CoChat
Sign Up
Cited by 346Pain Management and Placebo EffectTreatment of Major DepressionPsychotherapy Techniques and Applications

Meta-analysis of the placebo response in antidepressant trials.

Rief, Winfried, Nestoriuc, Yvonne, Weiss, Sarah, Welzel, Eva, Barsky, Arthur J., Hofmann, Stefan G.·2009·Journal of Affective Disorders
DOI 10.1016/j.jad.2009.01.029
Open this paper in CoChat — free account

Abstract

Unlabelled Improvements in placebo groups of antidepressant trials account for a major part of the expected drug effects. We aimed to determine overall effect sizes of placebo and drug effects in antidepressant trials, and to analyze whether the placebo effect in antidepressant trials also occurs for patient self-perception, general psychopathology, and quality of life.Methods Search terms covered different variants of pharmacotherapy for patients with depressive disorders from January 1980 to December 2005 in the databases Medline/Pubmed, PsychInfo and CENTRAL, a.o. We included RCTs with a placebo group and an antidepressant group in people with depression.Results We computed within group effect sizes for several outcome variables and integrated them using random-effect models. A total of 96 studies were included. Mean effect size in the placebo group for primary outcome variables was d=1.69 (95% CI=1.54-1.84) compared to 2.50 in the drug group (95% CI=2.30-2.69). There was a major difference between placebo effect sizes assessed with observer ratings (d=1.85, 95% CI=1.69-2.01) versus patient self-perception (d=0.67; 95% CI=0.49-0.85). The effect sizes in placebo groups in 2005 were more than twice as great as those in 1980, but only for observer ratings, not for patient self-ratings. The result was partly due to increased homogeneity of samples of recently published trials.Conclusions The placebo effect accounted for 68% of the effect in the drug groups. Whereas clinical trials need to control the placebo effect, clinical practice should attempt to use its full power.

Integrity signals

Registry

Crossref · 10.1016/j.jad.2009.01.029

Cites

46 of 46 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • A meta-analysis showed that the placebo response in antidepressant trials is approximately 68%, although this effect is not clear yet in light therapy trials specifically.

    “A meta-analysis showed that the placebo response in antidepressant trials is approximately 68%,72 although this effect is not clear yet in light therapy trials specifically.”

    From Effects of bright light therapy for depression during pregnancy: a randomised, double-blind controlled trial (2020) · cites this paper as [72]

  • Large-scale meta-analyses suggest that the effectiveness of antipsychotic and antidepressant medications is only marginally different from placebo, and neither has successfully remediated cognitive dysfunction.

    “However, several large-scale meta-analyses have recently suggested that the effectiveness of antipsychotic and antidepressant medications is only marginally different from that of a placebo (Leucht et al., 2009; Rief et al., 2009), and neither have been able to successfully remediate cognitive dysfunction (Keefe et al., 2013, 2014; Solé et al., 2015).”

    From Aerobic Exercise as a Tool to Improve Hippocampal Plasticity and Function in Humans: Practical Implications for Mental Health Treatment (2016) · cites this paper as Rief et al., 2009

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Rief, W., Nestoriuc, Y., Weiss, S., Welzel, E., Barsky, A. J., & Hofmann, S. G.
Affiliations
  • Philipps University of Marburg (DE)
  • Brigham and Women's Hospital (US)
  • Boston University (US)
Corresponding author
Rief, Winfried
ORCID
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2009-11
Volume
118
Issue
1-3
Pages
1-8
ISSN
0165-0327 (ISSN-L)
DOI
10.1016/j.jad.2009.01.029
OpenAlex
W2020001299
Cited by
346
References
46
Citations by year
2026: 9 · 2025: 13 · 2024: 21 · 2023: 20 · 2022: 25 · 2021: 10 · 2020: 23 · 2019: 15 · 2018: 48 · 2017: 23 · 2016: 19 · 2015: 23 · 2014: 24 · 2013: 26 · 2012: 11
FWCI
1.11
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Affective Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
placebo response, antidepressants, depression, placebo effect, antidepressant trials, observer ratings, patient self-perception, quality of life, psychopathology, effect size
MeSH terms
Antidepressive Agents, Depressive Disorder, Humans, Placebo Effect, Randomized Controlled Trials as Topic

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review