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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by noa on November 3, 2000, at 14:24:53
Posted by SLS on November 3, 2000, at 21:09:25
In reply to Research:difs bet SSRI responders non-responders, posted by noa on November 3, 2000, at 14:24:53
> http://www-east.elsevier.com/bps/abstracts/5014abs.htm
Hi Noa.Keep 'em coming.
Two of my Columbia buddies were in on this one: Quitkin and McGrath. As I read it, the differences were response vs nonresponse to Prozac (fluoxetine).
1. It cannot be extrapolated to other SSRIs.
2. Without a comparison to other types of antidepressants such as tricyclics, MAOIs, Remeron, Wellbutrin, and Serzone, the possibility exists that the dichotomy represents response vs nonresponse to antidepressants in general.
What elsevier URL allows you to access a table of contents for past abstracts?Thanks.
- Scott
Posted by Seamus2 on November 3, 2000, at 21:25:45
In reply to Research:difs bet SSRI responders non-responders, posted by noa on November 3, 2000, at 14:24:53
>http://www-east.elsevier.com/bps/abstracts/5014abs.htm
Fascinating! But what the heck does dichotic mean?
Seamus
Posted by JohnL on November 4, 2000, at 5:13:22
In reply to Research:difs bet SSRI responders non-responders, posted by noa on November 3, 2000, at 14:24:53
>
>
> http://www-east.elsevier.com/bps/abstracts/5014abs.htmVery interesting. I usually prefer to look at the bright side of things. I also always try to poke holes in theories and find flaws.
The bright sides of this study are obvious. Being able to predict response or nonresponse to Prozac based on EEG tests could be of huge benefit to the suffering patient.
The downsides.
I wonder how expensive this is? Probably not an issue, but just curious if it costs $50, $100, $200, $500, or what?
If the patient is predicted to be a nonresponder, what next? Yikes. We're right back where we started. I guess at least we eliminated one drug choice from the multitude of options.
The test predicts response to 12 weeks of Prozac treatment. 12 weeks? That's a long long time. I wonder, have any of these researchers ever experienced depression themselves? I mean, 12 hours is an eternity. 12 days is incomprehensible. And 12 weeks is out in the ozone. It's not even on the radar screen from a depressed person's point of view.
Almost any drug chosen purely at random is more likely to work than not if given 12 weeks. Even if a drug is way off target, 12 weeks is plenty of time to cause change reaction domino effects that eventually get through the maze to the real problem.
If this test predicted a 50% response in one week, that would be worth its weight in gold. But 12 weeks? I don't see much value in that compared to simply pulling a random drug out of a hat.
I'm just thinking out loud. This test is fascinating. It provoked me to ponder the pros and the cons. I just wish overall researchers would put more emphasis on getting patients well real fast. Too many people commit suicide, get divorced, lose friends, lose jobs, or slip through the cracks while waiting so long for a drug to take effect. I think that's where smart researchers looking for a Nobel Prize should be focusing their efforts.
Johnps...kind of off-topic, but...back in the 1980s a study was done that proved helpful in predicting response. In the study, a good response to Ritalin predicted a good response to Desipramine. If the response to the Ritalin test was not good, it predicted a good response to Nortriptyline. I wonder why no one ever expanded on this? In my own n=1 test, I verified it. Unfortunately I just couldn't deal with the impotence and tinnitus of Desipramine, but the test proved valid for me. Obviously n=1 is meaningless, but was still intriguing to ponder.
Posted by Noa on November 4, 2000, at 10:27:48
In reply to Re: Research:difs bet SSRI responders non-responders, posted by JohnL on November 4, 2000, at 5:13:22
It is interesting, isn't it? Thanks for pointing out the limitations of the study. I guess I see this as a very preliminary study, not one that is useful in clinical practice yet. But, perhaps it will lead eventually to being able to use EEG, or imaging, etc., or even to a more cost efficient method of identifying a "marker" of some sort to identify more specifically what kind of depression and what kind of medication might work. For now, it is a step in better understanding as to why some meds work on some people and not others. But just a baby step, maybe.
This is the end of the thread.
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