Trial reportArchives of general psychiatry2011
Trajectories of depression severity in clinical trials of duloxetine: insights into antidepressant and placebo responses.
Trial report in Archives of general psychiatry, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
49 citing papers in PubMed, 114 citations in OpenAlex.
- Heterogeneous trajectories of suicidal ideation and depressive symptoms during an indicated school-based CBT intervention: a group-based trajectory modeling study.BMC psychology · 2026Trial
- A common symptom geometry of mood improvement under sertraline and placebo associated with distinct neural patterns.Psychological medicine · 2025Trial
- Longitudinal Trajectories of Alcohol Use in Vietnamese Adults with Hazardous Alcohol Use and HIV.AIDS and behavior · 2023Trial
- Trajectories of Symptom Change in School-Based Prevention Programs for Adolescent Girls with Subclinical Depression.Journal of youth and adolescence · 2022Trial
- Trajectories of depression symptom change during and following treatment in adolescents with unipolar major depression.Journal of child psychology and psychiatry, and allied disciplines · 2020Trial
- Assessment of a Precision Medicine Analysis of a Behavioral Counseling Strategy to Improve Adherence to Diabetes Self-management Among Youth: A Post Hoc Analysis of the FLEX Trial.JAMA network open · 2019Trial
- Treating insomnia in depression: Insomnia related factors predict long-term depression trajectories.Journal of consulting and clinical psychology · 2018Trial
- Early Symptom Trajectories as Predictors of Treatment Outcome for Citalopram Versus Placebo.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2017Trial
- Trajectories of relapse in randomised, placebo-controlled trials of treatment discontinuation in major depressive disorder: an individual patient-level data meta-analysis.The lancet. Psychiatry · 2017Trial
- Inflammation as a predictive biomarker for response to omega-3 fatty acids in major depressive disorder: a proof-of-concept study.Molecular psychiatry · 2016Trial
- Depressive symptoms among patients receiving varenicline and bupropion for smoking cessation.Journal of substance abuse treatment · 2015Trial
- Genetic variants in combination with early partial improvement as a clinical utility predictor of treatment outcome in major depressive disorder: the result of two pooled RCTs.Translational psychiatry · 2015Trial
- A preliminary double-blind, placebo-controlled randomized study of baclofen effects in alcoholic smokers.Psychopharmacology · 2015Trial
- Reducing eating disorder risk factors: a controlled investigation of a blended task-shifting/train-the-trainer approach to dissemination and implementation.Behaviour research and therapy · 2014Trial
- Trial
- Trajectories of change in anxiety severity and impairment during and after treatment with evidence-based treatment for multiple anxiety disorders in primary care.Depression and anxiety · 2013Trial
- Sudden gains in prolonged exposure and sertraline for chronic PTSD.Depression and anxiety · 2013Trial
- Trial
- Trajectories of Function and Symptom Change in Desvenlafaxine Clinical Trials: Toward Personalized Treatment for Depression.Journal of clinical psychopharmacologyTrial
- Depression care trajectories and associations with subsequent depressive episode: a registry-based cohort study (The Norwegian GP-DEP study).BMC primary care · 2025Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 2 countries.
Funding
Abstract
contextThe high percentage of failed clinical trials in depression may be due to high placebo response rates and the failure of standard statistical approaches to capture heterogeneity in treatment response.
objectiveTo assess whether growth mixture modeling can provide insights into antidepressant and placebo responses in clinical trials of patients with major depression.
designWe reanalyzed clinical trials of duloxetine to identify distinct trajectories of Hamilton Scale for Depression (HAM-D) scores during treatment. We analyzed the trajectories in the entire sample and then separately in all active arms and in all placebo arms. Effects of duloxetine hydrochloride, selective serotonin reuptake inhibitor (SSRI), and covariates on the probability of following a particular trajectory were assessed. Outcomes in different trajectories were compared using mixed-effects models.
settingSeven randomized double-blind clinical trials of duloxetine vs placebo and comparator SSRI. Patients A total of 2515 patients with major depression.
interventionsDuloxetine and comparator SSRI. Main Outcome Measure Total score on the HAM-D.
resultsIn the entire sample and in the antidepressant-treated subsample, we identified trajectories of responders (76.3% of the sample) and nonresponders (23.7% of the sample). However, placebo-treated patients were characterized by a single response trajectory. Duloxetine and SSRI did not differ in efficacy, and compared with placebo they significantly decreased the odds of following the nonresponder trajectory. Antidepressant responders had significantly better HAM-D scores over time than placebo-treated patients, but antidepressant nonresponders had significantly worse HAM-D scores over time than the placebo-treated patients.
conclusionsMost patients treated with serotonergic antidepressants showed a clinical trajectory over time that is superior to that of placebo-treated patients. However, some patients receiving these medications did more poorly than patients receiving placebo. These data highlight the importance of ongoing monitoring of medication risks and benefits during serotonergic antidepressant treatment. They should further stimulate the search for biomarkers or other predictors of responder status in guiding antidepressant treatment.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.