Aswad
Posts: 9374
Joined: 4/4/2007 Status: offline
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quote:
ORIGINAL: NorthernGent Any comments? This is old news, as has been stated in expert testimony to parliament in the past. Also not surprising, they're reacting by throwing the baby out with the bathwater here. Modern SSRI and SNRI antidepressants are essentially on par with placebo; others are not. SSRIs' main advantage is low toxicity. They don't really do anything much, so it's rather close to being impossible to accidentally or intentionally kill yourself by an overdose, unless you combine them with other drugs. Their low efficacy has been known for a long time. SNRIs are essentially the same in this regard, as demonstrated in another, statistically sound study. They also tend to have more profound withdrawal effects during tapering, though neither are addictive per se. The only reason these drugs have been approved and found widespread use in treating depression is the amazing effort spent on it by drug companies, who can make a comparatively easy buck off them. For these reasons, experienced psychiatrists prefer to use other drugs, particularly the older ones that are effective. Such older drugs are first and foremost the tricyclics and the MAOIs. Those tend to inspire irrational fear in doctors who have little or no experience with them, because of misunderstandings that have been passed from one paper to another without critical thought. Also, they are off-patent, so there isn't nearly as much money to be made off them. Among these, drugs like Anafranil (clomipramine), Elavil (amitriptyline), Nardil (phenelzine) and Parnate (tranylcypromine) have an exceptionally good track record. They are also reasonably priced, for those who live places where that is an issue. My experience has been that Parnate is the best and most effective choice of these, and the literature clearly supports it, with remission rates (i.e. full recovery) of 85% for treatment "resistant" patients. Compare that to improvement rates (i.e. 50% reduction in severity, but not recovery) of about 35% with modern drugs in clinical practice. There are others out there, of course, but if people would use these instead, the job would get done. It would pretty quickly get boring for most of the drug company researchers. Health, al-Aswad.
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"If God saw what any of us did that night, he didn't seem to mind. From then on I knew: God doesn't make the world this way. We do." -- Rorschack, Watchmen.
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