How many roads must a man walk down … The answer my friend is blowing in the wind… There is a persistent assumption that drug choice for the treatment of depression can be based on something other than adverse effects – that some people might preferentially respond to one or another drug or class of […]
I like this article in the American Journal of Psychiatry even though I don’t understand its nuances. It’s a meta-analysis of the last ten years of all genetic studies where genotype and environment interactions have been the target [G×E]. An example "In 2003, Caspi and colleagues reported an increasingly positive relationship between number of self-reported […]
ro·bust /rÅˈbÉ™st/ adjective: (of a person, animal, or plant) Strong and healthy; vigorous. (of an object) Sturdy in construction. Why have so many lightweight scientific studies of the efficacy of psychiatric drugs had such a profound impact on prescribing habits of the last several decades? From the present vantage, the second round Anti-depressants [SSRIs] and Antipsychotics […]
It’s hard not to be skeptical about new scientific developments in matters psychiatric after the last several decades of confusion and misinformation. SSRIs, SNRIs, Mood Stabilizers, Atypical Antipsychotics – each came with inflated or distorted claims of efficacy and illusions of safety that evaporated with widespread usage. While that’s an expected danger in any […]
My last post [first rate madness…] and particularly Dr. Carroll’s comment to that post are prequels to this post. Several years ago, Dr. Stephen Stahl wrote a short article that pretty much summed up the state of the art of "personalized medicine" in psychiatry then and now [for a more complete view of the figures […]
Fall is just getting going here in the mountains. Some cool mornings, the dogwood leaves are turning a dark red. It’s too soon to know if this is going to be one of those breathtakingly beautiful seasons or if it’ll be a race to brown. I can’t ever predict, but I spout theories anyway, "been […]
In 1969, a couple of things happened. I became a father, and I started a fellowship in Immunology as part of an Internal Medicine residency. Both were pretty big deals. Immunology wasn’t/isn’t a specialty, so my clinical assignment was in Rheumatology. It wasn’t my main interest, but it was plenty interesting enough. The older Rheumatologists […]
Time to discontinuation of first- and second-generation antipsychotic medications in the treatment of schizophrenia. by Kreyenbuhl J, Slade EP, Medoff DR, Brown CH, Ehrenreich B, Afful J, Dixon LB. Schizophrenia Research. 2011 131(1-3):127-32. BACKGROUND: Continuous adherence to antipsychotic treatment is critical for individuals with schizophrenia to benefit optimally, yet studies have shown rates of antipsychotic […]