| Design makes a difference: a meta-analysis of antidepressant response rates in placebo-controlled versus comparator trials in late-life depression. | |
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MedLine Citation:
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PMID: 17998306 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Qualitative reviews of late-life antidepressant clinical trials suggest that antidepressant response rates in comparator trials are higher than antidepressant response rates in placebo-controlled trials. No quantitative review has been conducted to test this hypothesis. METHODS: A meta-analysis was conducted of all published articles in peer-reviewed journals from 1985 to the present to identify randomized clinical trials contrasting antidepressant pharmacotherapy to placebo or an active comparator in late-life depressed outpatients. Sixteen studies (nine comparator trials and seven placebo-controlled trials) were identified. Antidepressant response rates in both placebo-controlled and comparator trials were extracted and submitted for analysis using multilevel meta-analysis procedures. RESULTS: The authors found significant variability in antidepressant response rates beyond chance. This variability decreased by 27% when the authors included study type in the model. As expected, antidepressant response rates in comparator trials were significantly higher (60%) than antidepressant response rates in placebo-controlled trials (46%). CONCLUSION: Antidepressant response rates are higher in comparator trials as compared to placebo-controlled trials. These findings have important implications for combined medication and psychotherapy trials that use placebo-controlled medication conditions because the response rates from these conditions are likely to be lower than those from unblinded conditions. |
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Authors:
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Joel R Sneed; Bret R Rutherford; David Rindskopf; David T Lane; Harold A Sackeim; Steven P Roose |
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Publication Detail:
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Type: Comparative Study; Journal Article; Meta-Analysis; Research Support, N.I.H., Extramural; Review Date: 2007-11-12 |
Journal Detail:
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Title: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry Volume: 16 ISSN: 1064-7481 ISO Abbreviation: Am J Geriatr Psychiatry Publication Date: 2008 Jan |
Date Detail:
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Created Date: 2007-12-31 Completed Date: 2008-02-28 Revised Date: 2011-12-05 |
Medline Journal Info:
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Nlm Unique ID: 9309609 Medline TA: Am J Geriatr Psychiatry Country: United States |
Other Details:
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Languages: eng Pagination: 65-73 Citation Subset: IM |
Affiliation:
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Department of Psychiatry, Columbia University, New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA. js2627@columbia.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Age Factors Aged Antidepressive Agents / therapeutic use* Depressive Disorder / drug therapy* Humans Models, Statistical Placebos* Randomized Controlled Trials as Topic / methods* Research Design* Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
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K23 MH 70056-01A1/MH/NIMH NIH HHS; K23 MH085236-02/MH/NIMH NIH HHS; K23 MH085236-03/MH/NIMH NIH HHS; T32 MH 20004/MH/NIMH NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Antidepressive Agents; 0/Placebos |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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