Posted by Larry Hoover on August 17, 2004, at 10:37:48
In reply to Re: drug effect on healthy people, posted by JLM on August 16, 2004, at 11:35:17
I come late to this debate, and I haven't read all that precedes my joining in.
> True, a healthy population is a healthy population.
It is an absolute necessity to consider population issues. They don't preselect depressed people for antidepressant trials for no reason. It is a critical parameter.
> But, that's exactly the problem. These drugs are vastly overprescribed, and that being the case, this phenomena is particularly relevent.That is a straw man argument, vis a vis antidepressant effects. The mismanagement of a drug is not a drug effect.
> There are all kinds of people out there, thanks to HMO's/Managed Care, that are walking around on SSRI's that aren't truly depressed.
I will not argue, in the slightest, with the (in)appropriateness of such prescriptions. The EU has recently brought down restrictions on the prescription of the SSRIs, and recommendations for better monitoring of patients provided with them. They are serious meds, and they have been managed in a very offhand manner.
> So, this potential phenomena is PARTICULARLY relevent to them.
No doubt.
> And, since the proposed mechanism is akathisia, it
> would/could be relevent to 'sick' people as well.Proposed mechanisms are not proof of anything at all. I suspect they reduce the ability to apply logic, not increase it.
> Look at all the people who got akathisia from antipsychotics.
Were you aware that naturalistic studies of schizophrenics in developing nations have shown identical incidence of tardive dyskinesia and akathisia in drug-naive and treated (age-matched) subjects?
> They didn't get akathisia because the drug behaved a certain way in THEIR bodies, they got akathisia because the drugs can cause akathisia in ANYONE, even a healthy person.
It begs the question if something is getting fixed what ain't broke.
> In the Teicher and Cole articles, the patients they were dealing with were obviously depressed (you wouldn't be seeing someone of the stature of Dr. Cole if you were not sick), and when put thru a challenge/dechallenge/rechallenge, they became suicidial BOTH times they drug was reinstituted. Coincidence?
I do not doubt the empirical evidence. The issue for me becomes, "Is it manageable?".
> Johnathan O. Cole is one of the most prominent psychopharmacologists in the world. He was a founding member of the ACNP and on their editorial board.
That is a logical fallacy, an appeal to authority. Einstein was wrong about his "correction" of the Cosmological Constant.
poster:Larry Hoover
thread:208072
URL: http://www.dr-bob.org/babble/20040817/msgs/378643.html