: 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 -
The Brain on Trial.
Advances in brain science are calling into question the volition behind many criminal acts. A leading neuroscientist describes how the foundations of our criminal-justice system are beginning to crumble, and proposes a new way forward for law and order.
"We may someday find that many types of bad behavior have a basic biological explanation—as has happened with schizophrenia, epilepsy, depression, and mania." [more inside]
posted by Eideteker
on Jul 15, 2011 -
The Prozac, Paxil, Zoloft, Wellbutrin, Celexa, Effexor, Valium, Klonopin, Ativan, Restoril, Xanax, Adderall, Ritalin, Haldol, Risperdal, Seroquel, Ambien, Lunesta, Elavil, Trazodone War
New York Magazine's Jennifer Senior writes on prescription drug (ab)use among soldiers and veterans of Iraq and Afghanistan. [more inside]
posted by l33tpolicywonk
on Feb 15, 2011 -
Interview with Profiler Roy Hazelwood.
Enough to make you feel a little less safer, and to marvel at both the "the infinity of darkness," the depths of potential monstrosity, and the ability of some to understand broken minds and bent hearts. "'If I were to give you each a test, could you take it the way you think this offender would take it?' We said yes.... Both of us came out as paranoid schizophrenics. The psychiatrist was astounded. We sat there and tried to take the test as we thought the guy we had in mind would take the test. "
posted by namespan
on Aug 2, 2003 -
Utah Leads Nation in Rate of Anti-Depressant Use.
It is interesting (to me) in that the people doing the study credit a "Mother of Zion" syndrome of married Mormon women putting on the happy face regardless of how happy they truly are. My state is up at the top also. Could be all the rain I guess. . .*sigh*
posted by Danf
on Feb 20, 2002 -