We have a list of some 85 physicians nationwide, and a few in Canada, who have had the same experience as we when they treat with guaifenesin. Were a placebo effect the beneficial mechanism, it would seem strange that 80 percent of our patients fail to improve when we begin with only 300 mg of guaifenesin twice daily. Some continue to fail at double that amount, and we increase to 3600 mg. per day. We would assume our level of care is equal at each dosage, and if charisma were responsible for patients improving, the percentage who improve would not be dosage-dependent. Sometimes initiating guaifenesin at 600 mg. twice daily for a stoic patient results in a violent cycle that forces me to reduce the dosage.
Improvement proceeds at the lowered amount as before.
When raising the dosage on an improving patient to speed the process, even a small increment of 300 mg. This sometimes forces us to withdraw to the lower, previous effective level and accept a less greedy road to recovery. No patient can anticipate these events. Many drugs we tried in past years, such as allopurinol, failed, though none of us could predict results. The placebo effect should have been similar with each, since patients had no insight into comparative strengths of varying milligram dosages.