Posted by SLS on January 3, 2013, at 0:33:00
In reply to Tardive Dysphoria - Does it scare you too?, posted by Prefect on January 2, 2013, at 22:13:58
The existence of tardive dysphoria has not been proven, although it may occur. Here is the abstract of the G. Fava (as opposed to M. Fava) paper:
http://www.ncbi.nlm.nih.gov/pubmed/12633120
I haven't seen any retrospective investigations producing numbers to scrutinize. It would be difficult study prospectively - and perhaps unethical. Your case does not support Whitaker's argument. You didn't have major depressive disorder (MDD) 16 years ago when you first started antidepressant treatment, and you still don't have it. The "oppositional" explanation is nothing more than a theoretical model at this point. There are some observations that support its occurrence, though. Changes in receptor numbers (upregulation or downregulation) is a consistent observation with antidepressant drug exposure. There are probably other compensatory reactions as well. However, it might very well be that these compensatory "oppositional" phenomena are precisely what is needed for these drugs to work. The course of untreated depression is one of increasing severity. It would be difficult to prove that the worsening reported by Whitaker should be explained by tardive dysphoria rather than being the natural course of the illness.
What do I believe? While I do believe that tardive dysphoria is a possibility, I am not convinced that it occurs with great frequency. Robert Whitaker would have us believe that it is ubiquitous. This comes from a person who states that he doesn't even believe that antidepressants work in the first place. They appear to work for you and me. Whitaker writes books and articles as a reporter without having a Ph.D. or M.D. Or course, I also write stuff without academic credentials. However, I find Whitaker's arguments to be circumstantial rather than scientific. I don't think he has been able to prove cause and effect, either physiologically or epidemiologically.
It is only natural that you should be concerned after reading the article that you found. In your subject line, you asked "does it scare you?" The answer is "no", it does not scare me. I am keeping an open mind, though. Personally, I feel that the benefit to me is worth the theoretical risk.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1034522
URL: http://www.dr-bob.org/babble/20121231/msgs/1034533.html