Abstract

Pain management should be individualized for each patient as much as possible, and the use of a placebo in the clinical practice can help. The treatment with compounded topical analgesics holds a great promise for such individualized therapy, due to the fast response of patients after applying cream containing adequate concentrations of an active pharmaceutical ingredient. We present and discuss a new single-blinded placebo-controlled test paradigm, enabling the physician to quickly differentiate between responders and non-responders, and to further explore the concentration-effect response. This way the placebo assists in selecting the optimal pain treatment, and such use should be regarded as beneficial for patients and ethical correct.

Keywords: Ethics; Analgesia; Topicals; Phenytoin; Amitriptyline; Analgesic cream