Placebo in Depression Discussion

by | Sep 6, 2011 | Amino Acid Therapy, Anger depression

This study, published in International Clinical Psychopaharmacology showed the following results:

  1. Remission rates for escitalopram (Lexapro) were superior to placebo (sugar pill) (48.7% versus 37.6%, P=0.003)
  2. Remission rates for escitalopram (Lexapro) were superior to citalopram (Celexa)  (52.8% versus 43.5%, P=0.003),
  3. Remission rates for escitalopram (Lexapro) were similar to venlafaxine-XR (Effexor-XR) (P=0.97).
  4. Response rates for escitalopram (Lexapro) were superior to placebo (sugar pill) (48.7% versus 43.1%, P<0.001)
  5. Response rates for escitalopram (Lexapro) were superior to citalopram (Celexa) (62.5% versus 49.5%), P=0.001),
  6. Response rates for escitalopram (Lexapro) were similar to venlafaxine-XR (Effexor-XR) (P=0.52).

So what does this really mean?

First off, some definitions are in order. Remission means that these people experienced a significant drop in their depressive symptoms (according to the Montgomery-Asberg Depression Rating Scale) after 8 weeks.  A response means that they had at least a 50% decrease in symptoms (according to this same scale) after 8 weeks. The placebo used in these studies was a simple sugar pill.

This data means that:

  1. People that took Lexapro achieved relief of their depressive symptoms (remission) only 11.1% (48.7%-37.6%) more than those people that took a sugar pill. Said differently, based on this study 88.9% (100.0% – 11.1%) of people taking Lexapro can expect relief of symptoms no greater than taking a sugar pill. That means the drug only worked in 11.1% of people.
  2. People that took Lexapro achieved relief of their depressive symptoms (remission) 9.3% (52.8%-43.5%) more than those that took Celexa. Comparing this to the previous result would mean that those people taking Celexa have similar rates of remission as those taking a sugar pill.
  3. People that took Lexapro had a similar remission rate to those that took Effexor-XR. This means that about 11% more people taking Effexor-XR experience remission rates greater than those taking a sugar pill.
  4. People that took Lexapro had response rates 5.6% (48.7%-43.1%) greater than those taking a sugar pill. Said differently, based on this study 94.4% of people taking Lexapro can expect no greater relief of symptoms than taking a sugar pill.
  5. People that took Lexapro had response rates 13.0% (62.5%-49.5%) greater than those that took Celexa. Comparing this to the previous result would mean that those people taking Celexa have similar or worse response rates than those taking a sugar pill.
  6. People that took Lexapro have similar response rates than those that took Effexor-XR. This means that about 5.6% of people taking Effexor-XR would be expected to have a response rate better than those taking a sugar pill, or, said differently, that 94.4% of people taking Effexor-XR would be expected to have response rates no greater than if they took a sugar pill.

However, the majority of people in all of these studies (62.9% – 72.0%) that took SSRI medications reported at least one adverse event due to the drug. Therefore, only 5.6%-13.0% of them experienced a response no greater than those taking a sugar pill, but about 70% of them experienced side effects from taking the drugs.