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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 54 to 78 of 166. Go back in thread:
Posted by Phillipa on July 6, 2006, at 20:01:39
In reply to Re: Correlation vs causality » ttee, posted by linkadge on July 6, 2006, at 18:35:25
Link the people I know have no problem saying they are on antidepressants. Their reaction and they say everyone they know is on some type of medication. I know my next door neighbor a teacher takes up to 6mg of xanax and lexapro. The neighbors across the street both take zoloft . And the wife uses a fentanyl patch. No one thinks anything about talking about meds. It seems like it's almost bragging to say you're on Meds. Not so around l0years a go but then most of the nurses I worked with took benzos and Ad's SSRI's. Love Phillipa
Posted by Klavot on July 7, 2006, at 2:01:49
In reply to Re: AD's and Future Use of Antiparkinson Drugs, posted by linkadge on July 6, 2006, at 18:47:10
Posted by pulse on July 7, 2006, at 8:17:49
In reply to Re: Correlation vs causality, posted by flmm on July 5, 2006, at 19:37:10
on the contrary, i'd say it's abundantly clear that not one of us is a med hater; rather, we are better, safer med WISHERS.
unlike many to most others, i'm in no way tx resisteant. i am 'med sensitive.'
however, far more problemetic, i'm also med side-effects intolerant, meaning: they never go away any longer, no matter how long the trial of ad or combos, all classes. also of all stabilzers as augmentors, or any & all other augmentors, including t3.
of course, you'd have to read more than this thread to know this, as most of us do.
in no way am i taking away from linkage's/ others likely legitimate concerns.
my new disclaimer (altho i think it's wholly unecessary, i'm just feeling 'expansive'): never did i say i wanted ANYONE to suffer.
pulse
Posted by linkadge on July 7, 2006, at 15:09:35
In reply to Re: Correlation vs causality » linkadge, posted by Phillipa on July 6, 2006, at 20:01:39
I suppose it could be slightly different with women (?).
Linkadge
Posted by flmm on July 7, 2006, at 21:42:54
In reply to Re: Correlation vs causality, posted by ttee on July 5, 2006, at 23:42:21
Ttee, my meds have "pooped out" more times then I can mention! You know what I do? Try another med and do something different in my life to help it more! Can't just sit back and whine....
Thanx for the passive agressive response!
Posted by linkadge on July 8, 2006, at 18:37:42
In reply to Re: Correlation vs causality TTee, posted by flmm on July 7, 2006, at 21:42:54
Yeah, meds are just a way to take your mind off of whats bothering you. For me, it wasn't the med that helped so much as it was the idea that "I was getting help", and that "things were going to be different".
You have to believe.
Linkadge
Posted by ttee on July 9, 2006, at 10:14:40
In reply to Re: Correlation vs causality TTee » flmm, posted by linkadge on July 8, 2006, at 18:37:42
Too bad they outlawed prescribing sugar pills. Sounds to me that they work the best with the least (but not zero) side effects. :-) I suppose the sugar could led to weight gain.
Posted by SLS on July 9, 2006, at 10:45:55
In reply to Re: Correlation vs causality, posted by ttee on July 5, 2006, at 23:42:21
> Unfortunatly, 99% of the people here are in the MAJORITY that psycho meds don't seem to work so well.
According to STAR*D, the majority of people remitted by their third drug trial.
- Scott
Posted by SLS on July 9, 2006, at 10:57:47
In reply to Re: Correlation vs causality » ttee, posted by SLS on July 9, 2006, at 10:45:55
> > Unfortunatly, 99% of the people here are in the MAJORITY that psycho meds don't seem to work so well.
>
> According to STAR*D, the majority of people remitted by their third drug trial.And the majority of the people entering the study displayed a recurrent course of illness and were inherently more difficult to treat.
- Scott
Posted by gardenergirl on July 9, 2006, at 13:29:50
In reply to Re: Correlation vs causality TTee, posted by flmm on July 7, 2006, at 21:42:54
> We have problems that get excaserbated by scare mongers! (from http://www.dr-bob.org/babble/20060701/msgs/663335.html )
and
> Thanx for the passive agressive response!
Please don't post anything that could lead others to feel accused or put down.
If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please see the FAQ:
http://www.dr-bob.org/babble/faq.html#civilFollow-ups regarding these issues should be directed to Admin and should of course be civil. Dr. Bob has oversight over deputy decisions, and he may choose a different action.
Regards,
deputy gg
Posted by linkadge on July 9, 2006, at 15:38:46
In reply to Re: Correlation vs causality » ttee, posted by SLS on July 9, 2006, at 10:45:55
>According to STAR*D, the majority of people >remitted by their third drug trial.
Which study are you referring to ?
Linkadge
Posted by SLS on July 9, 2006, at 19:17:42
In reply to Re: Correlation vs causality, posted by SLS on July 9, 2006, at 10:57:47
> > > Unfortunatly, 99% of the people here are in the MAJORITY that psycho meds don't seem to work so well.
> >
> > According to STAR*D, the majority of people remitted by their third drug trial.
>
> And the majority of the people entering the study displayed a recurrent course of illness and were inherently more difficult to treat.
"Combined with previous reports from the project, the new finding suggests that about 60% of people who have depression can gain complete remission by the time they've tried three drugs."http://www.usatoday.com/news/health/2006-07-01-depression-drug_x.htm
----------------------------------------------
From the McMan's Bipolar Newsletter:
"When Newsletter 8#3 reported on the STAR*D second round results a few months ago, Frederick Goodwin MD, co-author (with Kay Jamison PhD) of "Manic-Depressive Illness" got back to me with this observation:
"I noticed that the cohort they studied had a mean of six previous episodes; this means that they were relatively highly recurrent unipolar patients..."
----------------------------------------------
- Scott
Posted by linkadge on July 9, 2006, at 20:11:47
In reply to Re: Correlation vs causality, posted by SLS on July 9, 2006, at 19:17:42
Perhaps, I've seen statistics suggesting the rate of remission is lower than this. It depends on your critera.
I remember my doctor claimed I was in remssion, based on the few questions he asked me during my effexor trial. Perhaps if he had asked me if I was still suicidal that would have changed his opinion about what he percieved as remssion.
Other factors need to be considered. Unfortunately, younger people are more likely tend to respond to antidepressants, I think (though I may be wrong) that they are more likely to respond to placebo as well.
Linkadge
Posted by linkadge on July 9, 2006, at 20:44:50
In reply to Re: Correlation vs causality, posted by linkadge on July 9, 2006, at 20:11:47
http://www.dissidentvoice.org/July06/Levine01.htm
Althought, there are a few comments near the end of the article which I do not agree with.Linkadge
Posted by SLS on July 10, 2006, at 5:40:09
In reply to couldn't have said it better myself, posted by linkadge on July 9, 2006, at 20:44:50
> http://www.dissidentvoice.org/July06/Levine01.htm
Having been a research patient at the NIMH and having followed the work of many of the investigators of the STAR*D project, I disagree with the characterization of these entities as being corrupt and their treatment of science as a bastardization thereof. If you wish to feel indignance at anything, perhaps it should be at the pittance of funds allocated these institutions to pursue the understanding and effective treatment of mental illness by national governments. It is indeed disquieting that so many of our most brilliant minds are being distracted by private enterprise for lack of monetary allocation. Nevertheless, I am confident that most remain faithful to their moral motives and scientific ethics. I have dealt with some of these people personally.
- Scott
Posted by linkadge on July 10, 2006, at 16:53:45
In reply to Re: couldn't have said it better myself, posted by SLS on July 10, 2006, at 5:40:09
Language, and heated tone asside, he made some very valid points. Why was a placebo arm not used?
Were thay afraid of what it might show ?
That is of course why there is so much heated debate about the use of active placebo's. Those incharge are afraid of what they might, and often do show.
You can't convince me by attacking his tone, to convince me, you'd need to attack some of the valid points he made which in themselves essentially still stand posed free of emotional tone.
Linkadge
Posted by SLS on July 10, 2006, at 21:34:12
In reply to Re: couldn't have said it better myself, posted by linkadge on July 10, 2006, at 16:53:45
> Language, and heated tone asside, he made some very valid points. Why was a placebo arm not used?
I don't believe it was the goal of the study to separate out an active treatment from a placebo. It was an attempt to test treatment algorithms in real-world clinical settings and determine treatment success rates. Placebo response rates in double-blind clinical trials are already well established.
> Were thay afraid of what it might show ?
What makes you think that they would be afraid to show anything? More conspiracy theories? They certainly weren't afraid to show the dismal results of the third step of their treatment algorithm. Neither mirtazapine nor nortriptyline monotherapy produced a remission rate of 20% for those who had failed to respond adequately to the two previous steps. Their reporting was manifestly unbiased. There was no attempt made to declare any of the treatments used as producing a remission rate of greater than 50%.
- Scott
Posted by Klavot on July 11, 2006, at 6:45:49
In reply to Re: couldn't have said it better myself, posted by linkadge on July 10, 2006, at 16:53:45
> You can't convince me by attacking his tone, to convince me, you'd need to attack some of the valid points he made which in themselves essentially still stand posed free of emotional tone.
Actually, I can. You *assume* his points are valid. When a quack like L. Ron Hubbard writes about psychiatry, I don't take it seriously, likewise here.
This is a man who wrote a book called "Commonsense Rebellion: Taking Back Your Life from Drugs, Shrinks, Corporations, and a World Gone Crazy". Sounds like something that the Church of Scientology would publish. He is a psychologist with probably no medical training.
Are you telling me that the thousands of medical scientists, and millions more medical doctors, who are behind contemporary psychiatry, are all wrong? That they are all in the pockets of Big Pharma? Like they say, no quack would be complete without a conspiracy theory.
If drug-based psychiatry is so flawed, then why are psychiatric hospitals at an all-time low?
It seems to me that there are some people on this board who, based on their own isolated anecdotal exeriences with psychiatric drugs, are hell-bent on discrediting these drugs.
I would also be careful to take everything that I read on the net seriously. The internet is often the medium of quacks, who are unable to have their work published in proper literature.
By the way, is is not a given that you MUST use a placebo in clinical trials. Often the efficacy of a treatment is compared not to a placebo, but to other well-established treatments, particularly where it is unethical to use placebo (for example cancer drugs).
Posted by Klavot on July 11, 2006, at 7:08:12
In reply to Re: couldn't have said it better myself, posted by Klavot on July 11, 2006, at 6:45:49
What are Levine's "valid points"?
1. There is simply no way that antidepressant medication could possily be effective, and any scientist who establishes postitive correlation in this regard must be corrupt having been bribed by the pharmaceutical industry.
2. NIMH and the FDA - two of the world's most respected medical bodies - employ sloppy research methodology and are in cahoots with the pharmaceutical industry.
3. The tens of millions of people around the world who have benefitted from psychotropic medication are all "mistaken" in thinking they feel better, and have been brainwashed by the evil parmaceutical companies.
4. The hundreds of studies performed on psychatric drugs all around the world over a period of decades should be ignored in light of the Zoloft / SJW study.
5. The hundreds of drug regulators around the world have all been fooled by corrupt pharmaceutical companies who spend billions of dollars on research and development in order to manufacture dud drugs.
6. I quote: "Even the most enthusiastic antidepressant prescribers agree that these drugs can have serious adverse affects". Uh, would that be life-threatening sexual dysfunction? Fatal headaches? Deadly insomnia? Bah! What nonsense.
etc. etc. etc. ad nauseum
Really! I've heard it al before.
Posted by linkadge on July 11, 2006, at 17:01:02
In reply to Re: couldn't have said it better myself » linkadge, posted by SLS on July 10, 2006, at 21:34:12
In my opinion the real response to a drug is that of the trial responce minus the placebo responce. You cannot accurately tell how a drug works unless you attain a guage of placebo responders.
Without a placebo, such and such a sucess rate is only speculative.
Linkadge
Posted by linkadge on July 11, 2006, at 17:02:02
In reply to Re: couldn't have said it better myself » linkadge, posted by SLS on July 10, 2006, at 21:34:12
Hey, this buisness is rife with conspiracy.
Linkadge
Posted by linkadge on July 11, 2006, at 17:24:48
In reply to Re: couldn't have said it better myself, posted by Klavot on July 11, 2006, at 6:45:49
>Are you telling me that the thousands of >medical scientists, and millions more medical >doctors, who are behind contemporary >psychiatry, are all wrong? That they are all in >the pockets of Big Pharma?
Just like it was mentioned below, 50 years ago, methamphetamine was used to treat depression. The doctors who pused it probably claimed that it was treating some genuine biochemical abnormality, and the people who took it probably believe in it based upon the notion of "how could these doctors be wrong?" Its "The Emperor's New Cloths".
>If drug-based psychiatry is so flawed, then why >are psychiatric hospitals at an all-time low?
Because drug-based psychiatry is so flawed.
>It seems to me that there are some people on >this board who, based on their own isolated >anecdotal exeriences with psychiatric drugs, >are hell-bent on discrediting these drugs.
The drugs will discredit themselves. The operative demention here is time. I have my own opinions, but thats no proof in itself. I don't believe in opinion. I try to take information and process it for what it is, information.
Breggin, maybe he's a bit of a nerd. When he asserts that ECT seems to cause significant and observable abornmalities in glial function, I take that for what it is, either true or false. If you think in black and white, and lable Breggin as bad, and assume everything he says is wrong because he is bad, then you may be missing the whole story. We all like to compartmentalize information because it helps us cope with the decisions we must make.
>I would also be careful to take everything that >I read on the net seriously. The internet is >often the medium of quacks, who are unable to >have their work published in proper literature.
I don't read an article with preset opinions. He brought up the point about why no placebo was used. I never thought of that, its a good point. If the placebo showed what it was probably going to (which might make the already dismal responce rates seem even more insignificant), one might reconsider its use.
>By the way, is is not a given that you MUST use >a placebo in clinical trials. Often the >efficacy of a treatment is compared not to a >placebo, but to other well-established >treatments, particularly where it is unethical >to use placebo (for example cancer drugs).Yes, but cancer doesn't get better with hope (at least in my books), but depression can, and often does. That's why a placebo is so critical in the trial of depression drugs. It gives you a guage of the degree to which the setting, care and support, are contrubuting to a person's recovery.
Think of the sertraline, SJW, placebo trial. Without placebo, it would say that 30% of people responded to sertraline (roughly the number of people who responded here), with placebo, you'd see that 40% responded to placebo. All of a sudden, the "response" to sertraline seems virtually nonexistant.
Linkadge
Posted by linkadge on July 11, 2006, at 17:34:13
In reply to couldn't have said it better myself, posted by linkadge on July 9, 2006, at 20:44:50
Those were not his points. The Zoloft/SJW trial is by far not the first trial to suggest that antidepressants often perform worse than placebo.
He suggested that the trial might be biased based on some of the investigators vested interests drug compaines.
He claimed that the results are essentially meaningless without a placebo control.
He also suggested that rates of spontanious remission should be considered by anyone trying to guage the degree to which an antidepressant influcences recovery.
Those are valid considerations.
I don't like Breggin much, but I do have respect for Dr. Kramer. He discusses some of the highlights from a growing body of information about the currently used antidepressants.
Linkadge
Posted by Klavot on July 11, 2006, at 17:53:24
In reply to Re: couldn't have said it better myself, posted by linkadge on July 11, 2006, at 17:02:02
> Hey, this buisness is rife with conspiracy.
>
> LinkadgeIf it is so rife with conspiracy, give me a few examples.
Posted by Klavot on July 11, 2006, at 18:34:40
In reply to Re: couldn't have said it better myself, posted by linkadge on July 11, 2006, at 17:24:48
> Think of the sertraline, SJW, placebo trial. Without placebo, it would say that 30% of people responded to sertraline (roughly the number of people who responded here), with placebo, you'd see that 40% responded to placebo. All of a sudden, the "response" to sertraline seems virtually nonexistant.
Yes, I take your point. The sometimes narrow margin between SSRI's and placebo has bothered me too.
I think one practical and ethical issue is whether to subject a suicidally depressed patient to placebo treatment.
Linkadge, if you don't mind my asking, exactly what is your position on pshychiatric drugs? Are you opposed to all drugs or just SSRI's? Do you believe in drug-based psychiatry or a different treatment approach?
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