Falling STAR*D?: It is common practice for psychiatrists to switch depressive patients between different antidepressants if their current drug does not evince a symptomatic response. Despite clinical wisdom supporting this, little empirical, controlled evidence exists to direct “switching” protocols (e.g. if a patient with Z characteristics is on drug X, is it usually better to switch to drug A, B, or C? Will switching help at all?) in the psychopharmacological treatment of depression. The NIMH-funded
STAR*D (Sequenced Alternatives to Relieve Depression) study aimed to address these questions of treatment direction in a very large (n>4000), “real-world” sample using a
multi-phase treatment plan with different drugs (and cognitive therapy) at every step to maximize chances of eventual remission. Overall, the NIMH reported that about
67% of patients eventually achieved remission,
with few differences in effectiveness between different types of treatment at each step. However, researchers and commentators have
raised concerns regarding inconsistent reporting of outcomes, after-the-fact changes in
study design and analysis, and other issues that may have inflated, partially invalidated, or misrepresented widely reported treatment outcomes. These inequities may also have implications for the secondary moderator analyses (i.e. does trait A predict switching to X or Y is better?) that were a major reason for the study.
[more inside]
posted by Keter
on Jan 14, 2012 -
12 comments
Suppose you have a problem with your thinking, your mood, or your relationships. Come in, sit down, and let the internet help. Meet
MoodGym and its newer sister site,
e-couch.
[more inside]
posted by sondrialiac
on Jun 15, 2008 -
8 comments
With a newly indurated PPD in my arm, I went looking for tuberculosis resources. According to the WHO over
2 million people a year die of tuberculosis. About a third of the 40 mil. people infected with HIV worldwide are also infected with TB. Successful treatment takes
6-9 months of powerful antibiotics, but that's assuming the bacteria in your body aren't
drug resistant. Epidemics of drug resistant TB are raging in some parts of Central America and in the
Russian prison system. Paul Farmer is the man for treating it, and quite a
good man in general.
On the plus side, possibly having TB puts me in good company:
Orwell,
Kafka,
Chekhov,
Chopin, and the 70s favorite mummy,
King Tut all had it. Every one of the
Brontes did too, and they were all geniuses. Of course they all died of it. On a more sober note, if I do have to get treatment, but I refuse, I might be
ordered to take medications by a
judge.
posted by OmieWise
on Dec 2, 2004 -
11 comments
Prozac Found in Britain's Drinking Water. Norman Baker, environment spokesman for the Liberal Democrats, said it looked "like a case of hidden mass medication upon the unsuspecting public."
Or possibly something less alarming, like the recycled leftovers from the public waste... either way, very disturbing.
posted by Espoo2
on Aug 8, 2004 -
54 comments
Nootropics ("smart" drugs) - all wish to be smarter, correct ? And - while exercise, nutrition, learning, travel, and social interaction (the last 3 via release of
neurotrophins) effectively do this, Nootropic drugs have been researched since the 1950's and have been shown to cause at least short term cognitive function enhancement. Piracetam, the first of this drugs,
shows promise in the treatment of Alzheimer's and Attention deficit Disorder. Alas, as with poor little
Algernon, the effect seems
temporary. Nootropics can be a little
difficult to acquire in the US.
Beer is not a nootropic, but sex on the other hand.....
posted by troutfishing
on Mar 5, 2004 -
20 comments
Pills for Problems: The
British have taken steps to restrict the use of some antidepressants.
Breggin and others have been warning us for some time now about the many problems with medicating behavior. The Big Picture: Aren't "medications" (legal or not) used for behavioral problems just an
excuse for us not
controlling ourselves?
posted by ewkpates
on Dec 16, 2003 -
111 comments
Is forcing a prisoner on death row to take antipsychotic medication to make him sane enough to execute cruel and unusual punishment? (NYT link) A federal appeals court ruled that officials in Arkansas can force a prisoner on death row to take antipsychotic medication to make him sane enough to execute. The problem is that the American Medical Association's ethical guidelines prohibits precisely that.
To make the case more surreal, a representative of the Arkansas attorney general's office who argued for the state later said: "The ethical decisions involving doctors are difficult ones, but they are not ones for the courts". Does this mean that COs -Correction Officers- are to figure out for themselves which medication to administer? Do they also call the shots when deciding if the "waiting" patient is sane enough???
posted by magullo
on Feb 11, 2003 -
58 comments
Inside the JFK medical files. Very interesting article from Sunday's NY Times (reg. req'd) about the long-term health of John F. Kennedy, from World War II to his death. Corresponding Yahoo News item
here also. [more inside...]
posted by PeteyStock
on Nov 19, 2002 -
11 comments
Move over, Jared... there's going to be a hot new way to lose weight. Scientists have "found the chemical pathways that muscle cells use to build strength and endurance," making it possible to have a fitness pill.
posted by Kevin Sanders
on Apr 11, 2002 -
9 comments
