Posted by linkadge on April 25, 2010, at 20:53:31
In reply to Re: Multiple drug exposures and treatment resistence » ed_uk2010, posted by Phillipa on April 25, 2010, at 20:26:22
I dunno.
Which scenario is easier to prove?
The forward direction is easy to see:
Logically, a patient who has inherently treatment resistant depression (to start with) will fail many antidepressant trials.
Proving the converse, that infact multiple antidepressant exposure *produces* treatment resistance requires comprehesive analysis. The study only notes a correlation.
In order to prove this assertion you would need to find a group of patients who:
a) had sucessful initial trials with tidepressants
b) didn't come off this antidepressant because of poop out
c) retried other antidepressants in a similar fashon
d) only later became treatment resistant
Failing any of these, you introduce other possibilities. For instance, if the patient comes off the antidepressant because its not working anymore, then logically they are starting to show signs of resistance even before a subsequent agent is introduced.
Of course it has been a theory that those who keep coming on and off antidepressants fair more poorly, but I would argue the other way around. That people come off the drugs because they're not doing a heck of a lot of good for them.
Linkadge
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URL: http://www.dr-bob.org/babble/20100425/msgs/945067.html