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.
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
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
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
