The drugs don't work, they just make you worse

[venta]

So... we still have no government, so I still have a cough. On the way to work this morning, I bought some cough mixture - said cough isn't particularly painful, but it is noisy and I thought I ought to make the attempt not to irritate my colleagues.

Actually, I seem to have irritated them anyway, because they're all wildly indignant that I paid for cough mixture when "it doesn't work". I'm vaguely aware that there have been news stories claiming that cough mixture was ineffective, but am vague on the details. It certainly appears to have made some difference. I bought the least expensive bottle available in Boots this morning and its ingredients list doesn't include "placebo", so it can't be that.

Anyway, I am mildly outraged by my cough mixture. It is a sort-of branded, sort-of ownbrand affair, being somehow "Boots Nirolex Chesty Cough relief Linctus". The capitalisation is theirs.

Firstly I was outraged because the box didn't contain a spoon. Don't you even get a free spoon these days ? Admittedly, sensible grown-ups with medicine cabinets don't need another spoon, so I suppose it reduces waste. However, as an immature type who hasn't bought liquid medicine in years I found myself in the unfortunate position this morning of swigging it out of the bottle. And it was rather nasty. More outrage. I always expect cough mixture to be nice. Junior Benelyn was (when I was a kid) lovely stuff - more or less worth having a cold for.

Anyway. Swigging from the bottle, as it turns out, meant I didn't realise until just now how quite how outraged I was. Post lunch, I thought it was about time for another dose so used the small purple pottery spoon which lives on my desk. Pouring the gloopy stuff out... I realised it was clear. Transparent. Totally colourless.

Everyone knows that cough mixture should be red. Or brown. Maybe reddish brown. Possibly - on appeal - yellow if it's that buttercup stuff. But colourless ?

No wonder it doesn't bloody work.

Comments

[valkyriekaren.livejournal.com]

Covonia. *nods*

[venta.livejournal.com]

Yes, Covonia would be my normal choice. But the only bottles they had in Boots this morning had slightly unfamiliar-looking labels, and seemed to have added the word "mentholated" to the name. I distrusts menthol, I does.

[ar-gemlad.livejournal.com]

I recommend Benylin for chesty coughs, non-drowsy version. I use that for tickly coughs too, because the tickly cough version tastes of licorice and is therefore vile. The chesty coughs one is a lovely deep brown-red, and it is sweet and lovely. I think it works - it at the very least calms the throat down so you stop trying to cough up your voice box.

I used to like Cavonia, but when I last tried it (about 10 years ago?!) it was a bit runny and felt watered down.

Chemists sometimes have dosing spoons if you ask for them, but they stopped putting them in medicine boxes ages ago.

[venta.livejournal.com]

Your spelling of Benylin looks much more convincing than mine. I have a vague idea that last time I tried grown-up Benylin it was woefully disappointing compared to the cherry-red junior stuff.

[lnr]

The modern stuff has an added ingredient to make it less appetising to alcoholics. Or so it's rumoured. It may just be an extra decongestant.

I've tried several cough medicines, and to be honest none of them work very well, and Benylin is still my favourite. I hate with a passion the bottle of nasty licorice flavour stuff I have at the moment that you're supposed to take as a teaspoon full dispersed in warm water. Grim. And I *like* licorice! The trouble is I feel I really ought to finish it.

My GP prescribed me one with codeine in which was a little more effective, but that was for a cough that just wouldn't go away, and which was pronounced to be mostly now just irritation caused by too much coughing.

Hall's mentholyptus extra strong cough sweets are my friend.

[j4.livejournal.com]

I'm vaguely aware that there have been news stories claiming that cough mixture was ineffective

Not just news stories but actual peer-reviewed science, by the looks of it. Wikipedia has lots of links to both: http://en.wikipedia.org/wiki/Cough_medicine

Whatever you do, don't take Lemsip, or you'll end up like Andrew Motion.

I've not seen a spoon with cough medicine for years - these days it's always those little plastic cups instead. I have about a grillion of them if you want some... :-} Otherwise I am thinking of glueing them together to make a fake eggbox brontosaurus.

Hope the cough gets better soon!

[venta.livejournal.com]

Whatever you do, don't take Lemsip, or you'll end up like Andrew Motion.

How very odd. Firstly, I can never imagine doing anything remotely creative when I have a cold. Secondly, Lemsip is absolutely vile.

Thanks for the wiki link - I failed because I searched for "cough mixture", which doesn't redirect to "cough medicine", and I didn't following enough links to locate that article.

Plastic cups suggest "real" medicine to me, and therefore greater illness. Wanna spoooooon!

[venta.livejournal.com]

Having now read the wiki link - the trouble is, the efficacy of cough syrup is compared against "placebo".

Now, I haven't read the trial data, but I'm guessing that the placebo will have been a sweet-tasting goopy liquid. Which is pretty much what I want for a cough - but the only format in which one can readily purchase it is... cough mixture.

Where do I purchase my ready-made sweet-tasting placebo goopy liquid ? Honey and lemon isn't the same when home made (unless you're practically drinking neat honey).

[sushidog.livejournal.com]

Glucose syrup? Should be available at your pharmacy, and actually might help a bit, as it'll be faintly soothing. Add food colouring and/or flavouring to suit.

[venta.livejournal.com]

OK, thanks, I might consider trying that.

Do you think it's marketable ? Venta's Patent Cough Placebo ? "Does you no good, but tastes lovely..."

[sushidog.livejournal.com]

You'd have to find a more scientific, more obscure way of saying "It does you no good", otherwise you'll be undermining your own placebo effect.
You could always advertise it by having lots of people saying "Well, they _said_ it woudn't do me any good, but I took some, and it tasted great,a nd three days later, I felt loads better".

Mind you, I have a feelin there's some research somewhere hwich suggests that placebos work better if they taste nasty!

[venta.livejournal.com]

Mind you, I have a feelin there's some research somewhere hwich suggests that placebos work better if they taste nasty!

Dammit, there's always some spoilsport scientist who actually finds out stuff like this.

I was hoping to market it to people who are well aware that cough medicine is ineffective, but still hanker after something which fills the same purpose (ie to be goopy and nice when your throat is irritated). It is possible this is too niche a market demographic, though.

[beckyl.livejournal.com]

Residual guilt complex that nothing that tastes nice can be good for you. See also attitudes to sensual pleasures in a Puritan derived culture. Can't find a sensible citation, but I'm in total agreement that there was some research about it done that came to that conclusion.

[beckyl.livejournal.com]

If you can get it - Bottle Green Spiced Berry cordial. Take as a hot drink (as in comfortably warm, not boiling hot) and feel the goodness happening to your throat.

http://www.bottlegreen.co.uk/Products/Cordials

Unfortunately, it tends to be only readily available in supermarkets near me from about November to February, and it's just expensive enough that I hesitate to stock up with the twelve bottles I think I should have for one a month.

I've yet to experiment with a bottle of neat ribena left to steep for a month or so with (the contents of) a packet of mulled wine spices in it, but I must get round to it, and will report back on the outcome...

[venta.livejournal.com]

That does sound nice - I'll have to try it if I see any for sale!

Sadly I doubt it fills my cough-treatment requirement, which is fundamentally gloopiness. Things like Ribena would be ideal if only they were a whole bunch more viscous.

[beckyl.livejournal.com]

Some kind of thickening agent in your cordial then - there's bound to be something that acts the same way as cornflour for drinks. No idea what it is, but there must be something.

[valkyriekaren.livejournal.com]

Arrowroot.

[sea-of-flame.livejournal.com]

Glycerine?

[sushidog.livejournal.com]

I can report that hot ribena with three or four whole cloves chucked in is very nice, and soothing to a sore throat (cloves having mildly anaesthetic properties). I suspect just mulling ribena would work quite well, actually, especially if you diluted it with cider (or apple juice) rather than water.
Also, Greens ginger wine is _excellent_ for sore throats and coughs, and is suitably sweet and burn-y.

[venta.livejournal.com]

I've never encounter Greens ginger wine - I've always bought Stones when I've had it in. However, ginger wine is a fine idea, and I should pick some up on the way home.

Crabbies is OK, but I mistrust them for that nastily disappointing alcoholic pop they've just foisted on an unsuspecting world.

(Edited to remove inexplicable reference to Faust).

[sushidog.livejournal.com]

I suspect I mean Stone's green ginger wine, don't I?
That, anyway.

[j4.livejournal.com]

I failed because I searched for "cough mixture", which doesn't redirect to "cough medicine"

Ah! OK. I have put in a redirect. :-)

[venta.livejournal.com]

Thank you!
I do usually do minor edits like that myself, but wasn't sure quite where the line between "legitimate edit" and "customising for own personal use" came in that case!

[onebyone.livejournal.com]

I had a conversation about this once which went:

My interlocutor: "I was thinking of buying this flu remedy, but I looked it up and it's no better than placebo."

Me: "That's fine. Placebos work incredibly well on mild pain and discomfort symptoms like flu. That's why saline injections outperform sugar pills as painkillers."

MI: "But if I don't believe it'll work, then it won't."

Me: "That's why I'm pointing out that the science proves it does work. Rationally, you should believe that it will work."

I don't think my argument prevailed, but then the stuff was probably 20 times more expensive than an ibuprofen and a bit of a lie down, so maybe I should have pitched that.

The relevance to cough mixture being, if the placebo performs as well as the standard treatment, take the placebo even if it is just a sugar pill. Bohr's horseshoe, and all that. We don't need doctors to lie to patients, we just need patients with a bit of imagination.

[venta.livejournal.com]

Unfortunately, it's considerably easier to buy cough medicine than it is to buy placebo syrup.

At least, I thought it was - several people have now made suggestions of where I can acquire placebo syrup from. Though, to be honest, given that it's probably still harder to acquire the placebo, unless it's substantially cheaper, I might as well carry on taking the no-better-than-placebo over-the-counter medicine :)

[onebyone.livejournal.com]

Sure, but you *know* that cough-medicine is as effective as placebo. If you try to improvise your own placebo, you might not get the good stuff. I think cuthbertcross's jargon is the right way to go, though. If a pharmacist is willing just to sell you that, perhaps with a side-order of raised eyebrows, then you're done.

Once you have the choice between the medicine and the correct placebo, then it's a cost issue rather than an efficacy-of-treatment issue.

Of course if you can convince yourself that the placebo used in the literature was a cup of tea and a biscuit, you're even better off.

[beckyc.livejournal.com]

Have you turned into an asthmatic in your old age? Not that you are old, it's just a figure of speech.

Things wot are good for chesty coughs:
Codeine
Liquorice (Red is nice, black is foul), unless you have high BP.
Lots of nice other sorts of sweeties what don't have active ingredients but are a bit soothing.
Glycerine and honey and lemon, what are just a bit soothing of the throat.
Steam

[venta.livejournal.com]

I sincerely hope I'm not turning into an asthmatic, you young whippersnapper - though I do sound somewhat like one just now. Am rather hoping this is a temporary state of affairs.

Is codeine any good for coughs per se ? I'd assumed it was good for the-pain-caused-by-coughing, what I don't (fortunately) have any of.

Honey and lemon is my usual approach, but it's a bit of a faff to brew up at work.

[beckyc.livejournal.com]

Both codeine and liquorice are (allegedly) put in to remedies as cough suppressants.

Of course, for some people it's dangerous to suppress a cough, so this may not be a good thing.

[phlebas.livejournal.com]

Isn't suppression what you'd want for a tickly cough? I'd have thought for a chesty one you want expectorant to help shift the nastiness out.

[rabbit1080.livejournal.com]

That sounds suspiciously like the cough-syrup I had during one of my earlier English winters. The cough-syrup worked fine - made my horrible chesty cough after a day or 2 - but it made me feel like a space-cadet.

By some quirk of planning, I ended up at home by myself that weekend. Watching "The Prisoner" (the 60s sci-fi series). Many episodes, back-to-back. And still on the weird cough-syrup. Finished the tv series at 2am feeling verrrrry weird - might've woken C via mobile phone ... :)

[rabbit1080.livejournal.com]

hmm, now that i think about it, "space cadet" is a silly description. i wouldn't want anyone to be flying a spaceship in that state!

[venta.livejournal.com]

Similarly, I watched Fear and Loathing in Las Vegas when I was running quite a high temperature and the world seemed a bit swimmy. I don't recommend that!

[bateleur.livejournal.com]

Diet Coke is my preferred chesty cough remedy.

However, I strongly endorse your insistence on colour in cough mixture. Without the scary red colour it can't possibly work.

[cuthbertcross.livejournal.com]

Yer desired placebo is called "simple linctus BP" in chemist-speak.

Codeine only acts as a cough suppressent if you take enough to stun a piebald.

All the syrups do is soothe an irritated throat (which is a perfectly good reason to take em IMHO).

Try Tixylix kids syrup-it tastes nice (ribena-ey) and I won't tell it you're a grownup.