Posted by SLS on July 16, 2006, at 6:41:21
In reply to Re: couldn't have said it better myself, posted by linkadge on July 15, 2006, at 22:09:11
> "I predict that the percentage of placebo responders in the STAR*D study will be much lower than you will see for any standard clinical antidepressant trial"
>
> Why should this be so? Most clinical studies seem to show similar or worse statistics. I don't know of too many trials that show better statistics.I believe I've already addressed this issue in previous posts. I have seen other abstracts on Medline and elsewhere reporting that clinical trials of antidepressants using rigid criteria allowing only the more severe cases of MDD demonstrate lower placebo response rates and greater superiority for putative antidepressants.
The following paper describes the failure of trials with high placebo response rates to demonstrate superiority of antidepressants, but not those with low placebo response rates. It is my contention that high placebo response rates are indicative of poorly designed inclusion criteria that allow people who do not have true MDD to enter the studies. I feel that this is more of a problem today than it was 20 years ago. I believe this is due to the increase in monetary pressure to produce subjects for clinical trials. This is born out by the steadily increasing rate of placebo response observed in these studies over the years. It is indeed ironic that the drug companies, in their haste and zeal, have cost themselves dearly in time and money by applying this pressure.
- Scott
poster:SLS
thread:662854
URL: http://www.dr-bob.org/babble/20060709/msgs/667442.html