Tranquilizing agents; some problems in evaluating them.

Abstract

Evaluation of tranquilizing drugs is more difficult by any technique than evaluation of drugs given for purely organic effect, since both the symptom and its evidences are conditioned by profound psychic values. Difficult as it is to match psychiatric patients as controls, it is equally difficult to use each patient as his own control, since his reaction either to drug or to placebo may be strongly affected by previous experience with the other dose or with other drugs. In a "double blind, double cross" test comparing the values of prochlorperazine and phenobarbital, the controller misled the observers by maintaining the same drug for each patient during the entire test period. The observers detected that the test was not going according to plan, and when the "double cross" was revealed they were able to guess fairly well which patients had received each drug. The experiment not only sharpened their future observation, but demonstrated the reliability of trained clinical judgment in evaluating drugs when bias is eliminated.