Posted by yxibow on June 8, 2008, at 6:07:45
In reply to Re: GREAT topic -- my answer is 'No, but...', posted by bulldog2 on May 31, 2008, at 18:34:46
> > > Can we really choose drugs based on known mechanisms?
> > >
> > > Are we really able to deduce our individual psychobiological abnormalities?
> > >
> >
> > I don't think there's enough information yet known for drugs to be chosen by mechanism. Just the fact that the SSRIs have such different effects, despite their related mechanisms, suggests that there's more to it than simply boosting one single neurotransmitter.Exactly
> > On the other hand, I do believe that past experience with medications can help suggest directions to explore. For example, I have done best on medications which target norepinephrine, and had problems with serotinergic medications. I'm much more willing to try the noradrenergic/dopaminergic medications than anything serotinergic, based on my own experiences. I don't think that's the same thing as being able to deduce my own biochemical eccentricities, though.But this, like everyone else's condition is individual, genetic, and a moving target over time.
>I don't believe there is enough information yet >known to say for certain that any particular >mechanism is The Cause of anyone's symptoms.
As my doctor has said, we're sort of in the middle ages of psychiatry. There is a lot we do not know about what certain psychoactive substances will do for one person or another. And psychiatry, though of course a medical field with scientific background, is yet more "of an art than a science."
That's one reason why importing prescriptions from secret no-question pharmacies over the internet is such a bad idea, not per se because of the quality, which is unknown sometimes, but because a doctor is not seeing you face to face, evaluating you, examining everything from body language to how you communicate.
> > And yet -- I do believe that prior experience with medications of various mechanisms can suggest directions to explore.
> >
> > How's that? "No, but..."That part I would agree with -- in the sense of how sensitive one is to side effects. But as said before since biochemical disorders change over a lifetime and some are known to become better with age such as some types of schizophrenia, and some we just don't know about.
There's an somewhat still new, expensive but given the green light scientifically for testing for certain P450 cytochrome deficiencies and metabolism, specifically 2D6 and 2C19, from Roche, called the Amplichip.
> yes i agree with you that depression is actually a symptom that is a sign of some physical disorder.Yes, it is only a symptom, just like dozens of anxiety symptoms are only symptoms, they don't actually say how many million cells need to be targeted, if that was even possible, which it isn't.
Similar to cancer which in my mind is actually many diseases with certain similarities.
> That's why there will never be a silver bullet that cures depression or cancer.Maybe in the end we will just have to manage it with many approaches and there will never be a cure.I wouldn't say never -- one can always dream, but I wouldn't say something any of us would see.
But yes, there is no magic bullet, I know from experience that has targeted a 7 year unwanted vacation with a disorder that mystifies trained neurologists -- and is a moving target.
There were points that "everything felt working to an extent" and I felt "on par" with society, but its different now and frustrating because it makes me feel alone to have the only disorder on the planet..
....the depression I can identify with others, but I never dreamed of taking antipsychotics in my life -- I only had a history of bad OCD that dissipated and some dysthymia.
And then a perplexing somatiform disorder came along that amplifies my vision and hearing 24/7 in ways that some could understand (natural phenomenon that are held longer and ignored like a gate or passed away in microseconds by others) and a few ways that are now coming out that are even more baffling like faster motion across my visual field in certain situations and staticky overlays when reading, e.g. (yes, MRIs fine and they wouldn't detect any disorder anyhow)
But anyhow that's just my story, I'm digressing.
I believe more that there will be cures or at least near lifetime remission rates for certain types of cancer in the lifetimes of some in this century.
Childhood leukemia has nearly a 90% success rate overall for people who meet certain criteria.
Some types of breast cancer caught early with regular mammograms and prostate cancer especially caught early with regular colonoscopies have better success rates (50% of most older males have BPH, or benign prostate hyperplasia which is not cancer).
There will be better vaccines, HIV treatment and possibly cures although it is a difficult moving target.
The real possibilities are stem cells for a number of conditions and there have been proof of concept for things including retinal regrowth in mice. This still remains a public controversy but private funding continues on.
If I were to say there were anything that there was a complete to limited cure now for are early caught strep throat and other non-complex antibiotic fought diseases. The trouble is the overuse of antibiotics and the ever increasingly sought fight for novel ones because for example 90% of things like pharyngitis are virally caused. The average person gets 1-5 infectious diseases a year and may not even be aware of all of them.
But then there are things like preventable conditions -- yes, quitting tobacco is very difficult and there are tons of arguments I can't list here but it equals the number of deaths by heart disease in the US for example, per year. Preventable flu deaths by vaccine may equal automobile incidents. At any rate, this is rather morbid, but regular physicals also have increased one's lifespan and reduced the load on hospital visits. Unfortunately there isn't universal coverage in the US and people without end up using the hospital as doctor visits (its illegal to turn away any patient with an emergency/illness at a hospital in the US)
Basically, there are no guarantees in anything in life but that doesn't mean the loss of hope or only looking or creating the most bleak scenarios (which I admit I do at times, I don't know where the future will bring me). Hope comes from within.But I want to emphasize also, that it isn't entirely the right polypharmacy that is the key to fighting a biochemical imbalance -- its also education about it and the fact that it takes someone with mental illness to have to work harder to succeed -- something that should empower people to seek therapy as well or self-help groups and keep as active as possible to fight off depression.
I'm not being Pollyanna --- there are serious disorders such as paranoid schizophrenia that may require a lot of medical intervention before someone has the hope of reintegrating with society in some capacity.
There is such a stigma still attached to mental illness and I rarely hear anything about such organizations as NAMI on here.
-- best wishes for a future worldJay
poster:yxibow
thread:830457
URL: http://www.dr-bob.org/babble/20080606/msgs/833578.html