Thank you, Firemonkey.
I found this interesting. A group representing drug companies is saying that anti-depressants don't work for bipolars.
They also say that pdocs prescribe based on symptoms rather than literature (lazy docs!). I thought that most kind of did both. I guess not.
Quote:
I advocate a reversal of prescription patterns such that antidepressants would be used mostly short term and in a minority of patients (perhaps 20% to 40%).
Clearly, further research is urgently needed to clarify these controversies, especially as to the long-term risks of mood destabilization with new antidepressants, as well as the relative risks versus benefits of antidepressants in bipolar type II disorder versus type I.
However, beyond the usual recommendation of more research, the continuation of this controversy reflects not so much how one interprets the data, but rather differences in underlying philosophies about psychopharmacology.
Toward a Hippocratic Psychopharmacology
It is important to discuss why and when clinicians prescribe medications, ie, a rationale for psychopharmacology.
Today, clinicians practice without such a rationale, leading to highly aggressive, symptom-oriented treatment. This has led to extensive use of antidepressants in general, with empirical evidence most unfavorable to benefit with such use in bipolar disorder. How can this practice be turned around?
Perhaps this can be done by following two rules of psychopharmacology derived from the history of medicine, and by truly understanding (and not simply parroting) the Hippocratic approach to medicine.[/B]
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