Abstract:
:In this paper we review the history of antidepressant (AD) development, since the discovery of imipramine in 1957 to the present day. Through this exploration we will show that the increasing placebo response is likely a red herring and that a higher magnitude of placebo response is not an adequate explanation for AD trials' high failure rates. As a better explanation for their lack of success, we will examine some of the fundamental flaws of AD clinical trials and their origins in historical forces. We focus on underpowering, which occurs as a consequence of unrealistic expectations for AD performance. In addition, we describe the lack of precision in the depression outcome measurements for the past 40 years and show how these measures contrast with those used in clinical trials of other chronic diseases, which use simpler outcome measures. Finally, we describe the role of regulatory agencies in influencing clinical trial design and how the assumption that 'one size fits all' for the past 60 years has led to flawed design of AD clinical trials.
journal_name
Int Clin Psychopharmacoljournal_title
International clinical psychopharmacologyauthors
Khan A,Mar KF,Brown WAdoi
10.1097/YIC.0000000000000229subject
Has Abstractpub_date
2018-09-01 00:00:00pages
239-248issue
5eissn
0268-1315issn
1473-5857journal_volume
33pub_type
历史文章,杂志文章,评审abstract::C-reactive protein (CRP) is an inflammatory marker associated with obesity, insulin resistance, and cardiovascular disease. A recent study found CRP levels to be higher in individuals treated with certain antipsychotic medications such as olanzapine; however, it is not clear whether this is associated directly with dr...
journal_title:International clinical psychopharmacology
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journal_title:International clinical psychopharmacology
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journal_title:International clinical psychopharmacology
pub_type: 杂志文章,评审
doi:
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journal_title:International clinical psychopharmacology
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journal_title:International clinical psychopharmacology
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pub_type: 临床试验,杂志文章,多中心研究
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journal_title:International clinical psychopharmacology
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