The drugs don't work

[hirez]

... Or at least, they're just papering over the cracks, rather than actually fixing something.

However, if Serotonin theory doesn't hold up, does that mean the scare stories about MDMA leaching the stuff away are as reliable as the folklore about LSD and chromosome damage?

Comments

[yaruar.livejournal.com]

it's a bit beyond my brain but my current neighbour is involved in running projects to use mri's and other such gubbins to test the effect on the brain of mental health issues and the drugs to treat them. apparantly he was saying no one in the past has considered this a good thing to research.

[markeris.livejournal.com]

Despite it being very much held up as current understanding (with a footnote that the people with supposedly depleted serotonin levels seemed to be scoring jolly high on all measures of feeling chipper and upbeat compared to people with non tampered level (1) ) when I was doing psychopharmacology - and thus causing the young me to not go anywhere near the stuff - in as much as I`ve kept up with the field since I believe that the whole neurotoxicity of MDMA has since had a series of metastudies with the effective conclusion of "Yeah. In RATS brains. If you misread some of the numbers."

Also there have not, to my knowledge, been any of the to be predicted midlife crises from hell / out of the fillum Blue Sunshine, or at least none that have been sufficiently identified and collated into "a thing".

(1) Their familiarity with experiental extreme joy seeming to rather over ride their supposedly frazzled happy wires. Which was always a sign that things might not be as supposed that was freely admitted to at the time.

[valkyriekaren.livejournal.com]

FWIW, when I was on SSRIs, I wasn't told, "This will fix a serotonin imbalance in your brain," I was told, "This will hopefully help you to not feel so low and weepy all the time."

To an extent, I don't much care how a drug is working, as long as it is. I don't really understand how ibuprofen gets rid of period pain, but if it works I'm going to take it.

[hirez.livejournal.com]

It may well be that the sort of people who went out and caned it of a weekend were perhaps getting out of it to escape a pre-existing life of grim pointlessness.

[zotz]

Odd article. We're always being told that the idea of a chemical imbalance is wrong, without me hearing anyone recently saying that an imbalance was the problem. Straw man, anyone?

Her analysis seems to be based on intellectual rather than empirical factors, but fundamentally we don't give people antipsychotics because we theorise about their brain chemistry, we do it because in practice it seems to solve certain problems they have. The theorising is secondary to that, and comes later. My own observations are of course only anecdotes, but the friends I have who've taken their meds have done far better than those who are in the habit of refusing to. The obvious explanation is that the drugs have a tendency to work, although of course there are other possibilities.

I don't remember reading MDMA concerns termed as "leaching away" anything. Concerns on theoretical grounds are reasonable, as long as you bear in mind any lack of solid evidence.

[liz-lowlife.livejournal.com]

You know my story.

I was hit by post traumatic stress on top of being rather SpeSHUL™ as it was.
Combination of speSHUL™ and breakdown=a bit bonkers for a protracted period.
Beta blockers semi controlled the shakes and the panic-central but they did not change the fact that I was slowly descending into depression mode as well.
I asked for CBT and instead was offered SSRIs.
You know the rest...I spent 3 months dying inside on a drug that should NEVER have been prescribed to a Synaesthete and ended up with "DO NOT ADMINISTER SSRIs" on her medical record.

Doctors do not always recognise the difference between those who NEED to face their demons and those who need to be somatised. Since I am not one of the latter, the article speaks to me that essentially, when it comes to malaises of the mind, modern Science still has no real clue. They will cure cancer before they cure the manyfold subtleties of mental illness....

[bogwitch64.livejournal.com]

See! This is what I've been saying ever since the first time someone suggested my son needed to be medicated! I'm NOT crazy! Well, that's not entirely true, but at least I'm not alone in thinking that these 'brain levelling' drugs aren't doing anything more than masking symptoms.

Ok, at this point in time it's what the medical field can do for people who can't seem to control panic or psychotic behavior, but it's a plaster bandage on a belly wound. All these kids taking drugs for 'attention disorders' and such need techniques, not mind altering chemicals!

Ok, off my soapbox. Thanks for posting that link. I sent it to my son (who's now 23 and willingly back on medication though against his wishes) and to my son-in-law, who also wavers back and forth as to how he feels about medicating himself.

[steer.livejournal.com]

They test the drugs not by measuring seratonin levels but by comparing the improvement in the patient measured against placebo on standardised "wellness scales".

That's the thing about Evidence Based Medicine, it does not matter a jot whether the theory behind it is Activated Water, Seratonin Level or Space Pixies. What matters and what is measured is "is this thing better or worse than a sugar pill and a pat on the head".

Certainly a theoretical underpinning helps at the drug design stage.

[bogwitch64.livejournal.com]

Let me also go on record as saying that I am not totally against such medications. There are instances where, while it might not actually level out this or counter that, it actually helps the patient to function, to feel better, and to all-around feel happier. My problem is with the automatic medicating of so many (especially YOUNG) people even when there are serious side effects. There HAS to be a happy medium where not everyone is automatically pegged as circular and then shoved into a square hole.

[perlmonger.livejournal.com]

Aye, and that switches the question to the validity of "wellness scales", who defines them, and to what ends. I'm not suggesting there's any serious problem with them (in the UK, in 2009), but there's no way on Earth that they can be value- (or politics-) free.

[steer.livejournal.com]

Possibly you could question the wellness scale but I don't think that's a particularly fruitful line of inquiry. A questionnaire based wellness scale would have to be pretty strangely broken to have an ineffective anti-depressant work better than placebo in a double blind test. (The amount they work better than placebo is not too much in some cases mind).

However, to my mind at least, what's much more likely is that they do "work" to the degree the tests show them to work but that the pop-science "seratonin makes you happy" explanation the original article criticises is to some degree wrong. I have no idea to what degree drug companies and researchers in the field believe that model -- my suspicion is "not at all".

Incoherent rambling follows

[inulro.livejournal.com]

I can't even read articles like that. I take the psychoactive substances because they make me get sleep and relieve my pain. I know they don't touch the source of the problem (medical science still not so hot on the sleep disorders and pain issues), but they make me a functional human being, and that's all I care about.

[hirez.livejournal.com]

I suspect a poor choice of words on my part. Perhaps 'The drugs allow you to function. (We're just not quite sure why)' would be a better start, with the last para reading something like 'I more or less remember scare stories about MDMA upsetting the natural balance of serotonin and the brain going "Well bloody sod yer then" and thereafter producing Not Enough out of spite.'

(Obviously everyone who went and had it large in the early 90s has a tiny Bobby Chariot hidden within their brain.)

Re: Incoherent rambling follows

[hirez.livejournal.com]

Yes. And I sometimes take small doses of a drug which is no longer prescribed as heart medication because it makes the anxiety go away. Which appears to work by sticking an oar in the feedback loop, so there's one small part of me desperately trying to have a complete meltdown while the rest is going "Can you hear something? Nah, must be a shagged bearing in yer superego. Anyway, who's round is it?"

Re: Incoherent rambling follows

[inulro.livejournal.com]

I remember that. It's an odd sensation. "oh look, I've found another way we're open to being sued, and it's not that I don't care, but I can't panic about it either".

Also, on reflection, there's other medical conditions where the symptoms rather than the cause are treated, yet nobody suggests we should throw away the pills we take for those...