Paul Annette and others: I liked what Paul said re skepticism. It is, imho, the only viable position for a scientist (as opposed to a technician) to take! But I would add that psychopharmacological texts do have an explanation for those opposite reactions to the same drug. I'll shorten it to say that the idea is that SSRIs are not the drug of choice for anxiety- more likely benzodiazepines (so you'll have to get into modulatory explanations). Sticking to your question though, they'd argue that SSRIs have a primary effect (obviously blocking re-uptake) and several longer term secondary adjustments to cellular functioning (I think the research comes out of the work of Garcia-Sevilla on imidazoline receptors and follow ups). In other words, IF (and I think it is a big one) SSRIs treat anxiety at supra-placebo levels it is due to the increased availability of 5HT. To the extent they are effective on depression it is the down regulation of pre-synaptic imidazoline receptors receptors (auto-receptors) and other gene-product level actions.
I'm not disagreeing with Paul's skepticism either but effects only 12 - 15 % over placebo are quite meaningful to those 12 - 15 %. :) One would like to think, however, that the billions of dollars spent is somehow related to huge effects which Paul rightly points out are largely absent. BTW- drug company claims to effects are closer to 85 - 92% with placebos at 30 - 50%. Just don't look too closely at how they arrive at these numbers as they do not reflect appropriate skepticism, as Paul points out. Tim _______________________________ Timothy O. Shearon, PhD Professor and Chair Department of Psychology Albertson College of Idaho Caldwell, ID 83605 email: [EMAIL PROTECTED] teaching: intro to neuropsychology; psychopharmacology; general; history and systems -----Original Message----- From: Paul Okami [mailto:[EMAIL PROTECTED] Sent: Sat 12/9/2006 6:05 PM To: Teaching in the Psychological Sciences (TIPS) Subject: [tips] Re: SSRIs and depression and anxiety Cynicism is an attitude of sneering dismissiveness, no more defensible than gullibility. Skepticism is the philosophy of the scientific method. In the case of treatment for psychological disorders, skepticism is sorely called for. Most people with such disorders do not experience relief from treatment--neither psychotherapeutic nor psychopharmacologic. Anti-depressants have a woeful record in efficacy studies and evidence of effectiveness is no better. This is not cynicism. Cynicism is the method of the pharmacology and psychotherapy industries. Paul Okami ----- Original Message ----- From: "Annette Taylor, Ph. D." <[EMAIL PROTECTED]> To: "Teaching in the Psychological Sciences (TIPS)" <[email protected]> Sent: Saturday, December 09, 2006 1:31 PM Subject: [tips] Re: SSRIs and depression and anxiety Thanks to those who provided useful comments. I am a little surprised at the cynicism and skepticism expressed by many of the respondents. I had a sense of an underlying belief that the disorders are perhaps non-existent as well, which I found a bit offensive and insensitive. At least I felt offended by some of the responses for their lack of sensitivity to the disorders. I have studied the effects of SSRIs in anxiety and understand the putative mechanism fairly well; in terms of depression I believe that the comorbidity link is closest to what I talked about in class. In depression in fact, there are anxiety-like symptoms in the sense of ruminative (almost obsessive type) thinking. For those people for whom the drugs do work, I believe the enhanced serotonin in the synapse provides an important inhibitory effect. In fact, in panic attacks it is my understanding that when these drugs work they don't necessarily prevent the full autonomic response, they simply reduced the conscious cognitive component of panicky mind. Annette Annette Kujawski Taylor, Ph. D. Professor of Psychology University of San Diego 5998 Alcala Park San Diego, CA 92110 619-260-4006 [EMAIL PROTECTED] ---------------------------------------------------------------- This message was sent using IMP, the Internet Messaging Program. --- To make changes to your subscription go to: http://acsun.frostburg.edu/cgi-bin/lyris.pl?enter=tips&text_mode=0&lang=english __________ NOD32 1913 (20061209) Information __________ This message was checked by NOD32 antivirus system. http://www.eset.com --- To make changes to your subscription go to: http://acsun.frostburg.edu/cgi-bin/lyris.pl?enter=tips&text_mode=0&lang=english
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