Posted by linkadge on April 8, 2006, at 16:46:21
In reply to Re: Drugs versus Psychotherapy - Backlash?, posted by SLS on April 8, 2006, at 14:20:53
>It is true that agitated depressives have >psychomotor activation. These people are >probably more at risk for having suicidal >ideation. Others are just too anergic, >psychomotor retarded, or vegetative to >contemplate suicide.
Or just people who's depression doesn't impact their energy levels at all. I never really had much psychomotor activation or retardation, it was just inexplicable sadness.
>One reason people develop suicidal ideations >while taking antidepressants is that they regain >enough mental energy to contemplate and plan. >This occurs as they begin to respond favorably >to treatment, but before they have responded >well enough to feel substantially less >depressed. It is an irony of sorts.
Yes, that is one theory as to why suicidiality can increase in the short term. There is also the theory of drug induced akathesia.
>> Antidepressants have a degree of toxicity and potential for dependance,
>As do many other types of drugs prescribed for various ailments. Prednisone?
I guess I mean that if a person could be made well without drug, it would probably make for a better long term outcome. How many people are driven back into dispair when they decide to discontinue their antidepressant?
>Still, you have a better chance of responding >robustly to an antidepressant than you do to >exercise if you are severely depressed (MDD). >This is my contention. I doubt we will agree >here.That one study I showed, the zoloft vs. exercise for MDD, showed a more robust outcome for the exercise group after a few months. I think we simply need more studies to quantify the extent of its potential.
>From what I have seen with the doctors I have >worked with, I think this number represents a >minority. I think the majority of responders >will demonstrate subtle improvements during >weeks 3 and 4 of treatment at a therapeutic >dosage.As one would expect to see some improvements with exercise. After about 3 weeks there was no doubt I was sleeping better.
>Despite all of my treatment failures, I still >believe that, in capable hands, over 75% of MDD >people will respond well to the drugs we already >have available, especially when used as part of >a multimodal approach that may include >psychotherapy, nutrition, and even exercise.
I don't think that drugs are responsible for getting 75% of people better. Clinical trials certainly don't demonstrate this, and even less when you remove possible effect of placebo, and natural recovery. I think their effects are vastly overrated.
Linkadge
poster:linkadge
thread:629584
URL: http://www.dr-bob.org/babble/20060408/msgs/630633.html