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Re: We need placebo SLS

Posted by ed_uk on July 31, 2005, at 13:39:42

In reply to Re: We need placebo ed_uk, posted by SLS on July 31, 2005, at 7:44:25

Hi Scott,

>Another aspect of the study of individual compounds as antidepressants is that any one antidepressant may work for only a fraction of an ultimately responsive population. We know this to be true.

Absolutely. Now we need a better method of determining which drug is likely to work for a particular individual!

>Yet, we place demands upon new drugs that they be able to produce response rates tantamount to being silver bullets.

Very true..... and we'll never have a silver bullet which effectively treats all forms of depression.

>If each of 5 antidepressant drugs work in only 35% (compared to the generally observed 70%) of cases in different sets of people, depending on the heterogeneity of the population and the degree of overlap, you could conceivably cull a 95% rate of remission.

Excellent point. We need a variety of drugs with different mechanisms of action so that this can be the case. We don't need another ten SSRIs! Hopefully we'll soon have Valdoxan...... and I do hope that none of the TCAs or MAOIs are discontinued. It would be a truly depressing situation if the SSRIs and SNRIs were all we had to work with. I remember when my doctor said that he'd 'never needed to use an MAOI'. What rubbish. What about his patients who were chronically incapacitated - living in psychiatric residential homes?

In the UK at least, we urgently need to move away from the idea that people who's depression doesn't respond to SSRIs and SNRIs are untreatable. Psychiatrists must be willing to utilise a wide variety of treatment options in order to help as many patients as possible.

>From what I understand, new data on gepirone is to be included in a resubmission to the FDA by the manufacturer.

>placebo response of 1/3

If the studied population consists mainly of people suffering from relatively mild acute depression, spontaneous recovery might account for the high rate of 'placebo' response.




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