User:Artyom.korenevsky/sandbox

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Assignment # 3
Proposed changes to the following sentence: "Clinicians usually first recommend one of the selective serotonin reuptake inhibitors (SSRIs), a class of antidepressants that includes fluoxetine (Prozac), citalopram (Celexa), and sertraline (Zoloft).[47]"

Change 1: "Clinicians usually first recommend one of the selective serotonin reuptake inhibitors (SSRIs)" to: "Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants that have been studied most for the treatment of Major Depressive Disorder (MDD) in children and youth."

Change 2: "a class of antidepressants that includes fluoxetine (Prozac), citalopram (Celexa), and sertraline (Zoloft)." to: "Children/youth treated with SSRIs experienced less severe depression and achieved remission faster than those who were treated with placebo"

Rationale for proposed changes: The first part of the sentence makes a very ambiguous statement, does it mean that clinicians first recommend SSRIs before other modalities? It also doesn't explain why clinicians would recommend SSRIs first (it is because these medications have been studied the most compared with other drug classes used in MDD treatment).

The second part of the sentence is not interpreting the linked meta-analysis correctly by only listing 3/6 analysed SSRIs and it is not explaining why the three have been listed. Moreover, from the three that have been listed, Citalopram is actually not shown to be better than placebo in the cited meta-analysis.

Change 3: Change reference [47] from the cited meta-analysis to the CANMAT guideline (the guideline is a better choice based on MEDRS and includes the cited meta-analysis as one of its sources)

Controversies: A big controversy in treatment of depression is whether or not antidepressants are better than placebo, the controversy is further fueled by stigma of mental health disorders (the validity of depression as a disorder) and of course by other confounders (such as whether or not non-pharmacological modalities may be preferred by some over pharmacological modalities).

Another controversy is which drug class and which drug within the pharmacologic class are better to use. This is confounded by the relative availability of evidence (older antidepressants have been studied more than newer antidepressants) and by the risk/benefit of each antidepressant (i.e. the benefits in treating depression vs. harm from adverse effects).

Critique of Source: The source is a Canadian guideline and it is, therefore, most appropriately applies in the Canadian context and may not be equally applicable outside of Canada.

The source still relies heavily on the results of the 2012 Cochrane meta-analysis done by Hetrick et al.

This does impact what information I'm choosing to share. Specifically: the above reasons is why I want to exclude listing specific antidepressants seeing as they may not be available in markets outside of Canada/North America or, they may not be preferred in all clinical settings.

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 * Note: You will be emailing your assignment # 3 directly to your tutor, however, please paste a version here that excludes your personal information. This will allow us to support your efforts on Wikipedia prior to editing "live" in the article.

What to post on the Wikipedia article talk page?

 * This will also be covered on Nov 23rd in class. Your group should use the below template to share an outline of your proposed improvements (including your new wording and citations). Article talk pages are not places to share your assignment answers. The Wikipedia community will be more interested in viewing your exact article improvement suggestions including where you plan to improve the article (which section), what wording you suggest, and the exact citation (Note: all citations must meet WP:MEDRS)
 * You will not be able to paste citations directly from your sandbox to talk pages (unless you are interested in editing/learning Wiki-code in the "source editing" mode). We suggest re-adding your citations on the talk page manually (using the cite button and populating the citation by pasting in the DOI, website, or PMID). You will have to repeat this process yet again when you edit the actual article live.
 * Talk Page Template: CARL Medical Editing Initiative/Fall 2020/Talk Page Template