Re: J.P.'s office
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Joined: Mar 2010
Posts: 3,596 Likes: 1
connoisseur
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connoisseur
Joined: Mar 2010
Posts: 3,596 Likes: 1 |
[quote=medic8rRight on. Interestingly, the conventional wisdom is that the tricyclic antidepressants of the 1960s and 1970s are just as effective, or maybe even slightly more effective, than the newer generation SSRIs and SNRIs. The main reasons that the newer generation supplanted them are (1) better overall tolerability and (2) next to zero chance of lethality in overdose. [/quote]
How much $$ was shelled out in grants for us to learn this? I want half! 'cause all they had ta do is call me, don't be afraid, they can call me, maybe it's late, but just call me.....
Gee, I hope velevet hammers make a come back.
Always call the place you live a house. When you're old, everyone else will call it a home.
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Re: J.P.'s office
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Joined: Dec 2007
Posts: 7,786
axiomite
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axiomite
Joined: Dec 2007
Posts: 7,786 |
Right on. Interestingly, the conventional wisdom is that the tricyclic antidepressants of the 1960s and 1970s are just as effective, or maybe even slightly more effective, than the newer generation SSRIs and SNRIs. The main reasons that the newer generation supplanted them are (1) better overall tolerability and (2) next to zero chance of lethality in overdose.
Now thats interesting. Unfortunately, the general effectiveness of antidepressants is much lower than drug companies would like you to believe. It shows how little we really know about how the brain works (or doesn't). I'm just glad I don't need those things any more. Depression is hell on earth...
Fred
------- Blujays1: Spending Fred's money one bottle at a time, no two... Oh crap!
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Re: J.P.'s office
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Joined: Mar 2010
Posts: 3,596 Likes: 1
connoisseur
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connoisseur
Joined: Mar 2010
Posts: 3,596 Likes: 1 |
Right on. Interestingly, the conventional wisdom is that the tricyclic antidepressants of the 1960s and 1970s are just as effective, or maybe even slightly more effective, than the newer generation SSRIs and SNRIs. The main reasons that the newer generation supplanted them are (1) better overall tolerability and (2) next to zero chance of lethality in overdose.
Unfortunately, the general effectiveness of antidepressants is much lower than drug companies would like you to believe. Then you're not taking enough.
Always call the place you live a house. When you're old, everyone else will call it a home.
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Re: J.P.'s office
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Joined: Jun 2003
Posts: 8,488
axiomite
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axiomite
Joined: Jun 2003
Posts: 8,488 |
Seriously. "Don't under-dose" was one of the first rules I learned in college.
bibere usque ad hilaritatem
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Re: J.P.'s office
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Joined: Mar 2010
Posts: 3,596 Likes: 1
connoisseur
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connoisseur
Joined: Mar 2010
Posts: 3,596 Likes: 1 |
Seriously. "Don't under-dose" was one of the first rules I learned in college. But you've broken it, haven't you? Admit it!
Always call the place you live a house. When you're old, everyone else will call it a home.
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Re: J.P.'s office
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Joined: Dec 2007
Posts: 7,786
axiomite
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axiomite
Joined: Dec 2007
Posts: 7,786 |
Right on. Interestingly, the conventional wisdom is that the tricyclic antidepressants of the 1960s and 1970s are just as effective, or maybe even slightly more effective, than the newer generation SSRIs and SNRIs. The main reasons that the newer generation supplanted them are (1) better overall tolerability and (2) next to zero chance of lethality in overdose.
Unfortunately, the general effectiveness of antidepressants is much lower than drug companies would like you to believe. Then you're not taking enough. No. Wrong treatment. Divorce worked like a charm.
Fred
------- Blujays1: Spending Fred's money one bottle at a time, no two... Oh crap!
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Re: J.P.'s office
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Joined: Dec 2003
Posts: 10,420
shareholder in the making
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shareholder in the making
Joined: Dec 2003
Posts: 10,420 |
Jason M80 v2 VP160 v3 QS8 v2 PB13 Ultra Denon 3808 Samsung 85" Q70
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Re: J.P.'s office
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Joined: Mar 2010
Posts: 3,596 Likes: 1
connoisseur
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connoisseur
Joined: Mar 2010
Posts: 3,596 Likes: 1 |
Dear Doctor: Now that CGS (Complicated Grief Syndrome) is the hot new phsychosis, are there any neat drugs in the pipeline with cool side effects?
Inquiring junkies want to know.
Last edited by BobKay; 09/06/11 05:58 PM.
Always call the place you live a house. When you're old, everyone else will call it a home.
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Re: J.P.'s office
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Joined: Feb 2006
Posts: 6,471
axiomite
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OP
axiomite
Joined: Feb 2006
Posts: 6,471 |
Dear Bob, Thanks for your missive. The sad fact is that the psychiatric drug pipeline is flowing at a trickle these days. There's not much that's novel; most new drugs are either tweaks on existing drugs or "me-too" drugs in the same family as existing drugs. As one commenter in one of my favorite blogs recently observed, most new psych meds introduced since 1987 have been a clone of either Prozac (SSRI class antidepressant) or Clozaril ("atypical" antipsychotic). I've found the recent entries on said blog very interesting. I'm not sure that you guys will enjoy this discussion as much as I have, but for the curious, here's the back story. Blog author Daniel Carlat is a psychiatrist in the Boston area who has taken up the noble cause of getting the pharmaceutical industry out of the continuing medical education (CME) business. Up until now, there's been a lot of CME programs that were sponsored by "Big Pharma", to use the somewhat pejorative term. Such programs, unsurprisingly, cast the product(s) of the sponsor in a positive light, making it hard to tell how much of the content was objective and how much was "spin" or bias. Carlat is not alone in his quest. A lot of medical schools have done away with the old practice of industry-sponsored Grand Rounds, drug lunches, drug dinners, and, in some cases, visits from drug reps entirely. The AMA is starting to voice its concerns as well. Carlat is, however, one of the more vocal critics of Big Pharma, leading to this recent response by Stephen Stahl. Dr. Stahl is a psychiatrist and educator. He is on the faculty at UC San Diego and has his own Neuroscience Education Institute, through which he offers CME at symposia around the country. He is also a paid consultant/speaker/researcher for just about every pharmaceutical company - over a dozen of them. So if anybody is qualified to be the opposition in this argument, it's him. So Dr. Stahl has taken up the fight against the influence of Dr. Carlat and others, calling him a "Pharma-scold" and alleging that, because of people like him, the pipelines are drying up. It's quite a leap, to me, to draw that conclusion, and, I must say, Dr. Stahl's response seemed quite over-the-top, as did the later followup by his minion associate, Debbi Ann Morrissette, PhD. My take on the whole thing is that Carlat has a legitimate concern. When I was in medical school and residency, one of the popular games at Grand Rounds was "Guess The Sponsor". It was an easy game, usually over within five minutes. That was about how long it took to introduce the subject matter and begin talking about the studies that showed how drug X was a good choice for the disease under discussion. Bipolar disorder with rapid cycling? Depakote is good for that. Hey, the guys in the back row are wearing Abbott Labs name tags. I win a free breakfast! The other side of the coin is that, as far as the studies show, Depakote is really the best drug for that condition, so the drug companies have gotten out a message that will help me help patients. And they did disclose that they were the sponsors of the Grand Rounds. And, well, this is America, where capitalism encourages the companies to promote their products, generate sales, and generate profit. The hope is that the profit is married to real benefit for patients, not just the shareholders.
Bears, beets, Battlestar Galactica.
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Re: J.P.'s office
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axiomite
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