The article you requested is

Reply to Failure Rate and “Professional Subjects” in Clinical Trials of Major Depressive Disorder

J Clin Psychiatry 2011;72(9):1284-1285 [letter]

Letter to the Editor

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We acknowledge the potential contribution of “professional patients” to the rising placebo response, declining treatment effect over time, and persistently high failure rate seen in placebo-controlled major depressive disorder (MDD) trials. Unfortunately, there are no systematic data to document the impact that such subjects might have. The US Food and Drug Administration (FDA) has little capacity to investigate this concern, because patients are deidentified in the data submitted as part of new drug applications.