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Re: Antidepressants Hardly Help ????????? » chumbawumba

Posted by SLS on May 12, 2009, at 6:10:19

In reply to Re: Antidepressants Hardly Help ?????????, posted by chumbawumba on May 12, 2009, at 0:48:57

> Of course, biological processes are amenable to measurement. Pathological or not.

So... When does a depression become pathological?

> And since all depression is a pathology

Here, I disagree with you. You believe that depression is an answer to a single question. I believe it is a pathological phenomenon with specific symptom clusters.

Let us start at the beginning, again.

This time, I will state that the majority of clinical investigations of antidepressants are established to study major depressive disorder (MDD) - a phenomenon that is defined in the study and practice of medicine and using a set of observations of symptom clusters to aid in diagnoses. If it is the criterion that one be suffering from MDD to enter a study, why do you continue to see homogeneity when it is heterogeneity that confounds the selection process in the first place?

If you were responsible for the inclusion and exclusion of subjects in a study of MDD specifically, how would you go about it?

> I suspect some people with longer term untreated depression would show anatomic changes whereas

Even if they are treated.

> in others the differences would only be visible as fMRI or PET hotspots and cold spots.

Out of curiosity, do you feel that this is a trait or state specific finding?

> I also suspect as the technology improves more will be learned about the differences between normal and depressed brain functioning.

I am afraid that the technology has already determined that there are differences between people with MDD versus those without it. Among those without it are people who are depressed for one reason or another, but do not qualify as having this biological disorder.


> And if we look closely enough I'll bet we'll even be able to track in real time the changes in the brain as a person has a "hopeless thought" versus a "hopeful though". I don't think we're there yet.

Already been done. Even the presentation of different facial expressions produces measurable differences on PET and SPECT imaging studies. Not only that, but, most importantly, there is a difference between MDD versus non-MDD responses to the same stimuli.

> It is well known that there is an interaction between the environment and the genetic code

Yes, it is well known, along with much else that you have mentioned subsequently, so why bring it up when we are talking about the criteria and selection process for clinical investigations involving affective disorders?


- Scott

 

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