1BID. roxyi.150 mg.? BID,adding rifampin soon, pulsed tinii. every 3 weeks, as of oct.17/08, no rifampin as yet, just doxy and 1 gram daily of IV ceftriaxone, soon to

Norman Yarvin,

 I see your point. I can see the value of a placebo but only in a controled environment like if you where monitored in a hospital. but from my experience after seeing many doctors. I have never gotten emmitted for my cpni and myco infectionsi. so if a doctor tried to pull that placebo crap on me all I would do is get worse while the infection got more complicated and when I finally got a appointment to come back after the placebos where done who knows what he would give me.  A good strategy would be to test for everything first then give a placebo and if there is no changes in the patient within a week then come right back in (no 2-3 week out appt.) and continue tests until you find out whats wrong. In my opinion after what Ive learned how all these people on this website have seen all these crappy doctors and not getting diagnosed or any proper tests WHAT GIVES THEM THE RIGHT TO EVEN TRY PLACEBOS. They need to get off there fat asses and start doing real research.  Im not saying placebos dont have there place in the medical world but not when cpn, lyme or myco is suspected!!

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Fibro, CFSi,  Myco, CPNi, Wheldon protocol, Zithro 250mg M/W/F/S, Doxyi 100mg 2x day, NACi 1200mg 2x day,  Flagyli pulses 400 mg 3x day

I'm pretty much with Norman on this.  But I have a spin to share.

We assume things when we read.  WHO decided what was placebo and what was not?  WHO made that JUDGEMENT?  Did the doctor's who did the prescribing have the opportunity to explain their logic behind the scripts?  And even if so, on what basis might an outside evaluator make judgements about what the doctor prescribed?  Maybe they are looking at a Merck manual or something, so if Multiple Sclerosisi doesn't appear on the Rifampin page, BANG! how you going to sort that out?  BINGO, it's placebo.  Maybe the "acceptable" word we use is "off-label".  Did the person/group that wrote and researched this stuff have a cateory for "off-label"?  People who write stuff like this often don't know what they are doing, or they mold their INTERPRETATION to make the story more appealing.

While a subset of this data might be deliberate scripts for sugar pills (which would annoy me) I think it's important to discern just exactly how this "information" came to be.  Ken 

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In pursuit of ABX

I don't think doctors have anything but the patients' best interest in mind when they give a placebo prescription
The hard-to-accept truth is that doctors don't have proven treatments for many of the ills that plague their patients.

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Fibro, CFSi,  Myco, CPNi, Wheldon protocol, Zithro 250mg M/W/F/S, Doxyi 100mg 2x day, NACi 1200mg 2x day,  Flagyli pulses 400 mg 3x day