Posted by jay on April 15, 2002, at 21:52:44
In reply to Marketing Hype and Specificity of Drug Treatments » alan, posted by fachad on April 15, 2002, at 15:59:21
I just wanted to add a "me too" to your comments. Another area I think that really is scarry is the rationale for use of anti-psychotics for anxiety. (Doc's seem to think anxiety=mania. Can't sleep?..hhmm..must be manic!) So, they are not only putting people at risk for TD and EPS, but at a great financial cost, rather than using *the only 100 percent proven* cure for anxiety, which is benzos, and which are WAY cheaper...about the cost of a bottle of aspirin.Okay.../rant
Jay
> >I was not aware until elizabeth's post that ssri's and other AD's disrupted or changed sleep architecture.
>
> I think I might have missed that post. Was it recent?
>
> >The sleep study would only confirm, scientifically speaking, what elizabeth described.
>
> I don't know what was in the post, but sleep studies have been done, and SSRIs have been shown to invariably cause severe disruption of the sleep architecture. The makers of Serzone and Remeron funded the studies, and SSRIs were used as "controls" i.e., it was a setup to make their drugs look good because they already knew how badly SSRIs would perform on the sleep architecture parameters.
>
> >I fired two docs because of their anti-bzd bias. I essentially wasted 7 years at a very important time in my life because of that bias.
>
> Yeah, I wasted a number of years trying ADs when stimulants were really the best for me. I used the SSRI vs. benzos for anxiety as an example of drug company marketing hype because it's so obvious to me and I have no personal stake in the matter because I don't have any clinically significant anxiety.
>
> >Anyway, if you want to know my opinion, AD's are indicated when depression is primary and anxiolytics when anxiety is primary.
>
> I'm somewhat skeptical about the validity of DSM-IV diagnosis. I think they are a convenient way to group symptoms and present something “scientific” sounding to third party payers, but I don't think they are as valid as medical diagnosis like streptococcus caused strep throat.
>
> The one thing I absolutely don't buy into at all is medication treatment specificity in psych disorders. By that I mean I don't think one class of meds is always indicated in one class of disorders.
>
> Benzo's probably help some depression patients. Mood stabilizers help some anxiety patients. ADs help some OCD sufferers. Stimulants help some depression patients, and that does not necessarily mean those patients "really had" undiagnosed ADD all along.
>
> The diagnosis are somewhat questionable, but the specificity of treatment concept is a carryover from the germ / antibiotic medical model and it just does not hold water in psych disorders.
>
> It's a real shame in that it limits the possible treatments that are tried and also results in a diagnosis in the event of response. "Oh, I guess you really had (whatever) disorder, because you responed to (whatever class) of meds. Now expect these symptoms too, because they go along with your disorder."
>
> >Anxiety patients go through life thinking that that's just the best meds have to offer without having been given the freedom of choice to try bzd's on equal footing with ssri's and similiar drugs.
>
> Yes, and they have to PAY more for those less effective SSRIs, too. And depression patients go on from one ineffective, side effect laden AD to another, without trying stimulants, unless there is some indication of ADHD, or without trying benzos, unless there is evidence of GAD, or whatever...
>
> Well, this has turned into another rant. I just need to do that once in awhile.
>
> -fachad
poster:jay
thread:103076
URL: http://www.dr-bob.org/babble/20020408/msgs/103188.html