Out of the mouths..

BMJ 1995; 311 doi: (Published 08 July 1995) Cite this as: BMJ 1995;311:132
  1. Trisha Greenhalgh

    The Independent on Sunday recently published an article entitled “The Wonder-drug of the 90s: not Prozac--but Calpol.” Columnist Brian Cathcart described his attempts one evening to settle his fractious 3 year old, which were to no avail until he administered a dose of Calpol syrup. Ten minutes later, the child had miraculously calmed down and its parents were paying homage to the manufacturers of a product which contains, the readers were told, “a triumphant blend of sweetness and paracetamol.”

    I have no doubt that the story is true, and that the whole family gained almost immediate relief from a serious attack of tantrum induced stress disorder. Why else would an investigative journalist of international reputation put together 30 column inches of free advertising for a manufacturer who already commands 70% of the market for paediatric analgesics, and make extensive recommendations for off-licence use which, had they been included in an official advertisement, would have been rapidly brought to the attention of the Medicines Control Agency?

    Mr Cathcart assured me that he was not being paid by Warner Wellcome to bridge the palpable intellectual gap between the observation that Calpol had apparently calmed his child and the conclusion that it “calms babies by the million.” His speculation about what the exact ingredients of Calpol might be (“something that may or may not be sugar”) suggests that he was unaware of the existence of a patient information leaflet accompanying the product.

    Just in case I was missing something, I contacted Warner Wellcome and asked for evidence from randomised clinical trials or equivalent to support the claim that Calpol provides “mass relief from stress” on a scale superior even to Prozac, or that it has “brought more relief to more people in this country over the past 30 years than anything else bar aspirin and penicillin.” The company's medical advisers, who informed me by return of post that they do not recommend the use of their product for any indications other than pain and fever, chose not to send a similar communication to the newspaper--or if they did, the editors of the Independent on Sunday failed to publish it. According to Mr Cathcart, the manufacturers even took the trouble to pass his article on to their public relations firm.

    The journalist who wrote this article, and the editor who passed his piece for publication, hail from a profession whose members are often seen campaigning tirelessly for the banning of E numbers in peanut butter or stridently opposing the addition of fluoride to drinking water. What makes them so much less discriminating about the pharmaceuticals with which they are prepared to sedate their children? I cannot help feeling that many ostensibly discerning consumers actually prefer their own theories about the nature and efficacy of pills and potions to the candid, comprehensive, and standardised drug information for which activists and committed professionals have fought so hard for so long. More disturbingly, it would seem that the pharmaceutical industry has defined itself as neither legally nor ethically accountable for any unproved but commercially auspicious claims appearing in the popular press about its products.--TRISHA GREENHALGH, general practitioner, London

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