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Re: Article on treatment resistant depression » OldSchool

Posted by Elizabeth on March 26, 2002, at 21:27:55

In reply to Re: Article on treatment resistant depression, posted by OldSchool on March 22, 2002, at 21:29:31

> > I hope that advances in neurobiology may offer new clues about different types of "major depression."
>
> I read something Dr. Mark George wrote where he said he wouldnt be suprised that in ten or fifteen more years its been discovered that there are actually ten different types of depression.

That's what I think, yeah.

> This work would go faster I bet if psychiatry was just formally merged into Neurology. This is BRAIN stuff, not psychology or "mind" stuff.

People who think that there's a difference are confused, that's what I think.

> I think there are a whole bunch of things which can cause antidepressants not to work well. Subtle bipolar problems is just one of them.

Yeah, but we don't know of many other ones. I think that research has been misdirected -- instead of finding new ADs that are pretty much the same as the ones we already have, the research community should be looking into things like what might cause a particular AD to work for some people but not others (or even for one person at one time but not at a different time).

> > I was surprised to read that nomifensine (Merital) didn't seem especially effective for TCA-resistant depression
>
> I wouldnt believe what you read about nomifensine being an ineffective antidepressant.

"Surprised" is a euphemism -- it's a polite way of saying that I don't believe it. :-)

> Yeah but remember that "response" is not a full remission, which is the objective of depression treatment.

Yeah, that's a good point too. Still, when you're way down in the pit, just "responding" seems like nothing short of a miracle.

> But nobody wants to do the last two options
[MAOIs and ECT]
cause of the side effect profile.

I think the side effects of both of those treatments are exaggerated in people's minds. Also, a lot of people with anxiety and depression are hypochondriacs and misattribute minor and insignificant variations in things like heart rate, or symptoms that everybody gets sometimes like headaches, to drugs if they happen to be taking any drugs at the time. (Probably same for ECT, too.)

> There are a lot of things left to be desired in the treatment of severe depression.

There sure is.

-e


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poster:Elizabeth thread:98605
URL: http://www.dr-bob.org/babble/20020322/msgs/100415.html