Clinical Drug Trial Lengths and Effectiveness

I've always been a skeptical of the clinical drug trials since so many medications have provided me with little or no long term benefit. Now I have a bit more than skepticism to go on.

I've been trying Seroquel since the beginning of June and keeping daily notes and mood chart scores. The results have thrown up a peculiar issue which does relate to drug trials.

If I were part of a clinical drug trial that lasted 3 weeks, Seroquel would have scored perfectly. Once I got over the week long bout of mostly sleeping, Seroquel worked to keep me productive and stable for the next two weeks. On a scale of 1-5, five being the best, Seroquel would have gotten a 5.

However, I've been on Seroquel for nearly 5 weeks. If I had to score Seroquel at the end of 5 weeks, the result would be drastically different from the score at the end of 3 weeks. As it currently stands, Seroquel doesn't seem to be able to keep me from getting depressed. If I had to rate it now, it would get a rating of 1 1/2 or so.

So the length of a clinical drug trial matters. People like me, whose moods cycle rapidly, would score a drug to be more effective if we were in a short clinical drug trial than in a longer one. I'm assuming that people whose moods don't cycle rapidly would rate a drug more effective if they took part in a long clinical drug trial than in a short one.

If the trial was double blind and the people in the sample were completely randomised, this would theoretically help dampen the length effect. But not completely - if the number of rapid cyclers in the entire sample was higher than the number of slow cyclers, then the drug would be favoured in a short clinical trial and penalised in a long clinical trial. Vice versa, if the number of slow cyclers was higher than rapid cyclers in the entire sample, the drug would be favoured in a long clinical trial and penalised in a short clinical trial.

For people like myself who have to make decisions on which drugs to take, knowing the length of the clinical trials which supported a drug's effectiveness matters. This should be part of the information that is provided to us by psychiatrists when they are recommending drugs.

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