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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:

  • Analyzed all clinical trials of anti-depressants that were submitted to FDA

  • Analyzed according to criteria

Result:

  • Overall effects of SSRI not very effective and recommended

  • SSRI seem to be most effective when depression is very severe- but might due to a decrease of responsiveness in placebo

Strength:

  • Looks at the big picture

  • synthesize many different studies

 

Limitation:

  • Conformational Bias

  • time problem

  • 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. 

  • 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 

  • 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:

  • 51 patients with depression

  • Received either a placebo or an active medication.

  • An EEG was used to compare brain function in the two groups

  • Double blind

  • Used two different SSRI

Result:

  • The placebo group showed significant increase in activity in the prefrontal cortex

  • The pattern was different in those treated with SSRI, but both groups did get better

  • Both are very effective

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Limitation

  • Deception is involved

  • Should use triangulation because only used EEG scan , doesn’t really mean its getting better

  • Hard to generalize

Strength

  • Double blind- very much controlled

  • 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:

  • 3 groups—(1) patients who started with antidepressant then placebo, (2) patients with placebo, (3) patients who only take anti-depressant

Result:

  • Patients that does not take antidepressant have a 25% of relapse

  • 42% or higher for those that started the medication but stopped

Strength

  • Internal validity

 

Limitation

  • low ecological validity

  • Low generalizability

Do they really help? 

Implication

  • anti-depressants may interfere with Brain’s natural function and self regulation

  • Drugs  increase possibility of relapse

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