Serve only as expensive antacids

EDITOR, - We agree with Morten Andersen and Jens S Schou that H₂ receptor antagonists can safely be sold over the counter, and we understand the pressures on the government and the pharmaceutical industry's pressure to make these drugs available over the counter.1 We question, however, the clinical rationale for such over the counter drugs. Surely the most important issue apart from safety is efficacy. Will patients benefit from the ready availability of these drugs in pharmacies? The answer to this requires an examination of the potential range of clinical conditions for which over the counter H₂ receptor antagonists might be used.

The commonest cause of upper abdominal symptoms is functional dyspepsia, a term that describes an ill defined group of disorders that respond poorly to H₂ receptor antagonists apart from through a possible placebo …