Posted by linkadge on May 20, 2006, at 2:13:31
In reply to Re: Statistical question on SSRIs - ADDENDUM » linkadge, posted by Larry Hoover on May 15, 2006, at 9:54:44
>If antidepressant drugs caused a suicide, how >would you demonstrate that to another person? >How could you show that it was this one lone >variable that made the difference?
Thats exactly it. We can't prove anything yet. I'm not claming that the reason for my conclusion is at all scientific or provable in any sence yet.
>Anecdote. What is anecdote? It is an >uncontrolled experiment with one subject. What >have you got when you collect one thousand >anecdotes? One thousand different uncontrolled >experiments with one thousand different subject >populations. Anecdote is a point in space. How >do you extrapolate from one point?Hopefully anecdotal instances might persuade the initiation of a host of more systematic experimentation.
>Anecdote spurs people to create hypotheses, and >to consider experiments not yet done. How could >you design an experiment which would >demonstrate this suicidality, this inductive >effect? The fact is that you can't. Any >experiment that could do so is absolutely >unethical to perform.
We do have some experiements that show some interesting things. You take a regular clinical trial for an SSRI. Throughout the trial, you ask both groups a whole host of question relating to feelings of akathesia, acute feelings of suicidiality, feelings of hostility, increased feelings of self hatred or intent to self harm.
You compare the incidences of such events between both groups, and you discover what many such trials are indicating, that SSRI's statistically seem to increase the likelyhood of such feelings.Perhaps nobody actually kills themselves in such trials, but the information will lend merrit to many of the anecdotal reports.
>All we can really do, IMHO, is to manage the >drugs better than we did before. Serious drugs >for a serious disease require serious >management. I cannot fathom how the latter was >allowed to detach itself from the former, but >we let that happen. Thalidomide taught us a >lot. It turns out that thalidomide is a miracle >drug, when used in other contexts than for >morning sickness.I think that part of the mannagment, is in coming to terms with the extent of the problem.
There is still such a devide. Either they cause people to kill themselves, or they do no such thing.>It's the human component that we can influence. >No amount of posturing will affect the drugs >themselves. They are what they are. We have a >people problem, not a drug problem, IMHO.
Lets suppose that there is something really quite unique about the individuals who have such negitive reactions to SSRI's. Its like we've skipped back 40 some odd years, when MAOI's were not known to interact with tyramine. Sure, only some people were dying, and nobody knew exactly why. We still have yet to discover why people are reacting this way. It is still a drug problem, just like MAOI dietary interactions were a drug problem. It is my belief that we simply don't know the mechanism yet.
Linkadge
poster:linkadge
thread:640557
URL: http://www.dr-bob.org/babble/20060515/msgs/646147.html