Critical approach to antidepressant trials. Blindness protection is necessary, feasible and measurable

Br J Psychiatry. 2000 Jul:177:47-51. doi: 10.1192/bjp.177.1.47.


Background: Double-blind placebo-controlled trials are the academic standard for clinical psychopharmacology research.

Aims: To identify the potential defects of current double-blind procedures in trials involving antidepressants and to investigate whether safeguards for blindness protection are used.

Method: We reviewed the literature and devised a short seven-item checklist for evaluating the quality of blindness protection. We performed a computerised search for 1998 to identify the placebo-controlled studies that evaluated the efficacy of an antidepressant. The checklist was used to assess all traceable antidepressant trials published in 1998.

Results: Relevant criticisms question the blindness procedures. The available methods which may bolster blindness are very seldom used.

Conclusions: Improvement in the blindness procedures used for antidepressant trials is necessary, feasible and measurable.

Publication types

  • Review

MeSH terms

  • Antidepressive Agents / therapeutic use*
  • Controlled Clinical Trials as Topic / methods*
  • Depressive Disorder / drug therapy*
  • Double-Blind Method*
  • Humans
  • Placebos
  • Retrospective Studies


  • Antidepressive Agents
  • Placebos