![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by TomV on November 15, 2004, at 12:14:32
Something along the lines of a blood test or something. Maybe examine what chemical you are low on, or maybe how a certain chemical is behaving in your body.
With the hundreds of $ billions these drug companies are worth and make each year you would think they would invest some of it into serious testing regarding this issue. I do understand that we don't know a lot about these disorders and how the drugs work, but maybe we can start by focusing on what we do know. Perhaps we could start by testing patients who were helped by these meds and finding a common link. The possibilities are unlimited.
Posted by ed_uk on November 15, 2004, at 12:27:45
In reply to Are we near a biological mental disorder test?, posted by TomV on November 15, 2004, at 12:14:32
Hello Tom, interesting post....
In reality, drug companies exist to make profit, not for the benefit of people with mental health problems :-(
I don't think it's in the interests of the drug companies to develop tests to determine who is likely to respond to their product. Basically, pharm companies want as many people as possible to be taking their drug!
For example....... at the moment most new ADs are approved simply for the treatment of major depression ie. a massive no. of potential patients. If a test was available that selected the (rather small) subgroup of depressive patients who were likely to respond, the number of people treated might be less.
Ed
Posted by ed_uk on November 15, 2004, at 12:30:54
In reply to Re: Are we near a biological mental disorder test?, posted by ed_uk on November 15, 2004, at 12:27:45
On the other hand...... it would be fantastic if we could predict how people would respond to a drug based on the results of a blood test.
All the best...
Ed
Posted by Cruz on November 15, 2004, at 12:46:50
In reply to Are we near a biological mental disorder test?, posted by TomV on November 15, 2004, at 12:14:32
The pharmacuetical companies are doing great under the present confused situation. Many of us with mood disorders have a hormonal imbalance and will eventually be treated with certain hormonal proteins to correct these imbalances. Compaired to the income that they recieve from AD's that they presently produce, hormonal proteins do not have any where near the potential for revenue. So understanding the causes of mood disorders is not something the pharmacuetical companies are interested in. They have a situation that works for them( their making a great return on their investment), and the Pdocs are happy with the way things are at present. Patients that are helped with the current meds are fine with the things are. They could find out down the road that these meds cause liver, kidney and other damage, so they could change their opinion. People like myself are the ones that are not pleased with the status quo. I have'nt found success with the meds available. I can see in my disorder the evidence points to a endocrine imbalance but endocrinologists are not interested in treating mood disorders after they rule out thyriod problems. Eventually we will have clearer understanding of mood disorders, and appropriate treatments available.
Posted by linkadge on November 15, 2004, at 12:52:18
In reply to No monetary incentive for it, posted by Cruz on November 15, 2004, at 12:46:50
Actually there were some tests devised that accurately predicted who would respond to treatment with either paroxetine or mirtazapine.
It was a genetic test that looked at the coding varient you had for the 5-ht2a receptor.
Based on the test, they predicted quite well who would respond to either treatment.The treatment was randomized, and if one drug didn't work then the other was tried.
I will look for the study. It was done by univesity students and not drug companies.
Linkadge
Posted by ed_uk on November 15, 2004, at 13:09:25
In reply to Re: No monetary incentive for it, posted by linkadge on November 15, 2004, at 12:52:18
Am J Psychiatry. 2003 Oct;160(10):1830-5. Related Articles, Links
Comment in:
Am J Psychiatry. 2004 Jul;161(7):1308-9; author reply 1309.
Pharmacogenetics of antidepressant medication intolerance.Murphy GM Jr, Kremer C, Rodrigues HE, Schatzberg AF.
Neruroscience Research Laboratories Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford CA 94305-5548, USA. afschatz@leland.stanford.edu
OBJECTIVE: The authors sought to identify genetic markers for antidepressant medication intolerance. Genetic variation in drug metabolizing enzymes such as cytochrome P450 2D6 (CYP2D6) has been postulated to underlie antidepressant intolerance (pharmacokinetic effect). However, variation in genes encoding serotonin receptors could also explain antidepressant side effects (pharmacodynamic effect). METHOD: An 8-week, double-blind, randomized pharmacogenetic study compared the widely prescribed antidepressants paroxetine (a selective serotonin reuptake inhibitor [SSRI]) and mirtazapine (not an SSRI) in 246 elderly patients with major depression. Genotypes were determined for the 102 T/C single nucleotide polymorphism (SNP) in the serotonin 2A (5-HT(2A)) locus (HTR2A), previously associated with psychotropic medication treatment outcome. Oligonucleotide microarrays were used to extensively characterize variation in the CYP2D6 gene. Clinical outcomes included treatment discontinuations, adverse events, medication compliance, and change in mood. RESULTS: Survival analysis showed discontinuations due to paroxetine-induced side effects were strongly associated with the HTR2A C/C genotype. There was a significant linear relationship between the number of C alleles and the probability of discontinuation. Side effect severity in paroxetine-treated patients with the C/C genotype was also greater. In contrast, HTR2A 102 T/C genotype had no effect on mirtazapine side effects. CYP2D6 genotype did not predict treatment outcome for either medication. CONCLUSIONS: Pharmacodynamic differences among patients due to variant 5-HT(2A) receptors appear to be more important than pharmacokinetic variation in determining paroxetine intolerance. Pharmacogenetic markers may be useful in predicting antidepressant treatment outcome.
Posted by ed_uk on November 15, 2004, at 13:20:44
In reply to Re: No monetary incentive for it, posted by ed_uk on November 15, 2004, at 13:09:25
Just posted one of the studies I found...... there are a few more..
Ed
Posted by pablo1 on November 15, 2004, at 15:46:10
In reply to Are we near a biological mental disorder test?, posted by TomV on November 15, 2004, at 12:14:32
I just read in the alternative forum someone was going to take a $140 neurotransmitter urine test & then they sell supplements like amino acids to balance out any deficiencies. She did not follow up on that.
One I'm very tempted to sign up for is Dr Amen's brain scan treatment where he can show which parts of your brain are overfocused or underfocused. Unfortunately it's like a couple grand cost & he's kind of off on his own trip, not wasting time with the research universities to prove his theories. You can read all about it at http://www.brainplace.com I don't know anyone who has been through his program. It involves injecting radioactive tracers to detect blood flow inside the brain, there are some other brain scan techniques as well. He thinks he knows which medecines correct which brain scan patterns so it's supposed to save time with trial & error.
Posted by Shalom34Israel on November 16, 2004, at 18:43:09
In reply to No monetary incentive for it, posted by Cruz on November 15, 2004, at 12:46:50
> The pharmacuetical companies are doing great under the present confused situation. Many of us with mood disorders have a hormonal imbalance and will eventually be treated with certain hormonal proteins to correct these imbalances. Compaired to the income that they recieve from AD's that they presently produce, hormonal proteins do not have any where near the potential for revenue. So understanding the causes of mood disorders is not something the pharmacuetical companies are interested in. They have a situation that works for them( their making a great return on their investment), and the Pdocs are happy with the way things are at present. Patients that are helped with the current meds are fine with the things are. They could find out down the road that these meds cause liver, kidney and other damage, so they could change their opinion. People like myself are the ones that are not pleased with the status quo. I have'nt found success with the meds available. I can see in my disorder the evidence points to a endocrine imbalance but endocrinologists are not interested in treating mood disorders after they rule out thyriod problems. Eventually we will have clearer understanding of mood disorders, and appropriate treatments available.
LOL "Eventually we will have clearer understanding of mood disorders, an appropriate treatments available?"When? When we are all dead? Tests are needed NOW! As in, TODAY! The mental health profession is such a load of crap.
Shalom
Posted by linkadge on November 17, 2004, at 18:47:08
In reply to Re: No monetary incentive for it, posted by Shalom34Israel on November 16, 2004, at 18:43:09
"When? When we are all dead? Tests are needed NOW! As in, TODAY! The mental health profession is such a load of crap."
Actually the tests were needed thousands of years ago. Our suffering is no more significant than the suffering of long ago. Dispite my reserves about the way things are done, I'm still glad I'm in the care of doctors today, than doctors of the past.Linkadge
Posted by j. Backer on November 18, 2004, at 11:06:09
In reply to Re: No monetary incentive for it, posted by linkadge on November 17, 2004, at 18:47:08
id rather have doctors of the past circa 1890 man, they knew what was up.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.