Consider a pre-trial objective: "We will be testing this medication on patients who have already indicated that it helps with their affliction. Participants will be sorted into groups that get one of (a) a placebo, or (b) reduced, (c) increased, or (d) unchanged dosage relative to the dose they have reported to be effective enough relative to side effects." Such a trial could actually be useful, but good luck getting the epistemology sticklers to sign off on it.

Also, antidepressants characteristically have history-dependent effects. Often, suddenly going off one renders it ineffective if resumed. So good luck with the ethics.

Also: I would like to see the word "affliction" in more medical papers.

I hope you will find gruntling, in time.