Journal Club Critique Form - Randomized Control Trial Study Design

Over the years the “rate of antidepressant use among all ages [have] seen an increase by nearly 400%...” even though deemed ineffective (Smith). This increase came about after more doctors were given a wider range of prescription rights; this allowed them to access a wider range of drugs, capable of delivering a greater level of high if misused. Patients are often prescribed medications without being fully evaluated, leading to treatments which might not be needed. As a result “‘… at least half the folks who are being treated with antidepressants aren't benefiting from the active pharmacological effects of the drugs themselves but from a placebo effect’ " (Hollon, Smith)which affects a person’s state of mind. The Placebo Effect creates the feeling that an ineffective drug is working because it is supposed to work even if the prescribed medication was a simple sugar-water mixture. The efficiency of antidepressants decrease as the prescriber moves across the classes. They are especially less effective when used to treat serious medical conditions but are often used instead of more serious

Major depression is a commonly diagnosed psychological disorder affecting individuals’ ability to feel happiness and peace of mind. Those who suffer experience negative emotions, lack of motivation, changes in behaviour and dysfunctional cognitive symptoms. Depression is classified by the Diagnostic and statistical manual of mental disorders Fifth Edition (DSM-5) as five of more of the listed symptoms present persistently over the same two weeks. One of these symptoms must be depressed mood or loss of interest in previously pleasurable activities. Depression causes disruption to typical daily life such as inability to maintain friendships and jobs. Other symptoms outlined by the DSM-5 include; insomnia, fatigue and recurrent thoughts of death. There is much debate over what exactly causes depression. Biological explanations question hereditary and neurotransmitter factors. While psychological theories include the cognitive ideas of Beck’s negative triad and hopelessness theory. This essay will focus on the ways in which psychological and biological explanations contrast and how their theories can overlap to better understand depression.

Depression is a clinical condition associated with the normal emotions of bereavement and sadness. However, this condition does not pass on when the external causes of these emotions dissolve and is usually inconsistent to their cause. In essence, the classic severe conditions of depression have not been attributed to external precipitating cause. One of the most common conditions of depression is Major Depressive Disorder (MDD), which is a psychiatric condition that impairs moods, behavioral patterns, and thoughts for a protracted duration. This psychiatric illness tends to impair the patient’s social functioning and quality of life due to its impacts on cognitive functioning. Some of the most common symptoms of the condition include difficulty in concentration, weight change, minimal interest in pleasure, high rate of suicide, and physical impairment. The severity of this disease was evident in the year 2000 when the World Health Organization ranked it as the fourth cause of disability and premature death across the globe.

In 2005 the Center of Disease Control and Prevention 's (CDC’s) National Health and Nutrition Examination Survey (NHANES) tracked Americans using antidepressants for three years. The study concluded in 2008 that more than 1 in 10 Americans ages 12 and older have used an antidepressant drug. This study comes in the wake of a heated debate in the media about the effectiveness of antidepressants treating depression. Last year, antidepressants were the second most commonly prescribed medication, right behind drugs directed to lower cholesterol. With so many people in the United States relying on these drugs, it is easy to question if they are just expensive, overused placebos.

According to the DBSA in the US alone depression affects 6.7% of adults. This is approximately 14.8 million people who are diagnosed yearly. Depression puts you at a risk four times higher than that of a non depressed person for a heart attack. The majority of depressed peoples are women. In the medical world there are many techniques to combat depression. There are many forms of prescription antidepressants including; selective serotonin reuptake inhibitors (SSRIs), atypical antidepressants, tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs). Thanks to Ed Likovich, Kasey Russell, Richard Schwartz, Jacqueline Olds and Tom Hayes there is another form of prescribed antidepressant that we now know as Sunsprite.

Pharmaceuticals are a very popular method of curing depression. Although they are popular these drugs show little to no progress in curing depression. In the article, "Taking Anti-Depressant Medication: A Qualitative Examination of Internet Postings,” proves this. The article gives accounts of multiple patients who have taken the medication and recorded their results. One patient states, “It seems like I’m about five times as anxious/depressed as I was pre-Paroxetine”. (353). Research proves that pharmaceuticals do not help individuals with their depression, but in fact cause it to worsen. The studies shows that many individuals receive a

When antidepressant medication is advertised, benefits and negative side effects are provided, but what is not informed to the consumer is how it actually works. The truth behind antidepressant pills is that they don’t kick in right away and may take four to six weeks before they reach their full therapeutic effect. Many also find that it takes several trials before finding the one that works (Smith). This process can be long, strenuous, and costly. Additionally, a large portion of those who try pills in the end find that they are treatment-resistant to the medication, meaning all their efforts were a waste. There exists another form of resistance as well considered “depressive breakthrough” which is defined as the return of depressive symptoms

antidepressants such as SSRI’S, have greater efficacy than that of SSRI’S monotherapy as well as faster onset of action (62). In addition, two randomized control studies in bipolar patients showed that lamotrigine

Escitalopram is a second generation antidepressant; a selective serotonin reuptake inhibitor (SSRI) that is used in the treatment of major depressive disorder (MDD) and anxiety related disorders. It is generic for Lexapro and was approved by the FDA in 2012 for adults and children 12 years and older who suffer from major depressive disorder and adults who have generalized anxiety disorder. (FDA, 2012). Since its approval, Escitalopram has also been used in the treatment of Obsessive compulsive disorder, body dysmorphic disorder, and even premenstrual dysphoric disorder. This review will discuss the overall effectiveness of Escitalopram, the pharmacokinetic factors of the medication, the mechanism of action, common adverse reactions, pharmacological effects of the medication, and its efficacy across different populations.

Although this case report illustrates that Dextromethorphan has rapid antidepressant effects in humans, there are very few clinical trial on the effect of Dextromethorphan on major depressive disorder. This clinical trial will be one of very few controlled evaluating the safety and efficacy of Dextromethorphan in patients with major depressive disorder. Therefore, various assumptions will be required to estimate sample size. This trial will focus on patient who have

Depression is a normal emotional reaction to perceived loss and hopelessness (Segal, Williams, & Teasdale, 2002). There are a number of different types of depression such as chronic depression, manic depression and the primary focus of this essay Major Depressive Disorder (MDD). MDD is a clinical depression, which is more chronic and more severe compared to other types of depression. It significantly disrupts the individual’s ability to meet the normal demands of life. According to many clinicians, clinical depression should be considered as a medical illness in need of medical intervention. Other mental health professionals believe this is an overstatement of the role of physiology and the

People of all ages, backgrounds, and walks of life have felt depressed and unhappy at some time in their lives. These periods of sadness usually pass after a short time, but for some people, this feeling can remain for weeks, months, and even years. (1) This prolonged state of unhappiness is called major (or clinical) depression and is characterized by a persistent sad or "empty" mood, loss of interest in favorite activities, difficulty concentrating, and many other symptoms. It is not simply a mental state but an illness that interferes with the way people feel, function, and think.(2)

As the literature remains inconclusive as to the relation between current major treatment modalities and depressive disorder, and given the extremities of the potential dangers of antidepressant medications, it is apparent that there is a need to develop new interventions, which show greater efficacy, safety, and acceptability.

The first step to treating many of these new cases of depression is the prescription and use of antidepressant medication, however this has cause a mass flooding of our society with unnecessary prescription drugs. Due to the ease of treatment, primarily with prescription drugs, and the large range of severity in depression is often over diagnosed, adding to the problem.

The prevalence of MDD in the United States is approximately 7%, although the prevalence varies significantly by age groups and gender (APA, 2013). For instance, the prevalence of MDD in individuals aged between 18 and 29 is three times higher than the prevalence among individuals aged 60 and older (APA, 2013). Specifically, approximately 14.8 million American adults in a given year are affected by the disorder (Kessler, Chiu, Demler, Merikangas, & Walters, 2005). The World Health Organization assessed depression as the fourth leading disorder affecting individuals worldwide (Murray, & Lopez,