posted
So I wrote an article about some medical facts that have really surprised me.
Some of the stuff on there is really startling and I find very meaningful/concerning, like that some versions of the Hippocratic oath no longer include 'first, do no harm.'
I would really appreciate it you checked it out, and, if you find it good enough, Stumble or Digg it - if that means anything to you! =)
Posts: 3060 | Registered: Nov 2003
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posted
This might be TMI, consider yourselves warned but I think #6 describes me absolutely perfectly. I've looked up rumination syndrome and it fits me to a tee.
I've dealt with it my entire life, I'm dealing with it as I type this post in fact. I've had a scope placed down my throat and the doctor said I have a faulty valve, I've had some pretty serious esophageal damage, the only thing I can really do is take Prilosec so that when my food occasionally becomes a bit too acidic it doesn't hurt.
It's kind of strange, but I have foods that I enjoy because they continue to taste good with each other after I've eaten. Since I'm so used to tasting my food completely mixed it has given rise to a behavior where I will take a bite of food and drink something while still chewing it. People often ask me why I'd mix my foods and beverages like that, but to me, I'm going to be tasting it anyway.
Posts: 14316 | Registered: Jul 2005
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Blackblade, I have the same thing as well. Had it all my life. When I was younger I would do it so often and effortlessly that I didn't even know I was doing it. I'd be chewing on something and my mom would ask what it was, and I'd realize it was what I had eaten 5 minutes ago and it had come back up. I didn't even realize it was odd. The only thing that's changed as an adult is that I'm more aware of it, but it happens so naturally that it's hard to stop.
The thing is, there's no pain. No acidic feeling. I've never had any other health problems. And my teeth are perfectly fine. And as far as I know I have no mental impairments!
But every single meal I eat(or even single food item), some food comes back up. I've tried to be scientific about it at times and see which foods come up more prevalently, but it hasn't worked out so well. I think meats and cheeses seem to come up more than other foods. But I wouldn't swear on that. Because I went vegetarian a few years ago and it doesn't happen any less.
When I was younger, friends used to get a huge kick out of it. Asking me to perform on command, which I could.
Posts: 8741 | Registered: Apr 2001
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Strider: Generally it stops coming up when it starts getting acidic, but foods like pizza for example seem to hurt more often than others.
There was a time as a missionary once where I had just finished eating dinner when the bishop called my district up and reminded us that we had a dinner engagement. The rest of the missionaries panicked, I simply used my ability while I was riding my bike as a means to free up space.
There are also times where I know I've eaten something that is making me sick, and I'll get it out before I retch.
Posts: 14316 | Registered: Jul 2005
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quote:Originally posted by Phanto: So I wrote an article about some medical facts that have really surprised me.
I find this kind of blanket assertion:
quote: 10) Half of the studies into some antidepressants show that they are no more effective than placebo. Companies aren’t required to report studies that show their med doesn’t work when seeking FDA approval.
To be irresponsible. Even if you are correct, you link no research, give no details on the nature of the studies or criticism of those studies (for or against) and present the "fact" in a very biased manner- it appears that you are establishing a case for collusion between drug companies and the FDA that you make no effort to substantiate.
The problem with short "didn't you know" informational articles on medicine is that they are *hugely* misleading. I don't agree with the practice, and certainly not when it is done so flippantly. You are writing to an audience of people who may potentially be suffering from treatable depression. Encouraging folkish wisdom about the nature of medical science (and even medical politics and business) without due care and attention to detail is irresponsible. While again your statement or interpretation of the facts may not be a lie or even inaccurate, it is woefully incomplete, and it can be harmful to people who rely too much on you as a supposed expert who has supposedly done sufficient research to make these claims. Seeing as you have provided absolutely no research notes, you give no one an opportunity to critically examine your interpretation of the facts, nor even to glean a sense of how educated you actually are on this topic. For all we know, you copied that item from a similar website, or heard it from a friend.
Perhaps you should think of that oath before you write, if you only write in order to be scintillating or eye catching.
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posted
While I agree with Orincoro on the danger of short lists with no citations, I did actually read an indepth article on Newsweek about the antidepressant/placebo thing. It took about 5 pages to say essentially what Phanto says in one sentence - the difference between the placebo and the real drug were often very small.
One caveat I do remember was that the "rating" of a anti-depressant was an average of all the test subjects' results, and oftentimes anti-depressants work well for some people and not at all for others, so the average might not have been the most appropriate way to rank them.
Posts: 4136 | Registered: Aug 2008
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quote:Originally posted by Raymond Arnold: ...oftentimes anti-depressants work well for some people and not at all for others, so the average might not have been the most appropriate way to rank them.
This is the case, so it's misleading for someone to say that anti-depressants don't work half the time, when what they mean is that any given anti-depressant doesn't work for someone half the time.
The unsaid but very important element of treatment for depression is that the doctor and patient have to work together to find a particular medicine and dosage that works for the individual.
Anti-depressant studies and anecdotal evidence is especially tricky because patients are notoriously non-compliant with their usage. They frequently either give up before the medicine has a chance to work, or the medicine does start working, and they feel better, so they stop taking it and then go back to their depressed state.
In other words, it's much too complex and personalized to accurately discuss with a few sentences bemoaning the poor results of "anti-depressants" as though there were only one medication and it either works or doesn't on every person.
Posts: 3950 | Registered: Mar 2006
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And if, Phanto, you're referring to the most recently publicized article discussed in Newsweek which conducted a megastudy of antidepressants, I'm pretty sure you haven't actually read the study. There are numerous caveats that apply to the findings that a responsible reporter/blogger should report. For example, that the research group chose 6 studies to examine (718 subjects), looked at only two antidepressants (paroxetine and imipramine), some of these were at less than therapeutic levels, and the much touted "only as good as placebo" refers to mild-to-moderate depression not severe depression.
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That site plays it too fast and loose with 'medical facts.' It's not medically professional and it baldly editorializes.
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Plus, given your posting history here, I kind of suspect that your primary reason for compiling that list was giving voice to 'medical fact' #10. I could definitely see the rest of your list being chafe. I realize that I may be mistaken in my suspicions, of course, but still; when I saw the subject line of this thread, my first thought was "oh, this is going to be another anti-anti-depressant screed, isn't it."
[Edited to change "depression" to "depressant"]
Posts: 1087 | Registered: Jul 1999
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Sometimes I have to recuse myself from discussion about antidepressants because, well, my cousin would be entirely crippled without SSRI's. Her anxiety and panic disorder after she developed crohn's was just too severe and in her case as well as a vast amount of test cases from people who respond to SSRI/MAOI help, to insinuate that we don't even know whether or not they work better than placebos is asinine. Anecdotal compromise? Perhaps. But I know where I stand.
Fortunately, there is no need for it. We've been over this issue with Phanto. I believe this would be now the fourth event.
Posts: 15421 | Registered: Aug 2005
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quote:Originally posted by Jake: Plus, given your posting history here, I kind of suspect that your primary reason for compiling that list was giving voice to 'medical fact' #10. I could definitely see the rest of your list being chafe. I realize that I may be mistaken in my suspicions, of course, but still; when I saw the subject line of this thread, my first thought was "oh, this is going to be another anti-anti-depressant screed, isn't it."
posted
Anti-depressants are stimulants. Amphetamines started as diet pills. The hyper kid in my class is the ADHD kid today. We all had the weird kid in class, but now we've identified Asberger's Syndrome. We've made names for the things we've always known but definitions do not change reality. Now those names give them an excuse not to do their best since the word causes us to expect less of them. The ADHD kid use to get spanked, now he gets drugs and social security benefits. I prefer high expectations over an excuse and government handouts. We should push the handicapped to be their best, just as we do with regular society. The truly dysfunctional deserve the handouts and low expectations. Society's definitions and expectations doom many to failure when they could've overcome their disabilities.
Not really. The most common class of anti-depressants used these days are selective seratonin reuptake inhibitors (SSRIs) and these are not stimulants, at least not in the same sense that amphetamines are stimulants.
[ March 07, 2010, 05:48 AM: Message edited by: The Rabbit ]
Posts: 12591 | Registered: Jan 2000
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The last study I saw thought that they stimulated the regeneration of certain nerve clusters in the brain. Not that kind of stimulant? Posts: 2283 | Registered: Dec 2003
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I honestly don't spend that much time thinking or thought on antidepressants. I could have just as easily put another fact altogether there. Like that it is possible to have a legal prescription for methamphetamine, known as "crystal meth." If I cared that much about that issue, I'd write more articles - I haven't written anything about antidepressants in several months iirc. Frankly, I've gotten over it.
The data say that antidepressants work slightly better than placebo, especially when multiple attempts are made.
The data also say that antidepressants can highly increase risk of suicidal ideation, are physically addictive in as much as 25% of those who take them, cause sexual dysfunction et cetra. The side effects of antidepressants are so serious that 40-50% of people stop taking them soon after starting.
As for specifics: if you look at the studies into the antidepressant Valdoxan, you'll find that 3/7 were negative. Those studies also showed that Prozac did not work any better than placebo.
Analysts have argued that that lack of efficacy is a reason that Valdoxan should not be approved. That presumes that traditional antidepressants have performed better.
Remember, we don't see the negative studies.
I've read that if negative studies were published, antidepressants would only be effective in about half of the studies, which I believe considering what I've seen with Valdoxan and other antidepressants.
Antidepressants don't work that well. They do work slightly better than placebo. They have nasty side effects.
It's really not that exciting.
quote: Plus, given your posting history here, I kind of suspect that your primary reason for compiling that list was giving voice to 'medical fact' #10. I could definitely see the rest of your list being chafe.
If I were including the fact to titillate or because I wanted to draw attention to it, I could have pointed out that the State of New York won a major lawsuit against an antidepressant maker for hiding the fact that their medication was inducing suicidal behavior in children.
quote: GSK paid the State of New York $2.5 million in 2004 to resolve claims alleging that the drug company knew that Paxil use in teens caused suicidal behavior and was forced to disclose previously concealed studies on the issue.
quote: Only 51 percent of short-term, randomized, placebo-controlled studies in depression produce clear evidence of efficacy for the antidepressant, and the overall magnitude of the effect is modest.
quote:The data also say that antidepressants can highly increase risk of suicidal ideation
Tell me what "highly increase" is without looking it up. I will tell you the true answer without looking it up.
quote:are physically addictive in as much as 25% of those who take them
This is misleading. Addiction is "the continued use of a substance despite its detrimental effects, impaired control over the use of a drug (compulsive behavior), and preoccupation with a drug's use for non-therapeutic purposes (i.e. craving the drug)." Dependence which sounds like what you are trying to refer to, is "tolerance and where negative physical symptoms of withdrawal result from abrupt discontinuation or dosage reduction." This is true in the sense that virtually all pharmacologically active agents cause physical dependence. Beta blockers, caffeine, and tylenol can and frequently cause physical dependence.
quote:cause sexual dysfunction et cetra.
True, but this is temporary, prevalence around 25-35% (I acknowledge this is higher than some people would consider their personal risk threshold but many severely depressed people would consider it a bargain), and treatable even while on the antidepressant.
Posts: 1261 | Registered: Apr 2004
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"Normal" college students like to crush and snort Ritalin. Cocaine and Morphine were in patent medicines and today oxycontin is the street drug of choice.
Marijuana will never be legal. Not because it's harmful but it's too easy to avoid paying marijuana taxes. You can't grow oxycontin in your backyard.
Posts: 1495 | Registered: Mar 2009
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Ritalin is a drug for ADD but fun to snort for regular people. Cocaine was the miracle drug of Freud and supposedly non addictive. Morphine,..we can't live without for pain teatment. Oxy,,,,legal morphine. Marijuana? Definitely not a stimulant for anything other than appetite.
A drug's legality doesn't make it any safer or subject to abuse. A mind altering substance that can be grown in a garden will never be legal. How can a wild mushroom be outlawed in the land of the free? If the common man can grow it or pick it, it can't be taxed and controlled.
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quote:Originally posted by Phanto: Those studies also showed that Prozac did not work any better than placebo. ... Antidepressants don't work that well. They do work slightly better than placebo. They have nasty side effects.
It's really not that exciting.
Prozac, as an SSRI, is the Miracle Treatment (of which we are all thankful for) for two people in my extended family and allows them to have normal lives, something which a placebo is sadly not going to replicate. Also really not that exciting.
Posts: 15421 | Registered: Aug 2005
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posted
Malanthrop, I'm still replying to your statement "Anti-depressants are stimulants." It's so ridiculously wrong I'm questioning from where you're getting the idea. The rest of your ramblings don't bother me at all.
Posts: 1261 | Registered: Apr 2004
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posted
I double checked. There is one medication used as an anti-depressant that is technically a stimulant (wellbutrin). But there are like two dozen anti-depressants that aren't.
Posts: 1261 | Registered: Apr 2004
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quote:Originally posted by malanthrop: blahblahblah
yo I'm glad you're rambling incessantly again, but let's back up to the part where you said marijuana would never be legal.
do you still believe that despite it being, you know, legal in many places? There some definition you're not working on? waiting for fed approval?
Posts: 15421 | Registered: Aug 2005
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posted
Samprimary: thank God that something was able to help your family members.
I don't think that should take away my right to point out the fact that for some antidepressants half of the studies don't show superiority over placebo.
I can point to Valdoxan specifically as a medication where, at the point I analyzed it, 3/7 studies into its efficacy showed no superiority over placebo. I can point to an analysis in the NEJM that showed if negative studies were published, that only 51% of studies would show clear superiority of the treatment over placebo.
The response? Silence. I don't argue that the lackluster efficacy means that people who would benefit shouldn't be treated. But it is something that should give us pause.
If I don't point this out, or have the right to point it out, who will? Who does?
The thing is, I don't engage in ad hominem attacks because of someone's interpretation of facts. It's just not cool =)
As for stimulants - antidepressants are not all stimulants. But stimulants have been used as antidepressants in cases of treatment resistant depression.
Posts: 3060 | Registered: Nov 2003
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quote:Originally posted by Phanto: I don't think that should take away my right to point out the fact that for some antidepressants half of the studies don't show superiority over placebo.
It doesn't, nor does it take away the main thrust of the forum's contention with your analysis at large, which I don't think you are really addressing, nor did you the first two times we went through this discussion. You are still relying on a simplistic analysis which had been very, very well refuted, months ago. We're starting to do it again, so this would probably be rendered superfluous in short order, but should I drag up relevant quotes from the last time the forum's medical experts exhaustively rebuked the very same arguments you continue to use today?
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posted
Selective reporting is a problem and should be fixed. Saying 3/7 studies showed no superiority over placebo is still misleading. You're not giving any information that helps answer the important questions: why were 3 of the 7 studies showing different results from 4 of the 7? How were each of those studies conducted? What was the power of the studies? What would happen if you put all the data together? What biases and confounding variables were found in each study?
Placebo response has been increasing over the years. There are many reasons for this. Placebo isn't being properly understood in this context, I feel. In a study, being in a placebo arm still means extensive interaction with research staff that affects outcomes. There are no sugar pills we are allowed to prescribe our patients and tell them it might be psychoactive. There is no true equivalent of "prescribing a placebo" in medical practice. It's not available. So what's truly available is not treating, undertreating, treating, or overtreating.
I responded earlier to your comments about antidepressants but I have yet to see a specific response. "Antidepressants no better than placebo" is in mild depression, with two study drugs, without full dose, etc. Your claims about antidepressants being addictive are wrong. I cannot find a stimulant that is FDA approved for depression. On treatment algorithms I can't even find classic stimulants being suggested. TMAP does not list any classic stimulant (I don't believe either of us consider wellbutrin a classic stimulant). Star*D does not as well. If you agree that stimulants are being used for augmentation of treatment resistant depression as an off-label use without clinically supported data.... I agree that someone is probably doing it but it's not the norm and it's not being taught.
Posts: 1261 | Registered: Apr 2004
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I apologize if I miss things or come off the wrong way - I have a learning disorder and think slightly differently. I certainly do not want to marginalize what is an incredibly difficult subject.
quote: If you agree that stimulants are being used for augmentation of treatment resistant depression as an off-label use without clinically supported data.... I agree that someone is probably doing it but it's not the norm and it's not being taught.
Two psychiatrists I interviewed mentioned stimulants as a treatment for resistant depression as well as people I know whose psychiatrist's recommended it.
It's happening. I've read studies that specifically investigate rates of recovery in those who have treatment resistant depression and are treated with stimulants. The rates were impressive but not statistically significant or in a large group.
Whether or not it is normal or viewed as a standard backup option in serious cases of depression - I don't know.
As for the increase in suicidality - sure, I'll bite. Off hand, a 50-200% increase. It depends what data you look at and who is interpreting it.
Off hand, your number?
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