Posted by SLS on March 4, 2006, at 9:01:45
In reply to Re: Antidepressants don't work except for when the, posted by linkadge on March 3, 2006, at 16:07:00
> I honestly don't think we have come anywhere.
That's too bad. You might glean more hope to realize how intense and diverse is the work being performed in the field of psychiatry. Wait. You do realize this. With as much reading and understanding as you demonstrate, I am surprised you don't recognize this work as being true progress. Digging, digging, digging. They are still digging. They need more time to locate the buried treasures of understanding.
> We are still using the exact same techniques to treat depression as we were 40 years ago.
This is not true. rTMS didn't exist 40 years ago. Neither did SSRIs, Wellbutrin, and other drugs that have served to rescue those people whom were non-responders to TCAs and MAOIs. I served willingly as a guinea pig during this formative era that began around 1980. I agree that the pace of discovery in clinical therapeutics has been painfully slow. Rome was not built in a day - trite, but true. Some of these guys are working their *sses off.
> In addition we lack any conlusive evidence whatsoever that these are the mechanisms involved in the etiology of depression.
That's why there is such diversity in the targets of current investigation. Until the mystery is unravelled, we gotta go with what works, despite a lack of understanding of how it works. That's why animal drug screening protocols are so important.
> What does this modern research amount to?More people are getting well. Just not you - yet.
> In addition, we are uncovering solid evidence that links depressive disorders to low activity of the serotonin transporter (not to bring up old dirt). Many recent studies are currently baffling scientists because they suggest that depression is actually more common in people who have less acitivity of the serotonin transporter ie people with the (SS) varient of the serotonin transporter, a condition we are effectively reproducing with SSRI's.
I think it is the compensatory re-regulation of the synapse or circuitry that is the key, not the acute actions of the drugs that precipitate it. That's why a drug like tianeptine can work, in my opinion.
> We have a drug called tianeptine that is as effective as SSRI's yet it works the opposite,
Ah. You beat me to it. People investigating brain disorders need to think multidimensionally, not just linearly. Tianeptine might do "just the opposite" acutely, but the resulting compensatory mechanisms might yield an equilibrium similar to that produced by SSRIs. Research cannot be linear either. Pure research does not follow a path set up by theory or proposed destination. You never know where you will stumble upon a clue or an answer to a question that was never asked.
> leaving scientists reverting back to the old biochemistry kickstart theory of antidepressant action. It's great to marvel, but I still contend that we are clueless.
With respect, I offer the possibility that both you and I are clueless as to the volume and sophistication of investigation and theory synthesis going on currently in the field of neuroscience.
> I see our attempts as pathetic as the assumption that alzheimers is a disease cause by low acetycholine.I am under the impression that it is defective ACh neurotransmission that is the ultimate expression of the disease. However, this observation has never duped researchers into concluding that the neural synapse is the primary site of disease induction. But then again, the abnormal tissue morphology is obvious in DAT. Not so much in MDD. With MDD, it might be gene activity that will eventually elucidate the primary sites of disease expression. We are only just now developing the technology to accomplish this. I think this is where many people lose perspective on the rate of discovery. We can only observe what our current technology allows us to. The rate of biological discovery is thus tied to the rate of technological advances. Let's give our researchers some credit for using creatively what little they have to work with.
- Scott
poster:SLS
thread:615349
URL: http://www.dr-bob.org/babble/20060304/msgs/615789.html