Posted by 49er on October 27, 2010, at 15:31:24
In reply to Re: various bipolar meds, posted by SLS on October 27, 2010, at 12:51:52
> > Just so people know this isn't anti drug rant, I have seen mainstream psychiatrists come up with studies that show that poly pharmacy is not more effective than being on as few drugs as possible.
>
> You read the wrong stuff!
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> I've seen such literature. I don't know what the logic is behind rejecting rational polypharmacy in psychiatry. In cardiology, it is the rule rather than the exception to treat congestive heart failure with multiple drugs. Where is the scientific evidence that one antidepressant is better than two?
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> I read a recent study that concluded that it can make sense to start a patient on two antidrepressants simultaneously; the thought being that the two drugs have demonstrated a synergism that perhaps is the result of complementary mechanisms of action. The only time I responded robustly and persistently to antidepresseant treatment was when two drugs were combined and started simultaneously. Interestingly, I had already failed to respond to each of these two drugs monotherapeutically
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> I am trying to find the article so that we can critique its results and conclusions. No luck so far.
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>
> - ScottScott,
I don't mean to sound like a smart alleck but if polypharmacy is as wonderful as you say it is, why haven't you found the right combination?
Anyway, you might want to read this article on antipsychotic polypharmacy.
I am inferring that the studies have been limited but based on what exists, antispsychotic polypharmacy is not effective and greatly increases the side effects.
You also might want to read this blog entry:
http://davidmallenmd.blogspot.com/search/label/polypharmacy
A study of antidepressant and antipsychotic treatment effects showed there is an emphasis on "polypharmacy" in clinical practice, without much evidence of benefit and an increase in adverse effects. Swiss investigators reported these findings at the 23rd European College of Neuropsychopharmacology Congress (23rd European College of Neuropsychopharmacology (ECNP) Congress: Abstract P.2.c.019. Presented August 31, 2010).
"In our study, we found no advantages for 'complex' treatment approaches over conventional monotherapeutic approaches," said senior investigator Hans H. Stassen, PhD, of University Hospital of Psychiatry in Zurich, Switzerland. "There appear to be no controlled studies showing the superiority of combinations of drugs over [a single drug (monotherapy)]. We looked at this because we have observed in clinical practice that response rates are less and side effects are greater." (reported by Medscape).
49er
PS - By the way, the woman said her drug combination falls apart whenever she encounters a stressful situation. Doesn't sound like polypharmacy is working as life is not stress free,
I don't mean to sound flippant by the way but unfortunately, that is the way it is.
poster:49er
thread:966733
URL: http://www.dr-bob.org/babble/20101020/msgs/967145.html