The Increasing Placebo Response in Antipsychotic Drug Trials


The American Journal of Psychiatry explores the implications for science and ethics of the rising placebo response rate in trials of antipsychotic drugs, in an editorial prompted by this an article in November’s issue,  the “largest and most comprehensive meta-analysis to date of the phenomenon of increasing placebo response.”

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Agid, O., Siu, C., Potkin, S., Kapur, S.; Meta-Regression Analysis of Placebo Response in Antipsychotic Trials, 1970–2010. American Journal of Psychiatry. November 1, 2013; 170(11) 1335-1344. doi:10.1176/appi.ajp.2013.12030315

Leucht, S., Heres, S., Davis, J.; Increasing Placebo Response in Antipsychotic Drug Trials: Let’s Stop the Vicious Circle. American Journal of Psychiatry. November 1, 2013; 170(11) 1232-1234 doi:10.1176/appi.ajp.2013.13081129

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].


    • That is because the people who believe the biological model of mental illness, see the problem differently. They believe that the problem is how to design the trial to mend the problem of high placebo response rate. They already believe in a particular outcome. Now they want to find evidence to support the outcome that they believe exists. This is the problem with the profession of psychiatry. They never ask the right questions. Psychiatry is more dogma than science. There was one interesting comparison of the US in this study to other countries.

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  1. My psychiatric uses the term “anti-manic” when trying to sell drug treatment to me. Perhaps a child psychiatrist would call them “anti-ADHD”? Perhaps they’re just “anti-dysfunction” pills that really don’t work very well? They certainly appear to be prescribed for most psychological disorders.

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