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Re: We need placebo ed_uk

Posted by SLS on July 30, 2005, at 16:24:39

In reply to Re: We need placebo SLS, posted by ed_uk on July 30, 2005, at 12:49:48

Hi Ed.

> >It would be preferable to use an active placebo.....
> .....but what if the active drug produced a higher incidence of side effects than the active placebo.

That is always a difficulty whenever crossover investigations are performed. When I participated in this type of study with inactive placebo, I just figured they had simply increased the dosage on me.

> Due to the high incidence of side effects, people given the active drug may view it as being a 'powerful' drug,

They would not be aware of the crossover design of the study, only that they may or may not receive placebo.

> this may increase the placebo effect,

But placebo responders will have been removed from this phase of the study by the end of 10 weeks.

Now you are beginning to understand the power of the placebo effect when it comes to depression. It is a difficulty that must be addressed in order to evaluate the true efficacy of antidepressant medication.

> > One might consider withdrawal of the active compound for two weeks after a response, and then rechallenge if a relapse ensues.

> What about withdrawal symptoms?

This sort of procedure has been carried out in the past. Perhaps a taper could be performed over the course of two weeks rather than an abrupt continuation.

- Scott




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