Posted by JohnL on April 17, 2001, at 5:24:46
In reply to thoughts on active placebos and true efficacy? , posted by mikes on April 16, 2001, at 13:06:54
.....So a rough estimate is that 20 percent of people will respond to any one medication (by actual pharmacological mechanisms), if that.
My pdoc told me that 70% to 90% of patients will respond to medication if they try three different classes. At least one of them is likely (70%) to work.However, he also told me that only about 20% to 30% get totally well. The rest experience improvement, but they don't get totally cured. They are restored to a functioning state, but shy of a normal baseline state. He said the key to getting totally well is to keep experimenting, which most patients don't or won't do.
He believes that placebo responses and side effects can be confused with response, but that these are short term and do not endure the test of time.
And of course, ten different doctors would probably have ten different views. My pdoc though, being Head of Psychiatry and being in practice since before ADs were invented, offers insights gained from decades of experience and observation in real life clinical practice. I don't think any of his opinions are based on scientific principles, but rather they are based on what he actually saw occur in the real world.
True efficacy, as I see it, occurs when the particular drug is a superior match for the patient, in terms of chemical, genetic, and molecular variables. Our body chemistries will embrace the correct medication, but reject or ignore inferior matches, so to speak. Just my opinion.
John
poster:JohnL
thread:60081
URL: http://www.dr-bob.org/babble/20010417/msgs/60163.html