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Chemical imbalance lie

#11
Syne Offline
(Dec 31, 2017 07:50 AM)Magical Realist Wrote: You do realize that the anti-medication movement is just one step away from the anti-vaxxers?

Straw man, as no one said anything about medication in general. Rolleyes

Quote:http://metro.co.uk/2017/08/18/inside-the...t-6861500/

Really? A "Lifestyle editor"? Rolleyes


But whatever you need to keep your own placebo effect going.
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#12
Magical Realist Offline
Quote:But whatever you need to keep your own placebo effect going.

Yeah..you and the Scientologists..lol! Knock yourself out over this. We'll keep a light on..
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#13
Syne Offline
(Dec 31, 2017 08:49 AM)Magical Realist Wrote:
Quote:But whatever you need to keep your own placebo effect going.

Yeah..you and the Scientologists..lol! Knock yourself out over this. We'll keep a light on..

LOL! So all those sources I cited are Scientologists? Rolleyes
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#14
RainbowUnicorn Offline
(Dec 31, 2017 03:59 AM)C C Wrote:
(Dec 31, 2017 12:16 AM)Syne Wrote: [...] Prozac, approved by the US Food and Drug Administration 30 years ago today, on Dec. 29, 1987, marked the first in a wave of widely prescribed antidepressants that built on and capitalized off this theory.


Had an awkward debut as a numbered compound looking for a condition to treat when first developed in the early '70s. The Eli Lily company tested it as a high blood pressure agent and then as an anti-obesity drug. After one trial with a handful of subjects finally had success improving their mild depression, Interbrand contributed the "Prozac" name for it. In a marketing strategy move, Eli Lily dredged up and promoted the chemical imbalance theory to explain the supposed effectiveness. The practicing mental health community bought into it and spread the gospel to patients. A tradition of psychobabble was eclipsed by biobabble. [Though barring the possibility of being totally a placebo effect, there may still be biological / physiological reasons for the results. Daniel Carlat: ". . . [the] unequivocal, if perplexing truth about psychiatric drugs” [is that] “they work”.

- - -

i wish to exercise caution here on the subject for anyone who may be taking meds.
always talkto your specialist before you change anything or if you dont feel right.
always keep regular catch ups with your doctor to keep them advised of how they are making you feel.

with that in mind, i draw those who read on these things to ask the question around increased suicide within the first 90 days of taking anti depresants.
i am not saying it makes peopel suicidal, i am saying there is an observed increase incidence in suicide of those who start taking anti depresants and this is a well known concept.
it should be mentioned by prescribers to the patient and ongoing monitoring and counselling should always be included in the over all ongoing treatment.

there is some interesting data suggesting shorter more highly managed use with CBT that can deliver some long term excellent outcomes without the long term issues around behaviours and side effects that are potentially created or symptomatic of people suffering mental illness.

it is a highly complex field and almost every patient is unique to some point.


you should always consider yourself unique in your response to serious medication and keep close to your doctor so they may track and manage safely how the drugs are working and in what way.

to use an extremely simplified way to define the complexity of the issue is
PTSD
obviousely a very real and serious condition.
the focus should be on the patient rather than trends of colloquialized concepts.

Generically speaking there is an air of mystery surrounding most psychiatric medication and how it actually works specifically.
the focus should be on the patient, seeking tools through specialists and those medications they find safe and fit to work short term and or long term.

i worry that the anti science brigade and the pray the gay way cults may seek to produce media that is attempting to directly interfear with patients and their doctors.
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#15
Magical Realist Offline
Quote:So all those sources I cited are Scientologists?

You mean that English professor Lennard Davis and some "weekend writer" named Olivia Goldhill? lol! Yeah, that was some riveting data. Who you gonna quote next? The clerk at your local 7-11?

None of your opinion pieces hold a candle to the studies I cited. As well as to this meta-analysis:
=====================================================================
"Investigators are hoping a new "mega-analysis" puts a final cap on the ongoing controversy over whether antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), are effective for depression.

The review of 15 studies, with more than 3300 patients, showed that compared with those who received placebo, participants without early adverse events (AEs) who received either of the SSRIs citalopram (multiple brands) or paroxetine (multiple brands) had significantly greater reductions in symptoms, as assessed with the Hamilton Depression Rating Scale (HDRS) depressed mood item.

Previous research suggests antidepressants' superiority is "merely a psychological consequence of the side effects of the drugs enhancing the expectation of improvement," the investigators write.

However, the new analysis showed that patients who had early AEs and who were receiving one of the active drugs also had significantly greater reductions in symptoms vs their counterparts who were taking placebo. This suggests that "the severity of the adverse events did not predict response," the investigators write.

"I think, once and for all, we've answered the SSRI question. And we have effectively rebutted the side-effects theory," principal investigator Elias Eriksson, PhD, professor of pharmacology at the University of Gothenburg, Sweden, told Medscape Medical News.

And the number one take-away message for clinicians? "It's that SSRIs work. They may not work for every patient, but they work for most patients. And it's a pity if their use is discouraged because of newspaper reports," he said.

The findings were published online July 25 in Molecular Psychiatry."----https://www.medscape.com/viewarticle/884921

More on the same study:

"A theory that has gained considerable attention in international media, including Newsweek and the CBS broadcast 60 minutes, suggest that antidepressant drugs, such as the SSRIs, do not exert any actual antidepressant effect. A research group at the Sahlgrenska Academy has now analyzed data from clinical trials and can rebut this theory.

According to the challenged hypothesis, the fact that many people medicating with antidepressants regard themselves as improved may be attributed to a placebo effect, i.e. that someone who expects to be improved by a medication often also feels improved, even if the medicine lacks actual effect.

However, if SSRIs had indeed acted merely by means of a placebo effect, these drugs should not outperform actual placebo in clinical trials where patients have been treated with an SSRI or with ineffective placebo pills, and where neither the physician nor the patient knows which treatment the patient has been given until the study is over.


To explain why antidepressants in such trials nevertheless often cause greater symptom relief than placebo, it has been suggested that SSRI-induced side effects will make the patient understand that he or she has not been given placebo, hence enhancing his or her belief of having been given an effective treatment.

The beneficial effect of SSRIs that has been shown in many studies should thus, according to this theory, not be due to the fact that these drugs exert a specific biochemical antidepressant action in the brain, but that the side effects of the drugs enhance a psychological placebo effect.

This theory has been widely disseminated despite the fact that there has never been any robust scientific support for it. Thus, so far, it has never been investigated whether individuals in clinical trials experiencing side effects from antidepressant medication, and for this reason may have guessed that they have not received placebo, also respond more favorably to treatment than those without side effects.

In order to examine the "placebo breaking the blind" theory, a research group at the Sahlgrenska Academy in Gothenburg, Sweden, has now analyzed data from the clinical trials that were once undertaken to establish the antidepressant efficacy of two of the most commonly used SSRIs, paroxetine and citalopram.

The analysis, which comprised a total of 3 344 patients, shows that the two studied drugs are clearly superior to placebo with respect to antidepressant efficacy also in patients who have not experienced any side effects. The theory that antidepressants outperform placebo merely by means of side effects making the patient realizing that he or she has not been given placebo, and herby enhancing the expectancy of improvement, may hence be rejected.

The researchers conclude that this study, as well as other recent reports from the same group, provides strong support for the assumption that SSRIs exert a specific antidepressant effect. They suggest that the frequent questioning of these drugs in media is unjustified and may make depressed patients refrain from effective treatment."----https://www.sciencedaily.com/releases/20...102318.htm
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#16
Yazata Offline
(Dec 31, 2017 12:16 AM)Syne Wrote: Chemical imbalance lie

The word 'lie' means to knowingly speak falsely, with intent to deceive. So what justifies the use of the word 'lie' in this thread's subject line (and in the title of the opinion piece quoted)?

Stuff about Hippocrates and Prozac snipped because it has doubtful relevance to Olivia Goldhill's thesis. Which seems to be this:

Quote:One reason the theory of chemical imbalances won’t die is that it fits in with psychiatry’s attempt, over the past half century, to portray depression as a disease of the brain, instead of an illness of the mind. This narrative, which depicts depression as a biological condition that afflicts the material substance of the body, much like cancer, divorces depression from the self.

It's a philosophical complaint. Olivia seemingly wants to argue in favor of some kind of brain-mind dualism.

As for me, I do think that psychiatric problems most likely have a neurophysiological basis. So I disagree pretty emphatically with Olivia's thesis, which reminds me of the 50 year old views of Thomas Szasz.

The problem with psychiatry (and clinical psychology) is that nobody really understands how the brain and the rest of the nervous system actually work. It's just too complex. Psychiatric problems seem to arise deep down in there somewhere, but precisely how and why is a mystery. It's the same situation that conventional medicine was in, in ancient and medieval times before physiology and the germ theory of disease.

So like the physicians of the past, psychiatrists today are reduced to treating symptoms instead of the underlying disorders that cause the symptoms.

I think that most of the psychiatric drugs in use today do seem to work, some better than others, on some patients better than others. Clinical depression (they call it Major Depressive Disorder MDD) seems to be one of the difficulties that's more resistant to treatment in this way. There's a significant fraction of patients that experience little beneficial effect.

If anyone thinks that they can do better, I'd like to see some evidence of it.
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#17
C C Offline
RainbowUnicorn Wrote:there is some interesting data suggesting shorter more highly managed use with CBT that can deliver some long term excellent outcomes without the long term issues around behaviours and side effects that are potentially created or symptomatic of people suffering mental illness. it is a highly complex field and almost every patient is unique to some point.

Not surprising that psychotherapists champion alternatives to their rivals' substance remedies. But we should clarify in this thread that questioning the so-called "chemical imbalance theory" as having ascended to popularity through proper procedures doesn't equate to dismissing any biological / physiological causes and a denial that drugs can be effective (regardless of the selected explanation) anymore than criticizing jihadist terrorism is a censure of Islam.

(Dec 31, 2017 02:22 PM)RainbowUnicorn Wrote: i worry that the anti science brigade and the pray the gay way cults may seek to produce media that is attempting to directly interfear with patients and their doctors.


I doubt that there's any neat correspondence to political borders in this area, and in a sense that goes beyond just the in-common conspiracy afflictions they share.

The money-makers on the conservative and religious side are as much receptive to supporting the interests and pocketing money from the pharmaceutical industry as their culturally isolated counterparts or fringe-weirdos are in spurning the mainstream system for rugged individualist self-treatment, herbal remedies, "leave it in the hands of God" and snake-handling.

On the other side there's a similar dichotomy between affluent or corporation-backed progressives and the contrasting rogue slash outland descendants of the New Left and hippie activity of the '60s (their anti-vax community, alternative medicine, "get in tune with the nature goddess", disgust for commercial empires and Big Pharma).

Which is to say, the go-getter financial factions of both right and left will continue to ensure that medicine producers and their amply compensated practitioners / dispensers are legislatively defended and bolstered with widespread positive propaganda to counteract the influence of cult / survivalist outhouse cultures and eccentric socialist Wandervogel tribes.

With respect to doctors, they're recruited into the Good Ol' Boy Network like any other category of practicing professionals. And rival psychotherapists keep tabs on what biomedical mental healthcare experts are up to in that department. I chose Daniel Carlat as a neutral sphincter because he's gone the rounds of being officially bought-out by pharmaceutical psychiatry while still defending the effectiveness of the drugs even after coming out of that closet (albeit in perplexed or mysterion mode as to why they work).

- - -
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#18
Magical Realist Offline
The real "lie" here at the heart of the anti-medication movement is that being depressed or bipolar or OCD or traumatized or ADHD or schizoid or an addict is all your fault. That you should just pull yourself up by your own bootstraps and make yourself better with positivity and good diet and exercise. That is yet another attempt to re-stigmatize mental illness and make it into a character flaw and something to be ashamed of. The first step in mental illness recovery is admitting you have a problem and getting help for it. The anti-med movement wants you to believe there is no outside help for you and you can cure yourself thru willpower and positive affirmations. That mental illness is a myth foisted on us by Big Pharma and the psychiatric community. The reality is that accepting your condition as a brain disorder is a major breakthrough in the recovery process, a reprieve from any shame or guilt you may bear over it, and a discovery that you are not as alone or unique in your problem as you thought you were. And medications are a proven and effective tool on the road to some semblance of normalcy.
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#19
Syne Offline
(Dec 31, 2017 04:48 PM)Magical Realist Wrote:
Quote:So all those sources I cited are Scientologists?

You mean that English professor Lennard Davis and some "weekend writer" named Olivia Goldhill? lol! Yeah, that was some riveting data. Who you gonna quote next? The clerk at your local 7-11?

You mean the guy I already showed you was also "Professor of Disability and Human Development in the School of Applied Health Sciences and Professor of Medical Education in the University of Illinois College of Medicine"? Rolleyes

Quote:None of your opinion pieces hold a candle to the studies I cited.


Apparently you didn't bother to actually read any of the articles I posted, as they contained many links to studies. Confirmation bias can do that. Rolleyes
Among them:

Selective Publication of Antidepressant Trials and Its Influence on Apparent Efficacy
"Among 74 FDA-registered studies, 31%, accounting for 3449 study participants, were not published. Whether and how the studies were published were associated with the study outcome. A total of 37 studies viewed by the FDA as having positive results were published; 1 study viewed as positive was not published. Studies viewed by the FDA as having negative or questionable results were, with 3 exceptions, either not published (22 studies) or published in a way that, in our opinion, conveyed a positive outcome (11 studies)."

Prevalence and incidence of depressive disorder
"CONCLUSION: There has been a rise in the prevalence of depression in the prior quarter century among middle-aged females."

Despite the rise in antidepressant usage.

Comparative efficacy and tolerability of antidepressants for major depressive disorder in children and adolescents: a network meta-analysis
"When considering the risk–benefit profile of antidepressants in the acute treatment of major depressive disorder, these drugs do not seem to offer a clear advantage for children and adolescents."

Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration
"Conclusions
Drug–placebo differences in antidepressant efficacy increase as a function of baseline severity, but are relatively small even for severely depressed patients. The relationship between initial severity and antidepressant efficacy is attributable to decreased responsiveness to placebo among very severely depressed patients, rather than to increased responsiveness to medication."

Restoring Study 329: efficacy and harms of paroxetine and imipramine in treatment of major depression in adolescence
"Results The efficacy of paroxetine and imipramine was not statistically or clinically significantly different from placebo for any prespecified primary or secondary efficacy outcome. ... There were clinically significant increases in harms, including suicidal ideation and behaviour and other serious adverse events in the paroxetine group and cardiovascular problems in the imipramine group."

Selective Serotonin Reuptake Inhibitors and Violent Crime: A Cohort Study
"After adjustment for age, the association between SSRIs and convictions for violent crimes remained significant for individuals (males and females combined or males and females considered separately) aged 15 to 24 years but became non-significant among older individuals."

Rolleyes



(Dec 31, 2017 04:48 PM)Yazata Wrote:
(Dec 31, 2017 12:16 AM)Syne Wrote: Chemical imbalance lie

The word 'lie' means to knowingly speak falsely, with intent to deceive. So what justifies the use of the word 'lie' in this thread's subject line (and in the title of the opinion piece quoted)?

Selective Publication of Antidepressant Trials and Its Influence on Apparent Efficacy

When drug companies fail to publish negative results, any meta-analysis of published studies is skewed, at best. Pharmaceutical companies have both the means and motive to deceive.

Quote:Stuff about Hippocrates and Prozac snipped because it has doubtful relevance to Olivia Goldhill's thesis. Which seems to be this:

Quote:One reason the theory of chemical imbalances won’t die is that it fits in with psychiatry’s attempt, over the past half century, to portray depression as a disease of the brain, instead of an illness of the mind. This narrative, which depicts depression as a biological condition that afflicts the material substance of the body, much like cancer, divorces depression from the self.

It's a philosophical complaint. Olivia seemingly wants to argue in favor of some kind of brain-mind dualism.

Not so. It's an argument in favor of trauma being a more primary cause of behavioral issues than physiology. Considering the evidence for neuroplasticity, environment and experience would seem to largely trump physiology.

Quote:As for me, I do think that psychiatric problems most likely have a neurophysiological basis. So I disagree pretty emphatically with Olivia's thesis, which reminds me of the 50 year old views of Thomas Szasz.

So there's no efficacy in non-medicated therapies?

Quote:The problem with psychiatry (and clinical psychology) is that nobody really understands how the brain and the rest of the nervous system actually work. It's just too complex. Psychiatric problems seem to arise deep down in there somewhere, but precisely how and why is a mystery. It's the same situation that conventional medicine was in, in ancient and medieval times before physiology and the germ theory of disease.

Sounds like the "it's complicated" cop-out, when we usually have some idea of what traumas can do to people.
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#20
Magical Realist Offline
"A new study refutes the charge that most common antidepressant medications — the selective serotonin reuptake inhibitors (SSRIs) — are ineffective.

Researchers from the University of Gothenburg found the assertion of ineffectiveness is at least partly based on a misinterpretation of the outcome of the clinical trials once conducted to demonstrate their efficacy.

In recent years, many observers have argued that the most commonly used antidepressant medications, the selective serotonin reuptake inhibitors (SSRIs), are ineffective. This criticism has caused authorities in many countries to become increasingly cautious in recommending these medications.

One reason for questioning of the SSRIs efficacy stems from a retrospective review of the clinical trials conducted by the pharmaceutical companies as they were developing the drugs. The studies, conducted years ago, showed that less than half of the trials reported a statistically significant difference between the tested SSRI and placebo.

In order to shed further light on this controversial issue, researchers analyzed the data from all major company-sponsored placebo-controlled studies addressing the effect of any of three SSRIs — citalopram (Celexa), sertraline (Zoloft) and paroxetine (Paxil) — for major depression in adults.

The analyses was conducted by Ph.D. student Fredrik Hieronymus and others in a research team led by pharmacologist Elias Eriksson, M.D., Ph.D.

The researchers discovered a reason for the less than stellar outcomes may be traced to an outdated rating scale used decades ago.

“In order to measure the antidepressant effect, the pharmaceutical companies have unwisely assessed the reduction in the sum score for a large number of symptoms listed on a rating scale.

“However, the sensitivity of this instrument is markedly marred by the fact that many of these symptoms occur also in subjects without depression, while others are absent also in many depressed patients. For this and other reasons, the usefulness of this rating scale, which was constructed already during the 1950s, has since long been questioned.”

To overcome this bias, researchers analyzed the effect of the treatment on a key item on the the scale — depressed mood.

According to Eriksson, the results are noteworthy: Using the conventional (old) measure of efficacy, only 44 percent of the 32 comparisons reveal a significant superiority of the SSRIs over placebo.

When the Gothenburg researchers instead examined the efficacy on depressed mood, 29 of the 32 comparisons (91 percent) showed a significant difference favoring the active drug.

“Our conclusion is that the questioning of the antidepressant efficacy of SSRIs is to a large extent based on an unfortunate misinterpretation of the available data. The truth is that the scientific support for these drugs exerting an antidepressant impact is very robust across studies,” said Eriksson."----https://psychcentral.com/news/2015/05/28...85050.html

Quote:Not so. It's an argument in favor of trauma being a more primary cause of behavioral issues than physiology. Considering the evidence for neuroplasticity, environment and experience would seem to largely trump physiology.

Trauma and experience ultimately translate into physiological malfunctions. PTSD victims and abuse victims all have the trauma of their past etched upon their brain in some way, leading to their current mental problems. Medication can treat those physiological wounds and help to heal them over time.

https://www.popsci.com/fda-says-mdma-is-...d-patients

http://c-hit.org/2012/05/31/magic_antide..._for_ptsd/
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