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Re: Statistical question on SSRIs - ADDENDUM

Posted by linkadge on May 20, 2006, at 2:48:48

In reply to Re: Statistical question on SSRIs - ADDENDUM » Squiggles, posted by Larry Hoover on May 16, 2006, at 10:04:04

>But it is not relevant, IMHO, to even do such a >study. What would it tell us? We already know >what's missing from the care received by >depressed people. It is management of the >treatment. That's where we fall short. You >can't just hand a depressed person powerful >drugs, and leave him on his own.

Granted, the SSRI market has taken a drop in sales since the introduction of such reports.
It is still absolutely necessary to guage the extent of the problem so long as SSRI's are being prescribed.

Consider a lesser problem induced by the SSRI's. Sexual side effects are not argued against, (except by some doctors). Initially, such side effects were thought to occur in only a very small number of patients treated. As time progressed, we can piece together a better picture based on may different types of evidences, that a significantly greater proportion than originally estimated are thought to experiences such effects.

We need to get inventive. Where there is a will (plus a little cash) there is a way to find out what we are dealing with. No it won't be exact. But, I am willing to make decisions based on stastical significance.


The problem is important, and could be underestimated for many reasons. The "excuse" is that the patient group is depressed to begin with. Looking from another angle, this is an additional reason why the problem can be *underestimated*, these people are depressed to begin with. It is highly likely that such a group could confuse drug induced suicidiality with the feelings of their own illness. Same thing went with sexual side effects, its just going to be pawned off as a "consequence of depression".

These are peoples lives, and if we cared, we'd get inventive.


>IMHO, the problem has never been the drugs. It >has always been the people who were let down by >other people. We haven't taken the illness >seriously enough. Don't forget, fifty years >ago, nobody talked about mental illness at all. >We built great buildings, and populated them >with people who otherwise virtually ceased to >exist. We haven't come too far from that period >of great stigma. Don't kid yourself.

Management can only go so far, you first have to admit there is a problem, and understand the problem. Its like saying to an MAOI user, "call me if you start to have chest pain", thats useless; too little too late. Again, the patient may be suicidal to begin with. Suicidal means, I don't want to live anymore. You make sombody suicdial and they can go at any moment. You cannot underestimate suicidality, and you cannot make a paitent responsible for their own suicidiality. That is why it is absolutely necessary to try and identify who may be at increased risk of such occurances.

It has always been the drugs. Somebody would never say that SSRI induced anorgasmia and genital anesthesia was not an effect of the drugs. SSRI's are very effective chemical castration. That is a *real* drug induced side effect. I don't see how all of a sudden drug induced suicidialty falls a whole new category of "meh".

Oh, its too difficult to ascertain, so lets just sweep the notion under the carpet.

Its not too difficult to ascertain, but we need to be inventive.

Linkadge


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