In Open-Label Depression Drug Trials, Patient Expectations Boost Outcomes

Researchers have long suspected that placebo responses contribute to the better outcomes that are often seen in open-label intervention studies than in randomized, placebo-controlled trials (RCTs). Now, a first-ever direct comparison of trial types involving patients with major depression has examined this effect.

The investigators assessed depressed patients' treatment expectations (i.e., whether patients expected their depression to improve or worsen by the study's end) before and after randomization. Patients matched for prerandomization expectations were entered into an open-label study (N=28) or a blinded RCT involving citalopram (citalopram, 21; placebo, 5) for 8 weeks. The groups were similar in age, sex, ethnicity, illness duration, …