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Am J Psychiatry 1990; 147:1622-1626
Copyright © 1990 by American Psychiatric Association
Effects of pill-giving on maintenance of placebo response in patients with chronic mild depression
JG Rabkin, PJ McGrath, FM Quitkin, E Tricamo, JW Stewart and DF Klein
New York State Psychiatric Institute, NY 10032.
Fifty outpatients with mild, chronic, mood-reactive depression whose mood
improved markedly after a 10-day single-blind placebo trial were randomly
assigned in a double-blind design either to have their placebo medication
discontinued or to have it maintained for an additional 6 weeks. Half of
the patients in each condition relapsed within 6 weeks, indicating that
pill-taking itself does not influence maintenance of placebo response.
Placebo response was more likely to be maintained in patients who were
currently married. At the end of 3 months, the overall relapse rate was
58%. The authors raise questions about the utility of the initial 10-day
placebo washout in antidepressant clinical trials, and they discuss limits
on the generalizability of their findings.
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