Posted by Ilene on March 11, 2003, at 13:53:56
In reply to Re: For Dr. Bowden: More Q's on BP II, posted by jrbecker on March 11, 2003, at 11:32:42
The real issue is how the diagnosis (unipolar/bipolar, BPII, "soft" bipolar, etc.) affects treatment. Once a disorder proves itself to be refractory, treatment algorithms break down to trial and error.
So--if there were evidence-based and unequivocal diagnostic criteria that a psychiatrist could use as soon as a patient walks in the door, effective treatment could start earlier.
And--perhaps the variations in response to medications are because the disorders derive from different origins. If this is so, then maybe someone can figure out which drugs work for which patients.
This is a little obscure, but it might prove a good example. A friend of mine has a genetic heart arrhythmia called Long QT Syndrome or LQTS. (Q and T are points on an electrocardiograph.) One kind is associated with deafness, another not. So there were thought to be 2 kinds.
As the genome was unraveled, several point mutations were discovered that cause identical (or nearly so) LQTS symptoms. One affects calcium channels, another potassium; I know there are 5 or 6 specific mutations, but I don't remember if they all have to do with the same set of proteins.
Current treatments are blunt instruments: pacemakers, implanted defibrillators, beta-blockers, a few other things. (The defibrillator is like ect for the heart; a true current treatment.) You can see that if new medications are developed to treat LQTS, they may not be one size fits all, even though the disorders all *look* the same.
Okay, I'm not going to keep rambling off on tangents. This has gotten theoretical enough.
--I.
poster:Ilene
thread:205791
URL: http://www.dr-bob.org/babble/20030310/msgs/208095.html