Cough syrups act little more than placebo in children: Study
Last Updated: Sunday, September 13, 2009, 00:00

New Delhi: Administering cough syrups to
children with acute cough might be a fairly common practice in
every household, but the effect of medicinal administration
might be little more than placebo, a study says.

Published in the latest edition of the Indian Pediatrics
Journal, the study which analyses the clinical outcome of
cough syrups on children in terms of symptom relief, concluded
that there was no difference between various pharmacological
agents compared to placebo or non-medicated administrations.

Moreover, the study says cough syrups can also have the
risk of adverse effects, suggesting their use should be

"... the symptomatic relief with cough syrups observed
in uncontrolled settings is likely to be nothing more than
placebo effect," it concluded.

A placebo effect occurs when a treatment or medication with
no therapeutic value (placebo) is administered to a patient
and the symptoms improve. According to medical experts, the
patient`s belief sometimes has therapeutic effect.

The study was based on Cochrane Library reviews, which
include eight randomised controlled trials with 616 people
having cough associated with upper respiratory infection being
treated with various pharmacological agents singly or in

The reviewers measured several outcomes that quantified
improvement in terms of change in severity or frequency of
cough, comfort to the child in terms of impact on sleep, and
also included parental assessment of improvement as a measure,
the study says.

The study also analysed an additional trial evaluating a
mixture of four pharmacologically active products in children
and assessing a composite score of symptom relief of runny
nose, congestion, pain and cough.

"The trials showed that relief with cough syrups was not
only comparable to placebo, but both were of a fairly high
magnitude, suggesting significant placebo effect.

"In addition, sleep induced by cough syrups may be
mistakenly attributed as a therapeutic rather than side
effect, in some cases," the study says.

Besides, another trial that was analysed in the study,
showed that dextromethorphan, an anti-tussive drug which is
one of the active ingredients in many over-the-counter cold
and cough medicines, was "no better than placebo for the
treatment of cough".

"There was no difference between various pharmacological
agents compared to placebo or no treatment," the study

While suggesting that the effect of cough syrups was
little better than no treatment, the study also says that the
frequency and severity of adverse events reported with most
pharmacological preparations "disallows exploiting even the
placebo effect".

The adverse events "range from insignificant and
transient clinical events to serious adverse events and even
death in rare instances," it says.

Bureau Report

First Published: Sunday, September 13, 2009, 00:00

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