The use of placebos is often justified in therapeutic drug testing. They may be employed in order to compare their effects with those of a so-called active treatment, to compare two active medications, in double-blind comparisons of two drugs of different appearance (double-dummy technique) or to carry through initial washout periods. Although the scientific justification for this procedure is hardly contestable, the methodological difficulties and demands must be considered. The clinical use of placebo comparison poses a true ethical dilemma which increases with the effectiveness of psychotropic drugs. Placebos were used relatively rarely in France before 1978 as a general review of 120 controlled psychotropic drug trials published in French shows. Various precautions undertaken in drug testing designs respond, nevertheless, to both ethical and methodological demands in the majority of the cases. Examples are given regarding the testing of major or minor tranquillizers and antidepressive drugs.

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