We Need Data for Data Based Medicine

February, 12, 2012 | 6 Comments

Comments

  1. You are quite right, Jack, it does. However, my gp inherited me on Seroxat, thought herself they were not efficacious, but, on taking me off them equally did not realise that she almost killed me after eight weeks off Seroxat.

    So, where is the wisdom?

  2. My Gp told me to just take half a seroxat pill , then keep decreasing by half. It took 3 months. I have been suffering ever since now nearly 7 years. She has said to me in the past that maybe she should have taken it slower.
    Wiser now after the event !

  3. 18 years on most SS/NRIs, APs, TCAs, dopaminergics for what was fatigue/low energy in 1993. NEVER responded to serotonergics aside from bruxism/TMJ that coincided with Zoloft in ’93 (Rx Klonopin hs – still on). Tapered/ DC’d Pristiq (desvenlafaxine) over 10 months ending Spring ’11. Hellish protracted withdrawal and facing all of the life issues I didn’t attend to under the serotonin veil.
    Recent dx: premature ovarian failure, non-alcohol liver disease, several autoimmune disorders, MTHFR gene mutation (infertility, cardiac problems, depression in family).
    What could have been done differently–before jumping to the trashcan diagnosis of depression (to which all subsequent ailments have been attributed)??
    (Hashimoto’s thyroiditis diagnosed in ’96- treated w/Synthroid)
    Dr. Healy, I respect your work tremendously. I was, however, surprised to see that ruling out medical conditions/drug effects did not top your information to Prescribers. I hope you will reposition this key point in your treatment algorithm.

  4. “If a condition becomes more enduring, the treatment options become more complex and may vary all the way from changing work or relationships to a full investigation of contributing physical factors. Consideration should always be given to the role that current medications may have in stalling recovery – for every 9 people out of 10 who have the expected response to a drug, there will be 1 out of 10 who has just the opposite response. The only way to assess this is to stop treatment.”

    Dr. Healy, this needs clarification. As it reads in your draft, it appears you are recommending rule-out of medical conditions, drug effects, lifestyle interventions, etc. AFTER more invasive treatments have failed. Surely you can’t mean that?

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