Preventing hung juries about therapy studies.

Abstract

A series of arguments are presented that emphasize the importance of comparatively evaluating psychotherapies with appropriate pharmacotherapy and pill placebo. The lack of a pill-placebo arm has rendered moot those studies that compared pharmacotherapy directly with psychotherapy because of the lack of an internal sample defining calibration with regard to medication responsivity. The National Institute of Mental Health (NIMH) Treatment of Depression Collaborative Research Program is critically discussed because this program incorporated the recommended design features but still led to substantial controversy. The inclusion of a pill-placebo arm in future therapeutic studies is most desirable. NIMH should initiate a funded program specifically for multisite, pill-placebo-controlled studies of psychotherapy, pharmacotherapy, and their combination, jointly sponsored and supervised by skilled psychopharmacologists and psychotherapists.