Lakoff, A. (2002). The Mousetrap: Managing the Placebo Effect in Antidepressant Trials [Summary]
The article by Andrew Lakoff titled “The Mousetrap: Managing the Placebo Effect in Antidepressant Trials” strives to delineate some of the most disturbing facets in the development of antidepressants. The Author acknowledges that the development of drug is a risky and uncertain practice and is often characterized by placebo effects which are always unpredictable and at times not manageable. Since most of the attempts by the drug developers to determine effective of a drug always prove futile, the drug developers always resort to certain strategies to build confidence about the effectiveness of their antidepressant drugs. One of the strategies is the separations of “signal from noise”. Drug developers use the term “signal detection” to connote the goal of a given drug trial. Since the drug is already presumed to have a given efficacy, the developers look for ways to “pick up the signal” and when the trial fails, it is purported that “noise” crept into the trial. On the same note, once a trial has fail, trials that follow a designed in such a way that the “noise” is reduced or averted; this is called “noise reduction”. Another strategy commonly used by drug developers is the use of the right patients to test a drug. This is because, patients depending on their sensitivity to a drug will respond differently to a drug. Therefore, antidepressant drug developers shun sensitive patients and use patients who can respond desirably to the drug being tested. Mousetrap technique, according to the author, is the most recent technique, in which patients are given the drugs before the trial actually begins. Selection of patients for the actual trial is then done on the basis of how the patients responded to drug before the actual trial began.
Reference
Lakoff, A. (2002). The Mousetrap: Managing the Placebo Effect in Antidepressant Trials. Molecular Interventions, 2(2): 72-76.
