APRIL FOOL'S! 
Yes, you guessed it. Prescrire's "News Update" announcing the decision to withdraw all nasal decongestants from the pan-European market was in fact an April fool's prank. As was the Prescrire Editorial Staff's accompanying review of the new product "Pseudoeffichacine (Ateuchoum°)". A prank designed to remind readers not to let the dizzying speed of medical and other news get in the way of clear thinking and careful analysis.
One thing that is no joke: the serious adverse effects that nasal decongestants cause. Decongestants for oral or nasal use (ephedrine, naphazoline, oxymetazoline, phenylephrine, pseudoephedrine and tuaminoheptane) are sympathomimetic vasoconstrictors. They can cause serious and even life-threatening cardiovascular disorders (hypertensive crisis, stroke, and arrhythmias, including atrial fibrillation), as well as ischaemic colitis.These adverse effects are unacceptable for drugs indicated for minor, rapidly self-resolving symptoms such as those associated with the common cold.
See: "Drugs to avoid in the name of better patient care: 2021 update"
39 years of "fishy business" in April
The traditional April prank by Prescrire's editors serves as an annual "booster shot" to remind us all that, in the serious business of medical information, it pays to exercise critical judgement at all times.
In April 1983 Prescrire's "special correspondent" revealed to enthralled readers the enormous interest of protryptophane in the treatment of acute senility... And ever since, the experiment has been repeated yearly in La revue Prescrire's April issue.
And on a few occasions, Prescrire's "April fish" (as the seasonal pranks are known in France) have even made it into the English edition, Prescrire International. One of these is included below, in this sampling of Prescrire's yearly "Poissons d'avril".
Greatest hits from Prescrire's annual "Poisson d'avril" prank
- Pillflix 3D°: an Innovative new manufacturing process that could revolutionise the way we solve medicines shortages
"Pillflix3D° is a new drug that can be fully personalised online and downloaded for 3D laser printing. The physician ticks the boxes "Dosage" and "Desired length of effect". The pharmacist ticks the boxes "Breakable", "Crushable" and "Soluble". The nurse confirms the "Route of administration" and ticks the boxes "Printing", "To Do" and "Done". Then the patient clicks on the size of the tablet (large, small), its shape (square, round or oval), its colour (red, white, blue) and its flavour (salted caramel, strawberry, barley water, vanilla)..."
"Pillflix3D° : premier dispositif d'auto-préparation à distance d'un comprimé" Rev Prescrire 2020; 40 (438): 259. (Pdf, in French, subscription to French edition required)
- Innovative new research on "high dilutions" could change in the way we look at pharmacology (1 April 2019)
"While some remain mired in a sterile debate over whether or not homeopathy is "fake medicine", highly rigorous researchers have announced great strides in the area of "high dilutions", opening up a whole new era in critical thinking... These results, [reported in the April edition of La revue Prescrire], are noteworthy, since they could call into question the laws of universal gravity and the laws governing classic organic chemistry, the very foundations underlying all pharmacological principles."
"[Dés]illusions ?" Rev Prescrire 2019; 39 (426): 307. (Pdf, in French, free)
- "Speed Care": an innovative continuing education programme allowing doctors and pharmacists to save precious time (1 April 2016)
"Just one example of the promising innovations on offer is a weekly schedule organised according to patients’ conditions, to achieve an "optimisation of available physician brain-time"..."
"Speed care : un programme de formation innovant pour gagner du temps au cabinet ou en officine" Rev Prescrire 2016; 36 (390): 306. (Pdf, subscription to the French edition required)
- A new drug treatment makes headlines in France: olanzapine + topiramate (Obéfix°), maintains ideal weight without risk (1 April 2012)
"La Revue Prescrire has revealed unbelievable new results that will be welcome reading for medical professionals and patients alike..."
"Olanzapine + topiramate (Obéfix°)" Rev Prescrire 2012; 33 (342): 248-251. (Pdf in French, free)
- The 2001 "Golden Microphone" awards
for the pharmaceutical industry (1 April 2001)
"The drug industry shows that it knows how to show its gratitude to deserving "opinion leaders"..."
"Les micros d'Or 2001 de l'industrie pharmaceutique" Rev Prescrire 2001; 21 (216): 307. (Pdf in French, free)
- Diffunase° (1 April 2000)
"Prevention of stress, of sexual dysfunction, of insomnia, primal urges, bulimia, etc. All by a very novel means of administration: air travel."
"Gamme Diffunase°, n'importe quoi !" Rev Prescrire 2000; 20 (205): 266-268. (Pdf in French, free)
- A computerised medical information system in France? (1 April 1997)
"A confidential report by the Ministries of Health and Finance contains a proposal for a mandatory computerised medical identification system, in the form of an unremovable computerised bracelet to be worn by all beneficiaries of the national health insurance system..."
"Un carnet de santé informatisé en France ?" Rev Prescrire 1997; 17 (172): 284-285 and 308. (Pdf in French, free)
- Panaceum° tablets (1 April 1984)
"All the results are unanimous, just a single 5 mg dose is enough to cure the great majority of illnesses. The huge advantage for us prescribers is that there is no need for a precise diagnosis. As soon as we suspect some disorder, major or minor, no matter what it involves, the prescription is the same..."
"Panaceum° comprimés" Rev Prescrire 1984; 4 (34) : 2. (Pdf in French, free)
"Panaceum° d'avril" Rev Prescrire 1984; 4 (35): II. (Pdf in French, free)
- Kwajalumpur. 3rd Symposium of the International Federation of Experimental Gerontopathology: protryptophane can cure senility (1 April 1983)
"The press must be ever alert in order to satisfy readers' thirst for news..."
"Kwajalumpur. Troisième symposium de la Féderation Internationale de Gérontopathologie Expérimentale : le protryptophane peut guérir la sénilité" Rev Prescrire 1983; 3 (24): 13 - 14. (Pdf in French, free)
©Prescrire 1 April 2021
