The ethics of randomized placebo controlled trials of antidepressants with pregnant women

In recent years, a number of authors have advocated the merits of conducting randomised controlled trials (RCTs) of antidepressants in women with nervous disorders during the prenatal period. However, a critical review of the literature indicates RCTs are not justifiable. At a time when it has become clear that a significant proportion of the existing literature on the use of pharmaceutical agents is ghostwritten, ethicists and others making assertions that RCTs are needed risk becoming part of an apparatus that plays down the hazards of treatment and promotes the use of treatments that may be harmful.