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Re: where are the diagnostic tests?!!

Posted by zeugma on September 14, 2004, at 17:28:19

In reply to Re: where are the diagnostic tests?!!, posted by SLS on September 14, 2004, at 15:42:20

>
> > Part of the reason there is little effort is, paradoxically, that AD's have become such big business. Each pharmaceutical company wants their new drug to treat *all* depression, not just one possibly rare subtype of it. There was more incentive for pharmaceutical companies to look for a niche for their product when the market was seen as relatively small to begin with. Greed is the driving force behind a great deal of research and it is not leading to better treatments IMO, especially for depression, which has always been a heterogeneous disorder in presentation.
>
>
> Definitely.
>
> The silly drug companies should realize that their drugs will be no less effective because tests are developed to match individuals to specific drugs. The nature of the illness isn't such that a drug is matched to an illness subtype, but that a drug is matched to an individual's unique circuitry. The drug companies are lucky in that their products will always match a sizeable percentage of varying phenotypes, despite attempts to categorize them.
>
>
> - Scott

Scott,

You don't think that the concepts of melancholia and atypical depression are valid subtypes? There's an interesting paper written by Quitkin which attempts to identify the specific presentations (I suppose that's a colloquial word for phenotype, I'm feeling dazed right now!) of MAOI-responsive depression, as opposed to the 'classic' or 'TCA-responsive' depression subtype. http://www.psychiatrist.com/pcc/pccpdf/v04n03/v04n0302.pdf

it's remarkable that after 50 years, these theoretical constructs are still being played around with.

in any case understanding the individual's unique circuitry would appear to be a staggering task, given that our understanding of human brain circuitry in general is sketchy at best (and much of it is gleaned from the study of what existing psychotropics do in there). I'm also feeling a little frustrated that nortriptyline appears to be the only psychotropic that doesn't damage my circuitry somewhere, although it does not treat all my symptoms and so is acquiring quite a stable of fellow passengers in my bloodstream. I would like a neuroscientist to explain to me why this agent is so benign in contrast to the legion of other pharmaceuticals I have tried.

-z


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