Posted by linkadge on December 16, 2005, at 20:06:15
In reply to Re: Dr. Tracy on SSRIs.. » linkadge, posted by Larry Hoover on December 16, 2005, at 15:28:13
>I really want to simplify. I'm exhausted from >shovelling snow with one arm.
Nobody is preventing you from taking a break.
>Drugs that cause immediate increases in synaptic >serotonin concentration, e.g. Ecstacy or >powerful agonists e.g. LSD, stand in somewhat >stark contrast from the serotonergic >antidepressants, which take weeks for most of >the effects to appear. (There are exceptions, >but I'm just wanting to make a simple point.) >So, serotonin receptor mediated events that lead >to changes in regulatory behaviour in the neuron >are most likely what makes an antidepressant an >antidepressant.
You are mixing two aguments. I am familliar with the proposed mechanisms of SSRI's, and I still contend that the observed cases of SSRI related visual disturbances are related to a LSD like serotonin agonism. SSRI's can act as potent agonists at all serotonin receptors.
>I once posted an overview of changes in RNA >concentration following antidepressant exposure. >There were many dozens of significant changes, >up to 20-fold. Just looking at permutation, >we're already being forced to consider something >like 10^17 possible meaningful interactions of >those changes. I wish I could think of what the >paper was called.
I don't see where you are going.
>That's why I go back to empirics. We put this >drug into a mysterious processor, and we observe >these common outputs. How, why, why not.....I'll >never pretend to know.
>But they don't affect the system one way.
They affect the serotonin transporter in one way.
>Commercials. They ought to make them stop direct >marketing drugs.
Agreed
>But, Tracy falls in the same level of scientific >truth. That's the problem with her.That statement needs to be applied to her various arguments separately.
>Saying what happens is one thing. That is data >collection, and description. That's empiricism. >Of course poop out occurs, but if anyone tries >to explain why, that's over the line.
You are waiting for empiracal proof that a drug may have faults, you may have waited too long.
>No, those data are available. Post-marketing >surveillance puts the rate at about 3 times >that, off the top of my head. Clinical trials of >efficacy are not designed to collect information >that might be personal or embarassing. I may not >mention my erectile dysfunction, but I'd surely >mention hallucinations.The point is that the data can oftentimes be inacurate.
>Maybe. Placebo response is the bugbear of mood >disorder treatment. Placebo response in e.g. >positive symptom schizophrenia is estimated at < >3%. Here is an excellent article about the >difficulties in interpretation that arise >because of the clinical trial system for >medication being inappropiate for mood disorder >treatments.
When you have a drug that is oftentimes performing no better than placebo, you'd better make sure it is safe. Thats what sparks this contoversy, the combination of questionable efficacy, and questionable safety.
>Exactly. Perhaps I did. It certainly took place. >The role of Luvox is not clearly defined.I believe you know yourself well enough to distinguish. For me it is simple, sinusoidal head movements, head twisting sensations, severe ballance problems, and a whole host of co-ordination problems usually resolve within 4 hours of taking zoloft or celexa.
>You've confused me again, with your >parenthetical remark. Nothing was proven, but it >would be prudent for me to avoid that drug, in >future.I would argue that it is information that could proove to be more usefull than for you simply avoiding the drug again. If you were my mother, you would probably have been subsequently persuaded that you have bipolar disorder, and have to suffer a life of lithium carbonate treatment. I don't think you have bipolar disorder, do you ?
That's why they did these studies. Healy's an author on the first one.>A meta-analysis of 702 clinical trials....
>http://bmj.bmjjournals.com/cgi/content/full/330/7>488/396"Discussion Our systematic review, which included a total of 87 650 patients, documented an association between suicide attempts and the use of SSRIs. We also observed several major methodological limitations in the published trials."
>And, another, of 477 more....
>http://bmj.bmjjournals.com/cgi/content/full/330/7>488/385"Increased risks of suicide and self harm caused by SSRIs cannot be ruled out"
Thanks, that saves me the trouble.
Linkadge
poster:linkadge
thread:587690
URL: http://www.dr-bob.org/babble/20051211/msgs/589673.html