Are there viable alternatives to placebo controls for research?
Alternatives to placebo controls include active controls, who receive the standard drug for the condition, and historical controls, which are based on data from previous placebo-controlled studies with similar patients. Several writers have argued that placebo controls are essential to clinical trials in certain circumstances and that alternative control groups are inadequate. Given the need for placebo controls to permit meaningful conclusions to be drawn from clinical studies, it may be argued that not using placebo controls would be unethical because patients receiving the experimental drug would be exposed to potential risks in a study of questionable scientific benefit. What is the potential harm to patients receiving placebo? Conventional antipsychotics are not uniformly effective in schizophrenia, in particular against negative symptoms. Between 30 and 50 percent of patients are exposed to the risk of troublesome adverse effects for minimal or no benefit (2). Also, contrary to p
