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The Right Patients for the Drug: Managing the Placebo Effect in Antidepressant Trials

Published online by Cambridge University Press:  01 March 2007

Andrew Lakoff
Andrew Lakoff
Affiliation:
Department of Sociology, University of California, San Diego, 9500 Gilman Drive, 0533 La Jolla, CA 92093-0533, USA E-mail: alakoff@ucsd.edu
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Abstract

This article concerns the challenges faced by pharmaceutical researchers seeking to develop novel antidepressants. Based on ethnographic and documentary research into the drug development process, it shows how researchers try to manage the problem of the placebo response in antidepressant trials. The high rate of placebo response in these trials makes it difficult to demonstrate efficacy and often leads to trial failure. According to researchers, a major reason for high placebo response rates is the inability of standardized rating scales to define a coherent group of ‘drug responders’. They have developed alternative means of classifying patients in order to circumvent this problem and thereby improve the chances of trial success. In their search for ‘the right patients for the drug’, pharmaceutical researchers also provide an incisive critique of the epistemological assumptions underlying the clinical trial process.

Keywords

clinical trialsdrug developmentplacebo effectpsychiatry
Type
Articles
Information
BioSocieties , Volume 2 , Issue 1: Special Issue: The Construction and Governance of Randomised Controlled Trials , March 2007 , pp. 57 - 71
Copyright
Copyright © London School of Economics and Political Science 2007

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