If you had suspected CJD would you be indifferent between placebo and quinacrine?

EDITOR—After the apparent recovery of a patient with suspected variant Creutzfeldt-Jakob disease when she was treated with quinacrine, the Department of Health is reported as planning a clinical trial to evaluate the drug's effectiveness as a potential treatment for the disease.1 Should an ethics committee approve such a trial?

There is clearly considerable uncertainty about the effect of quinacrine in variant Creutzfeldt-Jakob disease and other prion diseases,2 but we find it almost inconceivable that a rational patient with suspected prion disease would be in equipoise—that is, indifferent—between quinacrine and placebo. The side effects of quinacrine are well known and are comparatively minor over a wide dose range; the drug …