Reviving the SCNP Committee on clinical trials: the need to enhance its future mission.

The paper by P. Bech and T. Ban is highly informative, aimed at reviewing the history of psychotropic drugs in the European Union, specifically, as regards the development of the Scandinavian College of Neuropsychopharmacology (SCNP). They cover its early successes, the UKU and the reasons for its later dissolution, and for determining that the UKU now needs to be revived with a somewhat broader mission. Although brief, the paper captures the early high expectations of the SCNP group when the new treatments were introduced, and the manner in which they went about dealing with the evaluation of the new drugs. It was clear then that a mechanism was necessary that would permit objective evaluation of these agents, while at the same time, making it possible for the science to advance and for new, even more effective, drugs to be developed. To accomplish these aims they established a clinical research committee, that is, the UKU (CRC), to oversee the standardisation and select the technology to be utilised in evaluation. The Committee bent to the use of rating scales for evaluation, and to accommodate the clinicians who would use them, would select only brief rating methods. Thus, they established use of the soundly validated brief Hamilton depression and anxiety scales (1) for the affective disorders and the broader Brief Psychiatric Rating Scale (BPRS) (2) for trials of anti-psychotic agents. The authors then trace the rise and fall of enthusiasm about the drugs and the problems of conducting clinical trials during the period of 1960–2000, alluding to the reductions in government support, the dissolution of the UKU and the European Committee for Standardization of Clinical Trials, and the increase in the dominance of industry, despite some major developments in the science, led by Arvid Carlsson and Mogens Schou. Now we view a scene where industry citing the failure during the last three decades to develop any new classes of psychotropic drugs for depression or the psychoses, and highly expensive clinical trials that have produced little information of value, have severely reduced their involvement in the development of central nervous system drugs. In order to break this ‘impasse’, to stimulate dialogue among industry and academia, the authors recommend and the SCNP will reassemble a new UKU Committee dedicated to advancing the clinical trial.