Sections
Statistics, Placebo Response, and Clinical Trial Design in Psychopharmacology: Introduction | Indications | Statistical Issues in Planning | Choice of Control Group | Equivalence and Noninferiority RCTs | Statistical Analysis and Power | Summary | References
Excerpt
Drug development is a highly complex process
that involves multiple steps of preclinical and clinical pharmacological
refinement and testing. Preclinical studies include assessing drug
bioavailability, metabolism, and toxicity; effects on known biological
targets (e.g., receptor binding); and performance in various animal
models of pathology. After sufficient data are obtained in animal
studies, drug testing in humans can begin. In the United States,
human clinical trials are divided into four phases. Phase I involves
testing multiple doses of a drug for bioavailability, pharmacokinetics,
and side effects. Phase II studies are dose-finding studies in patients
with a given disorder. They can be open-label or double-blind trials.
Phase III generally includes pivotal double-blind trials for demonstrating efficacy
and safety/tolerability. Phase IV trials, which take place
after a drug has received U.S. Food and Drug Administration (FDA)
approval and is on the market, are conducted to help clarify potential
uses of the drug.