Boots Loses Credibility Over Homeopathy Admission

No doubt UK readers will be aware that the country’s largest pharmacy chain, “Boots” (formerly Boots the Chemists) admitted two days ago that they sold homeopathic remedies for no other reason that they were popular. Speaking to the House of Commons Science and Technology Committee, which is investigating the scientific evidence behind homoeopathy, the professional standards director for Boots, Paul Bennett said,  “There is certainly a consumer demand for these products, I have no evidence to suggest they are efficacious.”

So customer knows best. Well as pointed out by an open letter to Boots from the Merseyside Skeptics Society, the British public trust Boots and have neither the time nor expertise to evaluate the claims made by homeopaths. Only this morning, a medical GP and head of the faculty of homeopathy, Dr. Sara Eames appeared on BBC Breakfast television proclaiming that there was overwhelming scientific evidence for the efficacy of homeopathy and moreover, it was not just a placebo effect. This is not simply misleading the general public, this is telling big porky pies.

The whole homeopathy saga is like a broken record. Various voices such as Ben Goldacre or the Quackometer have written extensively on this medieval belief system – yes its older than 200 years (read SuperSense). But now with money involved and the House of Commons, it seems likely that the future of  five NHS Homeopathic hospitals (one in Bristol)  looks increasingly uncertain. But is Boots so bad? I was in another independent pharmacy yesterday picking up Tamiflu vaccine and the place was stocked with all manner of woo from herbal remedies to copper bracelets. People who hang out at these places clearly lap the woo all up.

But what about conventional medicine? Well, things are not much better when it comes to new medical treatments of depression.  I have been writing and researching the new anti-depressants including selective serotonin reuptake inhibitors such as Prozac. These are some of the most common drugs prescribed by GPs today and the truth is that they are most likely as effective as homeopathy.

Last year, a meta-analysis of  SSRIs revealed serious flaws in the clinical trials. The authors confirmed first that the overall effect of these  antidepressants was below the recommended criteria for clinical significance. Then they showed that there was virtually no difference in the improvement scores for drug and placebo in patients with moderate depression and only a small and clinically insignificant difference among patients with very severe depression. The editor of the journal concludes, “These findings suggest that, compared with placebo, the new-generation antidepressants do not produce clinically significant improvements in depression in patients who initially have moderate or even very severe depression, but show significant effects only in the most severely depressed patients. The findings also show that the effect for these patients seems to be due to decreased responsiveness to placebo, rather than increased responsiveness to medication. Given these results, the researchers conclude that there is little reason to prescribe new-generation antidepressant medications to any but the most severely depressed patients unless alternative treatments have been ineffective.”

The US Food and Drug Administration (FDA), the UK National Institute for Health and Clinical Excellence (NICE), and other licensing authorities have approved SSRIs for the treatment of depression. But with such serious doubts about the efficacy of SSRIs, are GPs right to continue prescribing these expensive drugs or should they switch to an infinitely dilute solution of arsenic or cuttlefish ink? After all, both GPs and homeopaths believe their treatments work. I guess the difference is that one seems plausible (altering neurotransmitter activity) where as the other seems supernatural (water memory, essence, vitality – call it what you want). The other main difference is that the process of scientific evaluation should eventually force the medical community to abandon procedures that are invalid.

Still, it does make you think – whether it is the belief in magic or the belief in neurotransmitter imbalance, they are arguably triggering the same mechanisms that make people feel better.