Lilly Research Laboratories, Indianapolis, Indiana, USA.
Curr Opin Psychiatry. 2011 Mar;24(2):107-13. doi: 10.1097/YCO.0b013e32834381b0.
The magnitude of placebo response is an important factor in the outcome of clinical trials, in that excessive placebo response can obscure true drug-placebo differences. There is ample evidence of the impact of elevated placebo response in trials of major depression, but less intensive research has been done in the area of schizophrenia. We present a current review of placebo response in clinical trials of schizophrenia.
The existing evidence suggests that placebo response in schizophrenia trials may be similar in magnitude, quality, and impact to that observed in depression trials, and has similarly increased over the past several years. We discuss factors influencing excessive placebo response during the conduct of clinical trials and how they may be managed to help minimize placebo response.
There does not appear to be any single major factor contributing to the high levels of placebo response in schizophrenia clinical trials; therefore, a multipronged approach to minimizing excessive placebo response or its impact is recommended.
目的综述:安慰剂效应的大小是临床试验结果的一个重要因素,因为过大的安慰剂效应可能会掩盖药物与安慰剂之间的真实差异。有大量证据表明,在重度抑郁症的临床试验中,升高的安慰剂效应具有重大影响,但在精神分裂症领域的研究则相对较少。我们目前对精神分裂症临床试验中的安慰剂效应进行了综述。
最近的发现:现有证据表明,精神分裂症临床试验中的安慰剂反应在幅度、质量和影响方面可能与抑郁试验中观察到的反应相似,并且在过去几年中也同样有所增加。我们讨论了在临床试验进行过程中影响过度安慰剂反应的因素,以及如何管理这些因素以帮助最小化安慰剂反应。
总结:在精神分裂症临床试验中,似乎没有任何一个单一的主要因素导致高水平的安慰剂反应;因此,建议采取多管齐下的方法来最小化过度的安慰剂反应或其影响。