Posted by utopizen on July 22, 2003, at 16:54:50
In reply to Xyrem » utopizen, posted by Jack Smith on July 22, 2003, at 12:18:02
> I guess it would make sense that it would be helpful in treating depression if your depression is caused by lack of sleep.
>Considering 51% of the population suffers from chronic insomnia at some point, and far fewer suffer from depression at some point, and very few doctors understand that current research proves insomnia often induces depression if it's left untreated for five weeks, I would just say you're placing a lot of faith on what doctors know of for the causes of depression as they relate to sleep quality.
If you asked a random psychiatrist if insomnia can lead to depression, he would probably mumble something about how depression causes insomnia. Which is sometimes true. But new research also points to insomnia unrelated to depression ("primary insomnia") inducing depression when it's left untreated for five weeks. Current issue of Psychology Today discusses this finding. The insomniac doesn't have depression, the patient is misdiagnosed as having depression by an overly simplistic evaluation, and put on something like Paxil which can worsen insomnia instead of getting a sedative which will prevent the patient from getting depression in the first place. That doesn't make sense, does it? It shouldn't, but it's what doctors do because all they hear in med school is about how depression causes insomnia. Which it does, but they're not told that insomnia itself can often cause depression.
So instead of preventing something from occuring in the first place, they basically induce depression as a result of not properly treating the insomnia. And five weeks later, they "prove" their diagnosis because the patient is now depressed, whether or not he or she still has insomnia.
Unless a psychiatrist also studies sleep medicine (99% don't), few understand the correlations between sleep and mood to begin with, much less the correlation with specific drugs used on insomnia and the effects it has on mood during the day! Most couldn't spell Xyrem, even if they've heard of it. About 600 doctors prescribe it right now, to about 1400 patients. But it should be used in psychiatry, especially in treatment-resistant cases. For one thing, it can't hurt that much, especially if sleep apnea has been ruled out. Another thing, it's safer than atypicals.
poster:utopizen
thread:244065
URL: http://www.dr-bob.org/babble/20030718/msgs/244319.html