Thanks. Thats useful.


--- In [email protected], "shanti2218411" <[EMAIL PROTECTED]> wrote:
> -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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