Is drug-placebo difference in short-term antidepressant drug trials on unipolar major depression much greater than previously believed?
A pooled analysis of randomized placebo-controlled short-term antidepressant trials on unipolar major depression shows that the rate of antidepressant and placebo responders is 50% and 30% respectively. The traditional calculation of antidepressant-placebo difference (50-30=20%) in these drug trials is based on the assumption that all placebo responders should be antidepressant responders, a postulation that has been never investigated and proved. Further studies are needed investigating directly the relationship of placebo response in relation to antidepressant response/nonresponse. If a substantial part of placebo responders were antidepressant nonresponders, the drug-placebo differences in all short-term antidepressant drug trials on unipolar major depression are much more than 20%, and the previously published data on antidepressant-placebo difference should be re-calculated.
Rihmer
Zoltán
Z
Department of Clinical and Theoretical Mental Health, Semmelweis University, Faculty of Medicine, Budapest, Hungary. rihmerz@kut.sote.hu
Gonda
Xénia
X
D000928:Antidepressive Agents / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy*; D006801:Humans; D015990:Placebo Effect; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors
D000928:Antidepressive Agents