In Reply We appreciate Dr Lozano’s interest in our meta-analysis of placebo response in schizophrenia trials.1 If we understand correctly, Dr Lozano’s point is that the choice of rating scales in the trials comprising our sample changed over time. In particular, the Brief Psychiatric Rating Scale (BPRS) tended to be used in the older trials, whereas the Positive and Negative Syndrome Scale (PANSS) was preferentially used in the more recent trials. These scales differ, among other respects, in that the maximum score on the PANSS (210) is significantly greater than the maximum score on the BPRS (108). We understand Dr Lozano to be posing the alternative interpretation that the higher potential scores on the PANSS, combined with the preferential use of the PANSS in more recent studies, may explain the rising trajectory of placebo response over time.
Rutherford BR, Wall MM, Roose SP. Measuring the Effects of Treatment With Antipsychotics—Reply. JAMA Psychiatry. 2015;72(5):515-516. doi:10.1001/jamapsychiatry.2014.3184