Posted by Reggie BoStar on February 27, 2008, at 0:22:26
In reply to Re: ADs found to offer little clinical benefit, posted by yxibow on February 26, 2008, at 5:45:35
Now Time Magazine is running this one on the spin machine. Here it is:
http://www.time.com/time/health/article/0,8599,1717306,00.html
In these sorts of situations it's very difficult for me to separate the players from the actual data.
One side says their data is valid and previous studies are somehow lacking or flawed. Another side says the same thing about their data, with perhaps a twist to the effect that more recent studies need to be taken into account.
It's all Deja Vu for me, for almost 15 years now. The folks at the extremes have always been so biased that I don't trust any of their interpretations of the data.
I'm sure there is some valid data somewhere that's meaningful; but I doubt we'll ever hear of it. There are just too many different interests all normalizing the data in different ways.
Here's what I trust. I trust me. Whenever I start a new drug for any condition - not limited to depression - I remind the caregiver that there can be no placebo effect with me.
This isn't a boast at all. My attitude about any and all attempts to fix whatever's wrong with me is that they will fail. This is just a symptom of my flavor of depression and has been present since I was 10 years old. I'm now 56. It hasn't changed one iota in all that time.
For this reason I've been through a lot of medications, especially antidepressants. I started on Prozac in its very early days. There seemed to be some positive effects at first, but they disappeared over the course of a few months. Present always was my conviction that "even if this gets any better, it won't last".
I then cycled through just about all the SSRIs with the same or similar results (when Paxil failed, it was a CRASH). Until some the SNRI's started coming out, I saw no sustained relief to the point where I could at least manage my depression.
It turned out that SNRIs have the right combination of neurotransmitter tweakers to get me out of bed and out of the house. I'm not happy about doing that - far from it - but at least I'm getting out.
And with me, that's a real, measurable effect. That's because, as always, I don't expect it to last. Now I've been on Cymbalta for over 2 years and it's hanging in there. I can therefore trust myself enough to say that SNRIs do have an effect on me, and it's not negative, and it's lasted for a few years; i.e., so far it works and all the controversy that comes and goes over these things has nothing to do with it.
Since Prozac other medications besides SNRIs have been developed. These include Neurontin (Gabapentin) and Gabitril which mimic the action of the neurotransmitter GABA (gamma-aminobutryc acid); and the Triptan drugs which stimulate Serotonin production by binding to 5-HT* sites.
The resulting effects for me are:
1. Daily intake of the GABA simulators has dramatically reduced the number of migraines I get.
2. Even if I do get a migraine now, a Triptan drug such as Imitrex or Maxalt actually aborts the attack within an hour.I know these work for the same reason I trust myself to identify other meds that work without a placebo affect. I never believe they're going to work. This to some degree is how migraines affect me during attacks. Despite what I know about them, I'm absolutely convinced that an attack will never end. Migraines just affect my thinking that way, among all the other awful things they do.
So: as far as I'm concerned, the SSRIs which don't work at all for me have led to the development of other meds which help me function at least a little (Cymbalta) and which can reduce the number of migraines I get (Neurontin/Gabapentin) and stop the ones I do get (Imitrex/Maxalt).
The SNRIs have a ways to go because Cymbalta's action on me is minimal. But it's a start.
This is why I don't care much what the media hollers about this stuff from time to time. To me it's all sensationalism and is in the same class as the Britney-mongers.
This is just my case though and how these things work or don't work for me. Other folks are no doubt having different experiences. I hope they're good ones.
Reggie BoStar
poster:Reggie BoStar
thread:814746
URL: http://www.dr-bob.org/babble/20080221/msgs/814891.html