Posted by DSCH on August 17, 2003, at 15:55:52
In reply to Lou's reply to jlo820, » jlo820, posted by Lou Pilder on August 17, 2003, at 14:52:17
Ritalin and Prozac, as a result of their extensive prescribing to segments of the American public, have excited much heated debate involving both health professionals and what I will term "interested and informed/misinformed patients, relations of patients, and interested bystanders".
This debate quite naturally results in the formation of two extremist camps:
"This Drug Cures (X) No Doubt About it!!"
"This Drug only makes (X) Worse and is Evil and a Menace to Society!!"
The problem lies in how psychoactive drugs are tested and how patients are treated by orthodox medical professionals.
In drug testing, the accepted approach is the double-blind trial which is analyzed statisically. The problem with this is that human beings are treated as identical "black boxes" with the same problem. For example, they are all "depressed" or all have "ADHD". There should be no surprise that patient responses are all over the map when you consider that:
A) Every human being has a unique combination of DNA and life history (including diet, stress, injuries, drug use/abuse, and exposure to toxic substances).
B) Syndromes overlap. One could concievably have, for example, mild OCD along with ADD without hyperactivity and yet get lumped in with everyone under the umbrella of "ADHD".
C) There can be multiple root causes for each particular symptom, i.e. there are more things that can go wrong in the brain than there are accepted symptoms that something is wrong. What the patient "feels" in a subjective and qualitative sense may not be adequately reflected in a list of symptoms.
Thus a psychoactive drug comes onto the market after having had a "good" double blind trial for FDA acceptance. If it becomes popular it ends up being widely prescribed to patients who are asked about their history in a very cursory manner and with virtually no diagnostic tests being done (i.e. blood tests or brain imaging like SPECT). Naturally some people have horrendous side-effects and their stories become fodder for the "Evil Drug" partisans. Meanwhile the many people who are helped consider it important to throw their weight in with the "Great Drug" partisans.
The real answer is that we need greater discrimination in identifing the real problem(s) and then the ability to scientifically rather than "artistically" tailor treatment for that individual.
"Ask not what disease the person has, rather ask what *person* the disease has."
Neuroscience and MEMS/nanotechnology should be bringing a lot more light to bear on all this within the coming years. Remain hopeful!
poster:DSCH
thread:251524
URL: http://www.dr-bob.org/babble/20030812/msgs/251620.html