Doc, those new tablets just aren’t working so good….

Conversation overheard by the consulting room fly

“Hi Mr Brown, what have you done today?”

“Oh not much Doc, those new tablets you gave me for my back aren’t working as good as my last lot”

Hmmm, checking the prescription record and seeing no change in the medication.

“I haven’t changed your tables for a while, what happening?”

“Those new green tablets for my back pain, well they don’t work as good as the white ones. Hang on I’ve got those tablets in my pocket.”

Living in a world where there is supposedly generic equivalence I wondered if Mr Brown was inadvertently taking the wrong tablet. After all the TGA website suggests,

“A generic prescription medicine works in the same way as the existing medicine. What matters is the active ingredient, which is the same in the generic brands and the existing brand.”

Mr Brown handed over a packet of tablets which contained exactly the same medication as the one prescribed. Except that the brand I prescribed was indeed white and these were green.

Can the colour of tablet really affect how a patient may perceive its effectiveness?

Well yes it would seem!

Delving in to the BMJ from 1970, a trial in 48 patients with anxiety found that changing the colour of oxazepam tablets from red to yellow to green affected the response to the medication. Anxiety symptoms responded better to green and depressive symptoms responded better to yellow. Adverse effects were found not to be colour related. Unfortunate for the authors, despite the trend statistical significance was not achieved.

The colour of a placebo tablet has been found to influence patient’s perception of effect. an earlier study from 1962, revealed that the “maximum” placebo effect was obtained when the patients were given a placebo of the preferred color and the least effect obtained with the non-preferred color.

A more recent Dutch study found  perceived action of coloured drugs showed that red, yellow, and orange are associated with a stimulant effect, while blue and green are related to a tranquillising effect. It has been found that red stimulants work better than blue.   707cbd96c92af08d2c6bcec1af06c708

There has also been found a difference in efficacy between tablet and capsule of the same medication and shape and size of tablets.

Strange creatures aren’t we.

“Well Mr Brown, what i think you need to do it have a chat with your pharmacist and make sure you stick to the brand which you think works better.”