Faith in cold medicine?

nosho

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The latest news story about over-the-counter cough medicine is that it doesn't work. Drug companies are cashing in on a lie. Ailing consumers are wasting millions of dollars. (visit new.google.com and search for "cough medicine")

Drug companies defend all this by saying there's a huge demand in the marketplace for cough medicine. Sound familiar? (Think homeopathy.)

This also reminds me of the "counterfeit detection" pens sold on the false premise that they can be used to detect fake dollar bills.

- cough, cough -
 
ok... it might be time to add some usefull info here...

What sort of substance are we talking about?
 
I thought cold medicine was only used for the purpose of drowsiness or peppiness...
 
This morning, they were discussing this on the news, and the impression that I got, wasn't that they were ineffective, it was when they were using them on small children. Well-meanng parents could possible give their child an overdose. The other concern was that most cough medicines on the market are suppressants, and that by over suppressing the cough, it could lead to worse comlications, such as pneumonia.
 
Thanks, Hagrok :)

Well, indeed it turns out that there hasn't been any proof of effectiveness for OTC cough medication. K. Schroeder at the Bristol University did no less then three meta-analyses on the matter. One for children, on for parents and one (the biggest and latest) for both. His conculion for the first two: no proven effectiveness. His conclusion for the third: Inconclusive...
 
Interestingly enough, I've been taking OTC Cough medicine the past few days and it didn't appear to be doing much.

I figured Walgreens was selling it, so it must have had clinical trials demonstrating its effectiveness. Apparently not; at least according to the article I just linked.

I did notice some nice Homeopathic remedies sitting in the cold section, as well...
 
It's important to get your news from more than one source, and to read all articles carefully, not just the first attention-grabbing paragraph. The news is not, "Cough medicine doesn't work". The news is:

http://msnbc.msn.com/id/10777506/
Over-the-counter cough syrups generally contain drugs in too low a dose to be effective, or contain combinations of drugs that have never been proven to treat coughs...

...Many popular over-the-counter cough medicines proudly advertise that they don’t cause drowsiness, but Irwin said that is because they do not contain older antihistamine drugs that do help relieve coughs that are due to colds.

These antihistamines, including diphenhydramine — an active ingredient in Benadryl — are also available over the counter but are not marketed as cough medicines, he said.

Some over-the-counter cough syrups contain two drugs that have been shown to help relieve coughs caused by colds — codeine and dextromethorphan — but generally the doses are too small to be effective, Irwin said.
So, the news is that some cough medicines as currently packaged and purveyed do not work. But that's not the same thing as, "It's pointless to take cough medicine, period."
 
I suppose the problem is that the effective doses are so abusable, so the stuff has gotten weaker and weaker. I read a few years ago about how kids were buying cough syrup, going from store to store and guzzling dextromethorphan to get high. So now I suppose there's so little in the medicine that you'll get sick from the sugar and glop long before you get a buzz.

When I was a kid, I had croup and the only thing that worked on it was something called Stokes Expectant. The stuff was thick and brown, and tasted like road tar thinned with nail polish remover. But boy did it work - I'd come downstairs gasping and barking like a dog and ten or fifteen minutes later I'd be gently coughing up phlegm and falling asleep. Eventually I grew rather fond of the taste, too. Along with the expectorant, the cough suppressant was opium!
 
The American College of Chest Physicians is saying many of these products just plain do not work.
If one visits the Google news Web site mentioned in the first post and then searches for "cough medicine," one finds articles from many credible news sources. A few excerpts are included below. The bottom line: There is no clinical evidence for the effectiveness of the active ingredients dextromethorphan and guaifenesin in products such as Robitussin Maximum Strength Cough Suppressant. I probably should have been more clear and more specific in the opening post for this thread. I hope this post explains things better.

So consumers are spending huge amounts of money because they have put their faith in Walgreens, in drug companies, in the FDA, trusting that if a bottle of medicine manufactured by a drug company says "cough suppressant," it will ease their coughing. Those consumers are being cheated.
Drug companies profit, because they know consumers want to believe these products work, and because most will continue to believe they work even if presented with the fact that there is no evidence that they work.

The following is taken directly from the American College of Chest Physicians Web site (as a new poster I'm not allowed to include the link, but it contains chestnet and org), after navigating to the organization's latest press release:
OTC Cough Medication
The guidelines also stress that most over-the-counter cough expectorants or suppressants, including cough syrups and cough drops, do not treat the underlying cause of the cough. Therefore, the guidelines recommend that for adults with acute cough or upper airway cough syndrome (previously named postnasal drip syndrome), an older variety antihistamine with a decongestant is the preferred therapy.
“There is no clinical evidence that over-the-counter cough expectorants or suppressants actually relieve cough,” said Dr. Irwin. “There is considerable evidence that older type antihistamines help to reduce cough, so, unless there are contraindications to using these medicines, why not take something that has been proven to work?”

Here's how an article from UPI began:
Doctors say cough medicine doesn't work
NORTHBROOK, Ill., Jan. 9 (UPI) -- Chest experts say over-the-counter cough syrup doesn't work.
The American College of Chest Physicians says most over-the-counter cough expectorants or suppressants do not work to treat the underlying cause of the cough.

Here's how the Chicago Tribune article began:
Spoonful of cold reality
The American College of Chest Physicians on Monday revealed an open secret in the medical community: Over-the-counter cough suppressants don't work, they say, casting doubt on the billions spent every year to fight the common cold's most irritating symptom.

My question is this:
How, exactly, is the sale of unproven cough suppressants any more ethical than the sale of unproven homeopathic remedies?
 
I've known for years that NyQuil doesn't do a damn thing except dope you up so you don't care. I generally just hydrate and take a Claritin or something at the beginning and I'm good to go.
 
Lost Angeles: Exactly

That is what I do.... with the support of my doctor. When I have a cold... in the evening have a nice hot toddy. The purpose of the toddy is to get nice warm fluid down your throat (it often contains things like honey, lemon juice and cinnammon to sooth the throat).

THEN take a antihistamine which will make you sleep... like the generic form of Benydral we get at Costco. This takes the place of codeine. It knocks you out and relaxes your throat so you can sleep.

I gave up on cough syrups years ago
 
Here's how an article from UPI began:
Doctors say cough medicine doesn't work
NORTHBROOK, Ill., Jan. 9 (UPI) -- Chest experts say over-the-counter cough syrup doesn't work.
The American College of Chest Physicians says most over-the-counter cough expectorants or suppressants do not work to treat the underlying cause of the cough.
... snipe...
My question is this:
How, exactly, is the sale of unproven cough suppressants any more ethical than the sale of unproven homeopathic remedies?
Ethical practice measures the practitioner not the medicine.
Who is not doing things ethically?

Which unproven Homeopathic and unproven medical cough suppressants are you comparing?

Medicine is not just about cures for underlying cause.
And doctors as I understand have the responisbility also to humanely administer medicine, not just to cure, but also to relief.
Eg. Fever suppressant.

Cough mixture intended to relief, is similar to medicine commonly used to reduce the suffering due to the effect of fever.

If conventional medicine, that only treat the symptom but do not treat the underlying cause, requires rigourous clinical trial, testing and approval ;
Then why is it that Homeopathic remedies should be excluded from clinical trial, testing and approval by FDA? If it is not proven to work rigouously it should not be placed up for sale.

Is any Homeopathic remedies up to the challenge of a rigous clinical test?
I could think of only one. To cure dehydration.
 
I have to vaguely go with Jyera. I'm singularly unimpressed by a line like
The American College of Chest Physicians says most over-the-counter cough expectorants or suppressants do not work to treat the underlying cause of the cough.
because I already know that any "cold remedy" serves at best to suppress symptoms; it does not, cannot, address the cold-causing virus itself. I've used Mucinex expectorant tablets and perceived some relief; they don't stop me coughing, but they do make it less uncomfortable, or so I think. Maybe it's just a placebo effect, but as long as it makes me feel better, that's what matters, because that's all I expect: symptom suppression.
 
I think we have to be very specific here, because when we say "cough syrup" or "cold medicine" we can be talking about various concoctions that contain a wide variety of active ingredients. For example, acetaminophen/paracetimol (Tylenol) is a well-known, heavily studied, effective, and widely used anti-pyretic agent that is often an ingredient in these remedies. Likewise, diphenhydramine (Benadryl) is often the ingredient-of-choice for both its antihistamine and sleep-inducing properties. There's also pseudoephedrine (Sudafed) which is an effective decongestant and works by constricting the small vessels in the upper airway. Then, there is also plain-old ethanol, which is why you don't want alcoholics or the kiddies getting too much of some concoctions.

Having said all of that, I think the two primary ingredients in contention to which folks on this thread are alluding to are dextromethorphan bromide and guaifenesin. There has not been a lot of strong evidence that the former is extremely effective in suppressing cough, and the latter (a mucolytic) has not been consistently and demonstrably shown in clinical trials to be all that effective in breaking-up secretions. There exists a lot of controversy among some clinicians on whether or not these medications are effective at all. Both are relatively safe to take at the doses offered in the over-the-counter products, and may work well for some individuals. Pushing the doses into what some physicians consider to be truly the "effective" ranges of those medications can come with some unwanted side effects.

Again, with all that in mind, Euromutt's comments are key. No cold "remedy" will treat the underlying virus. Only your body's immune system can do that, unless you also have a bacterial infection for which there may be an effective antibiotic.

-Dr. Imago
 
Lost Angeles: Exactly

That is what I do.... with the support of my doctor. When I have a cold... in the evening have a nice hot toddy. The purpose of the toddy is to get nice warm fluid down your throat (it often contains things like honey, lemon juice and cinnammon to sooth the throat).

THEN take a antihistamine which will make you sleep... like the generic form of Benydral we get at Costco. This takes the place of codeine. It knocks you out and relaxes your throat so you can sleep.

I gave up on cough syrups years ago

Interesting... if I may confess an ignorance to dialect, could you say what a "toddy" is?
 

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