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Re: Some people don't want to believe. » Toph

Posted by SLS on August 5, 2008, at 13:24:21

In reply to Re: Some people don't want to believe. » SLS, posted by Toph on August 5, 2008, at 10:34:36

> > Name one FDA approved antidepressant that doesn't work.

> While this whole thread may just boil down to semantics Scott there are some people, especially those with treatment-resistive depression, for whom none of the FDA antidepressants work,

It is more than just semantics. That no one drug helps everyone is manifestly true. However, it is just as true that every drug helps some percentage of people get well. In my saying that drugs work, it was the point of my posting that drugs are effective and can help a much larger percentage of people than is often suggested. I never indicated that drug monotherapy works for everyone.

I am smitten with optimism for others, to be sure. I am not completely objective because I am projecting my own treatment history. It took decades and 73 different drugs to get to where I am today. (I need help with the math here) If we then take combinations of only two drugs from my list of 73, I think that would yield over 1000 permutations. Combinations of 3 drugs equals at least 10,000 permutations - perhaps more. Of course, no one wants to perform 1000 different 6 week drug trials. That would take 100 years. So, how then do you begin choosing drugs?

When do you stop trying?

I think it should infuse hope into some people that even a brief improvement in depression is an indicator that they are treatable. Often, it is the doctor that gets in the way. If no doctor were willing to combine Nardil with nortriptyline, I wouldn't be in this improved condition. The tools are there. Unfortunately, they are too often not used optimally.

Speaking of anger, I get angry when I see people stop pursuing drug treatment. The number of available combinations of drugs that can be used is staggering.

Currently:

Nardil 90mg
nortriptyline 150mg
Lamictal 200mg
Abilify 20mg
Deplin 7.5mg
N-acetylcysteine 1800mg
Omega-3 from fish oil


So, how did I come to find this treatment? Educated guesses and algorithms for combining drugs.

I would be curious to know how many of us would find their treatment to achieve remission contained within a single, published, algorithm - STAR*D. The STAR*D investigation is incredibly limited in the number of treatment permutations offered. However, even with so small a number of treatments included, 75%-85% of participants were robustly improved.

In light of these findings and my own experience, it is hard for me to want to qualify my statement that "drugs work". They do.


- Scott

 

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