-The effects of medical treatments are the result of multiple factors
which include psychological and biological factors.I have no doubt
that SRRI's have effects on brain function.The question is exactly how
and in what ways the SSRI's are effecting the brain.Making this even
more complicated is the fact that different brains can have very
different reactions to the same drug EG is common for pt's to have to
try several SSRI's or other anti-depressants before finding one that
works.There is no good theory to expain why this so.Infact SSRI's are
not used becasue there exists a coherent comprehensive theory about
how brain chemistry affects mood.The SSRI's are used because there is
empirical evidence that they work ie as compared to a placebo.Why this
is so at this point is mostly educated guesswork.However this is true
of a lot of medical treatments and we use these treatments not because
we understand why they work becuse we have scientifically shown that
they do work.A good book on the subject of the current limits of
medical knowledge is "The Rise and Fall of Modern Medicine"by J Fanu.
One thesis of this book that unless we begin to develop a much better
understanding of how the brain and body work their will be fewer
medical advances as time passes.Fanu suggests this is why there has
been very modest progress in the treatment in many chronic diseases
and pharmaceutical(sp?) companies have been emphasizing using "old"
meds for different purposes eg the anti-depressant wellbutrin has
become the anti-smoking drug Zyban.In any case believing that medical
science is going to end all disease anytime soon is pretty much
delusional.Kevin



-- In [email protected], anonymousff <[EMAIL PROTECTED]> wrote:
> --- In [email protected], "shanti2218411" <[EMAIL PROTECTED]>
wrote:
> > However,there are many treatments which
> > are only modestly more powerful than the placebo and I think this is
> > the case with SSRI's.
> 
> However, this I assume is only your conjecture, perhaps well founded
> by your experience as a practicioner, but still conjecture.
> 
> It would seem to me that whether a treatment has useful effects is a
> disccussion relevant primarily to the subject and their doctor. With
> possible input from family and health carrier if the treatment is
> being funded under insurance. And NOT relevant to any bystanders aor
> back seat drivers. 
> 
> And hypothetically, if there is  placebo effect, if thats what
> actually is occuring and the SSRI has no physiologic effect (a premise
> I find quite shakey), still as you point out, there is a structure of
> support -- with a myriad of factors, that is generating the real
> effect, via placebo. Thus the questions is certainly not, as some
> posters have implied now and in the past (BB), that the SSRI support
> structure is a waste, that the results are imaginary, aka placebo,
> that doing nothing would produce the same results.  
> 
> For example, its silly to tell someone "here are your sugar pills,
> take one daily", and expect them to have a REAL placebo effect. They
> have to BELIEVE that there is "Big MOJO" enlivened in the
> thereapy/pill for a placebo to have a REAL effect. 
> 
> The major research question would appear to be is there a more
> cost-effective support structure that can yield the same effect. That
> is, if its a real placebo effect, can a "Big MOJO" expectation be
> created by other, lower costs, less side effect means. Or if the
> effect is part direct physiologic and part placebo, is there a way of
> ramping up the "BIG MOJO" expectation and reduce the more costly and
> side-effect ridden drug.




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