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Re: Medications that don't touch the 5HT1 receptor? SLS

Posted by phidippus on June 14, 2015, at 16:49:11

In reply to Re: Medications that don't touch the 5HT1 receptor?, posted by SLS on June 13, 2015, at 10:06:11

I asked that he consider the placebo effect.

If a patient takes a pill that normally takes weeks to work and reports an improvement within the first few days, I'm inclined to suspect a placebo effect. Especially if the improvement is transitory.

I see this all the time amongst patients taking antidepressants, especially for anxiety disorders. Though it may be a variable phenomenon, this pattern certainly exists.

>Ever hear of ultradian rapid cyclicity?

I am an ultradian rapid cycler, with many mood shifts within a 24 hour period.

>I would not be inclined to call this a placebo effect, especially when someone presents this way as their untreated baseline as their index condition.

I have no idea what the patients's untreated baseline is. Nor do you. But I'm inclined to think placebo effect based on experience with many patients.

>Insisting on dismissing a patient's report of a transient improvement with medication can be confusing and belittling.

I'm not dismissing a patient's report of a transient improvement with medication. All I'm saying is "hey, this medication-in the vast majority of cases-takes weeks to work. Its great that you felt better for a few days, but it probably wasn't because of the medication. There is no need to think your medication has stopped working. It hasn't really started."

Also, why shouldn't we diminish a patient's report of a transient improvement? Is an improvement within the first few days of traetment with an antidepressant important? What does that mean that we shouldn't consider the placebo effect?

There's nothing insulting about the placebo effect. Its just something that happens.

Eric


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poster:phidippus thread:1079343
URL: http://www.dr-bob.org/babble/20150520/msgs/1079765.html