Glossary / History of psychiatry
Placebo
A tablet or similar that looks like the real drug but contains no active ingredient. Comparing a drug against it shows whether the drug really works.
In mental illness, both patients and observers are easily swayed by expectation, and illness can ease on its own. In 1954 Mogens Schou and colleagues in Denmark tested lithium by switching between lithium and placebo without the patients, the ward staff or the doctors knowing which was which[1].
In a 1965 trial in depression, 22 of 61 patients on placebo still reached discharge within six months. Because some share of patients improve without special treatment, counting those who improve does not by itself show that a drug works[2].
Related terms
- Lithium carbonateA lithium drug used to prevent relapses of mania and depression. In 1949 the Australian psychiatrist John Cade reported its effect on mania after experiments on guinea pigs.
- ImipramineRegarded as the first antidepressant. It failed as a candidate drug for schizophrenia, and in 1957 the Swiss psychiatrist Roland Kuhn reported its effect on depression.
- ChlorpromazineA drug that eases the hallucinations and delusions of schizophrenia. Synthesised in France in 1951 and tried as an aid to anaesthesia, it entered psychiatry in 1952.
Sources
- M. Schou, N. Juel-Nielsen, E. Strömgren, H. Voldby, “The Treatment of Manic Psychoses by the Administration of Lithium Salts,” Journal of Neurology, Neurosurgery and Psychiatry 17(4), 250–260 (1954).
- Clinical Psychiatry Committee, “Clinical Trial of the Treatment of Depressive Illness: Report to the Medical Research Council,” British Medical Journal 1(5439), 881–886 (1965).