Document Detail


Design makes a difference: a meta-analysis of antidepressant response rates in placebo-controlled versus comparator trials in late-life depression.
MedLine Citation:
PMID:  17998306     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Joel R Sneed; Bret R Rutherford; David Rindskopf; David T Lane; Harold A Sackeim; Steven P Roose
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Publication Detail:
Type:  Comparative Study; Journal Article; Meta-Analysis; Research Support, N.I.H., Extramural; Review     Date:  2007-11-12
Journal Detail:
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:
Created Date:  2007-12-31     Completed Date:  2008-02-28     Revised Date:  2011-12-05    
Medline Journal Info:
Nlm Unique ID:  9309609     Medline TA:  Am J Geriatr Psychiatry     Country:  United States    
Other Details:
Languages:  eng     Pagination:  65-73     Citation Subset:  IM    
Affiliation:
Department of Psychiatry, Columbia University, New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA. js2627@columbia.edu
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MeSH Terms
Descriptor/Qualifier:
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:
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:
0/Antidepressive Agents; 0/Placebos

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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