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posted by CoolHand on Friday April 24 2015, @03:11AM   Printer-friendly
from the the-big-corps-would-never-lie dept.

The British Medical Journal provides an editorial from Professor David Healy, Head of Psychiatry at the Hergest psychiatry unit in Bangor in which it is stated:

When concerns emerged about tranquilliser dependence in the early 1980s, an attempt was made to supplant benzodiazepines with a serotonergic drug, buspirone, marketed as a non-dependence producing anxiolytic. This flopped. The lessons seemed to be that patients expected tranquillisers to have an immediate effect and doctors expected them to produce dependence. It was not possible to detoxify the tranquilliser brand.

Instead, drug companies marketed SSRIs for depression, even though they were weaker than older tricyclic antidepressants, and sold the idea that depression was the deeper illness behind the superficial manifestations of anxiety. The approach was an astonishing success, central to which was the notion that SSRIs restored serotonin levels to normal, a notion that later transmuted into the idea that they remedied a chemical imbalance. The tricyclics did not have a comparable narrative.

Serotonin myth

In the 1990s, no academic could sell a message about lowered serotonin. There was no correlation between serotonin reuptake inhibiting potency and antidepressant efficacy. No one knew if SSRIs raised or lowered serotonin levels; they still don’t know. There was no evidence that treatment corrected anything.

[More...]

This lack of evidence-based practice was apparent to Thomas Insel, Director of the US National Institute Of Mental Health who announced in 2013 that the institute would abandon funding towards the DSM:

While DSM has been described as a "Bible" for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been "reliability" - each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure.

In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever. Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment.

Does this mean that psychiatry is finally moving away from a practice akin to leeches for everything?

 
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  • (Score: 1, Interesting) by Anonymous Coward on Friday April 24 2015, @05:30PM

    by Anonymous Coward on Friday April 24 2015, @05:30PM (#174750)

    If you have depression and problems with sleep, try the following. It might not cure depression (like diabetes, there are multiple types and the type determines the treatment), but this does help with sleep.

    Try this:
    Use 3 of these per room from waking up until 1 hour before bed time:
    http://www.amazon.com/gp/product/B0019HZQPM/ [amazon.com]

    Yes, this is bright. Very bright from what you are used to. That is the point. That is probably why your circadian rhythm is messed up. So fix your broken environment with this. Yes, it is broken. Residential lighting is closer to living in a cave than being outdoors. Do not simulate living in a cave with 60w incandescent bulbs (or the equivalent 11-14w CFLs & LEDs). The goal is to more closely reproduce sun like light inside. This is still "darker" than being outside, but it is good enough for most people. Your sensitivity may vary from another person.

    1 hour before bed time, one of these per room:
    https://www.earthled.com/collections/new-led-light-bulbs/products/lighting-science-sleepy-baby-led-nursery-light-bulb-12-watt-60w-equal-ls-p15-40we-slpb-120-g1-bx?variant=1259654776 [earthled.com]
    or 3 of these per room:
    http://www.amazon.com/30-Watt-Radio-Golden-Antique/dp/B004H4Z4P6/ [amazon.com]

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  • (Score: 0) by Anonymous Coward on Friday April 24 2015, @10:26PM

    by Anonymous Coward on Friday April 24 2015, @10:26PM (#174867)

    Those 30 watt radio bulbs might not be enough. Even though 2 of them is 60 watts, they are more red-shifted than normal incandescent bulbs are. This has a very pleasing effect (think candle light), but is less efficient. So you need more of them. In day mode, those CFLs should flood the room with light. In evening mode, you only need to light what needs to be illuminated. Think task lighting and safety. So you might need more for some tasks. Also, daylight lighting should be positioned above your head, and evening lighting should be below. So table lamps and rope light. A 1900K-2200K LED strip that is dimmed would be the most power efficient.