Psycho-Babble Medication | about biological treatments | Framed
This thread | Show all | Post follow-up | Start new thread | List of forums | Search | FAQ

Re: We need placebo SLS

Posted by ed_uk on July 31, 2005, at 6:56:17

In reply to Re: We need placebo ed_uk, posted by SLS on July 30, 2005, at 20:50:13

Hi Scott,

>However, I think the way that we approach evaluating the efficacy of antidepressants must be viewed in the context of the high rate of placebo response.

I agree. The placebo response is very high and seems to be rising - I've had the impression that new studies seem to have higher placebo responses than older ones. I think you're right that it's related to the selection criteria..... and perhaps due to impressive nature of being in a study of a new drug.

>I would still want to look to do studies in which the inclusion criteria included only the more chronic and severe cases of depression.

I agree. Also, drugs with a novel mechanism of action ought to be tested on patients who are resistant to a few current therapies eg. at least one SSRI, one TCA and Effexor.

>What would happen if we included only those severe cases where cortisol levels were abnormal?

Probably a poor placebo response and a good response to something like nortriptyline.

>If 30% of those included in the study are primarily psychologically depressed rather than biologically, but still qualify under DMS IV criteria for major depressive disorder, how would we want to interpret a placebo response of 30%?

It's always difficult to do clinical trials of drugs for MDD due to the relatively heterogeneous group of patients included - despite the selection criteria (which exclude many patients who'd be treated with ADs in practice).

Also, people with definite biological abnormalities can respond to placebo eg. post-operative pain could be relieved by a saline injection (which was supposed to be morphine).

Kind regards

~Ed


Share
Tweet  

Thread

 

Post a new follow-up

Your message only Include above post


Notify the administrators

They will then review this post with the posting guidelines in mind.

To contact them about something other than this post, please use this form instead.

 

Start a new thread

 
Google
dr-bob.org www
Search options and examples
[amazon] for
in

This thread | Show all | Post follow-up | Start new thread | FAQ
Psycho-Babble Medication | Framed

poster:ed_uk thread:534296
URL: http://www.dr-bob.org/babble/20050728/msgs/535918.html