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Medical English / By Tom Secrest

It's Time to Reevaluate Antidepressants / By Tom Secrest

American has always been on the leading edge of neuroscience research. For this reason U.S. researchers were among the first to probe the neurochemical imbalances associated with depression. It wasn’t long before the unfortunate stigma of depression as a mental illness was swept aside and depression became viewed more like diabetes, i.e. simply a deficiency of an important naturally occurring body substance. For diabetes the substance was insulin, for depression it was serotonin.

The race for the perfect antidepressant started in the 1950’s. Early products included opiates and amphetamines, and as you might well guess, were linked to some undesirable side-effects. As the frontiers of neurochemistry were progressively pushed back, and the black box between our ears revealed more and more of its secrets, there was the promise of more effective antidepressants with fewer and fewer side effects. Whether it’s the stress of modern living or relentless marketing campaigns, for over a decade, antidepressants have been routinely ranked in the top 5 most widely prescribed drugs. Most antidepressants sold today are SSRIs (selective serotonin reuptake inhibitors) and represent the most recent generation of anti-depressants with the fewest side-effect.

However, as it turns out, the gremlins that lurk in the shadows of our mind may be more resilient than we first thought. In a recent study (August 2010) researchers made an amazing discovery. They found that when it comes to treating depression, SSRIs are only “slightly” (and I use that word advisedly) more effective than a placebo. Perhaps more alarming, the authors discovered that the research protocol employed in the largest antidepressant effectiveness trial ever conducted (the STAR*D trail), tended to overstate the effectiveness of antidepressants at each step along the way, which means we have to seriously question what “slightly” really means. The study revealed that perhaps as few as 2.7% of those taking antidepressants derived any long-term benefits.

This leads to the realization that depression is not like a headache and having your general practitioner fire multiple SSRIs, from their pharmaceutical shotgun, into your blood stream may not be the best solution. Depression is a serious and often chronic problem and one that is perhaps best managed without regard to advertising, profit margins, sales and the convenience of pharmaceuticals. If you think you’re in the 97.3% of those experiencing no benefit; maybe it’s time to change path and contact a psychiatrist or a psychologist, maybe it’s time to talk to someone.

Glossary

  • research – výzkum
  • imbalance – nerovnováha
  • unfortunate – nešťastný, neblahý
  • illness – nemoc
  • to sweep aside – házet stranou,odmítnout, smést
  • undesirable – nežádoucí
  • relentless – vytrvalý
  • routinely – běžně, stále
  • widely – velmi, hodně,obecně
  • side-effect – vedlejší účinek
  • overstate – zveličovat, přehánět
  • profit margin – marže
  • gremlins that lurk – skřítkové, kteří číhají (idiom)
  • resilient – nezdolný, nezlomný
  • advisedly – po zralé úvaze

                                                                           About Tom Secrest / Tom Secrest online 


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