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November 2013

Placebo Response and the Company It Keeps

Author Affiliations
  • 1Department of Psychiatry, Ohio State University, Sunbury
JAMA Pediatr. 2013;167(11):1000-1001. doi:10.1001/jamapediatrics.2013.2704

In this issue of JAMA Pediatrics, King and colleagues1 treat us to some interesting insights into prognostic indicators, placebo response, and the vagaries of clinical trials. Although the study that provided their data (citalopram hydrobromide vs placebo for stereotyped behavior in autism spectrum disorder2) was a failed trial, they salvage considerable scientific and clinical knowledge from it in the process of investigating the failure to find a difference between the placebo and the active drug. Some of their findings are enlightening, others puzzling or surprising, but all clinically interesting. The interpretation depends partly on the perspective taken: placebo with citalopram as comparator or citalopram with placebo as comparator. The genius of the authors has been to “turn the tables” from the usual approach and focus on the placebo group as the primary group, with the active drug group as the comparator.1

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