Implication: This study shows that SSRI does not seem to be very effective in treating depression and may only work when depression is very severe.
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Kirsch et al 2008 5.8
Investigate meta analysis on the state of antidepressant ( Prozac) used between 1987 and 1999
Procedure:
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Analyzed all clinical trials of anti-depressants that were submitted to FDA
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Analyzed according to criteria
Result:
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Overall effects of SSRI not very effective and recommended
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SSRI seem to be most effective when depression is very severe- but might due to a decrease of responsiveness in placebo
Strength:
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Looks at the big picture
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synthesize many different studies
Limitation:
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Conformational Bias
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time problem
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Low internal validity- others paper may not work
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Not so Effective?
Might be the placebo effect
The Biomedical Treatment
SSRI (Selective Serotonin Reuptake Inhibitaor)
This treatment was base on the hypothesis that depression is caused by seretonin depletion.
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The SSRI is able to inhibit seretonin reuptake, therefore more seretonin can build up in the synapse and more frequently attach to a receptor and sent a electirc signal
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This allows more seretoin to be in an individual with depression and therefore fizes the problem with seretonin depletion
Evaluation
Leuchter et al, (2002) 5.8
Aim: To investigate changes in brain function during treatment with placebo
Procedure:
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51 patients with depression
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Received either a placebo or an active medication.
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An EEG was used to compare brain function in the two groups
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Double blind
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Used two different SSRI
Result:
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The placebo group showed significant increase in activity in the prefrontal cortex
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The pattern was different in those treated with SSRI, but both groups did get better
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Both are very effective
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Limitation
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Deception is involved
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Should use triangulation because only used EEG scan , doesn’t really mean its getting better
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Hard to generalize
Strength
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Double blind- very much controlled
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Interesting findings
Implication: This study suggests that SSRI might only work due to the placebo effects and not because it is actually helping the brain
Neale et al (2011)
Aim: To investigate the outcome of antidepressant versus placebo
Procedure:
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3 groups—(1) patients who started with antidepressant then placebo, (2) patients with placebo, (3) patients who only take anti-depressant
Result:
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Patients that does not take antidepressant have a 25% of relapse
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42% or higher for those that started the medication but stopped
Strength
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Internal validity
Limitation
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low ecological validity
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Low generalizability
Do they really help?
Implication
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anti-depressants may interfere with Brain’s natural function and self regulation
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Drugs increase possibility of relapse