Methodological Issues in Clinical Trials of Antidepressant Medications: Perspectives from Psychotherapy Outcome Research

Vol. 74, No. 1, 2005

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Special Article

Methodological Issues in Clinical Trials of Antidepressant Medications: Perspectives from Psychotherapy Outcome Research
Brandon A. Gaudiano^a, James D. Herbert^b

^aDepartment of Psychiatry and Human Behavior, Brown University School of Medicine and Butler Hospital, Providence, R.I., and
^bDepartment of Psychology, Drexel University, Philadelphia, Pa., USA

Address of Corresponding Author

Psychother Psychosom 2005;74:17-25 (DOI: 10.1159/000082022)

Key Words

Antidepressants/active placebos, psychotherapy outcome research
Psychotherapy outcome research, depression
Randomized controlled trials, antidepressants/active placebos

Abstract

Despite their widespread use, the specific efficacy of antidepressant medications has been a source of debate in recent years. Examination of the literature reveals that a significant proportion of the benefit produced in antidepressant trials is duplicated in pill placebo conditions. Furthermore, early trials utilizing active placebos, or medications that mimic the common side effects of antidepressants, showed even smaller differences as compared with active medications. We examine issues surrounding the use of placebo control conditions in antidepressant trials, including the pros and cons of active placebos. We conclude that similar challenges are faced by psychotherapy outcome researchers who have focused more on the separation of specific from nonspecific treatment factors and on the effects of researcher allegiance and patient expectancy on outcome. Within this context, recommendations for improving future antidepressant research are discussed.

Author Contacts

Brandon A. Gaudiano, PhD
Psychosocial Research Program, Butler Hospital
345 Blackstone Blvd.
Providence, RI 02906 (USA)
Tel. +1 401 455 6384, Fax +1 401 455 6235, E-Mail Brandon_Gaudiano@brown.edu

Article Information

Number of Print Pages : 9
Number of Figures : 0, Number of Tables : 1, Number of References : 70

Medline Abstract (ID 15627852)

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