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> Conventional psychiatric drugs and talk therapy are backed up by decades of robust scientific evidence. This is not true, he notes, of the typical PANDAS ther

> Conventional psychiatric drugs and talk therapy are backed up by decades of robust scientific evidence. This is not true, he notes, of the typical PANDAS therapies. I think my issue with conventional psychiatric drugs and talk therapy is that they are what Tylenol is to a headache, they don't actually cure the condition, they simply mitigate the symptoms. So it's clear that conventional psychiatry has no clue of the root causes, and doesn't yet understand what exactly in the body or brain causes the symptoms. In that sense, I feel anything that can show a return to "normalcy" and has a root cause explanation, should be considered very seriously and researched deeply, over what simply mitigates symptoms. > The long-term use of antibiotics especially worries him, because it could contribute to the problem of drug-resistant bacteria. This is still the mainstream position: The most recent edition of the Red Book, an exhaustive guide to childhood infectious diseases published every three years by the American Academy of Pediatrics, goes out of its way to recommend that children with PANS and PANDAS symptoms not be given an extended course of antibiotics. That's a valid concern, but I feel someone curious (like me), just has to wonder, well why are the antibiotics needed for so long? What is it here that prevents them from actually getting rid of strep in the brain? Maybe there are alternatives to just permanent antibiotics dosing.

maybelsyrup 5y ago
> I think my issue with conventional psychiatric drugs and talk therapy is that they are what Tylenol is to a headache, they don't actually cure the condition, they simply mitigate the symptoms. It's actually a bit worse than this, and that's saying something. Have a look at this article from 2019 summarizing the lay of the land in research on mental health treatment: https://pubmed.ncbi.nlm.nih.gov/31474241/ https://pubmed.ncbi.nlm.nih.gov/31474241/ There's a link inside to a free full text version of the article. I encourage you to explore the citations in the paper, too, they lead down some fun rabbit holes. Keep in mind too that the authors largely stay away from the potential iatrogenic harms of both prescribed psychotropics and talk therapy, both of which are terribly under-researched.
- deleted 5y ago
  [deleted]
Broken_Hippo 5y ago
I think my issue with conventional psychiatric drugs and talk therapy is that they are what Tylenol is to a headache, they don't actually cure the condition, they simply mitigate the symptoms. The same is true of insulin, though, and many, many other drugs. Somethings just slow down a disease (drugs for autoimmune disorders often do this). I find it completely unfair to expect everything to be a cure: Treating symptoms doesn't make the drugs bad. Treating symptoms is better than not treating them - this helps people not suffer. Actual cures are much, much harder to come by, especially when we don't know what causes them or what to fix to cure them. Medicine doesn't have to be perfect or ideal to be helpful.
- didibus 5y ago
  I don't think I negated anything about that. But here you've got a situation where a treatment that appears to cure a condition, and which has a root cause explanation of the problem, and addressing the root cause shows remission of the symptoms. And yet they are struggling to find funding for more research into it. Now personally, I think research should prioritize those leads over some other brain numbing pill. Also, I do think it's very different in psychiatry. Your example of insulin for diabetes is very different than my example of Tylenol for a headache. We know that your pancreas is failing to produce insulin, we often know why it is, but we can't repair it, so we need to manually do the job that it should be doing, and that will restore your body to a more normal state. It isn't a cure, but it also isn't simply masking symptoms, it's taking over the functions of the body through some other mechanism, for which we understand the bodily function well enough to supplement them ourselves. I don't believe psychiatry is at this point. We don't know why you have schizophrenia, we don't even know what in the body or brain is wrong, we simply observe symptoms, and we find that some pills which have effect on your brain mitigate your symptoms, often by producing other mental changes that distract from them. That's a farcry from our understanding of diabetes and its treatments.
JoeAltmaier 5y ago
That objection in particular (contributes to drug-resistant bacteria) seems deliberately obstructive. People all over the world are being overdosed with antibiotics. These few children with this issue are a drop in the ocean of antibiotic use. It is cruel and venal to throw that excuse in the way of a possibly effective therapy.
kayodelycaon 5y ago
> I think my issue with conventional psychiatric drugs and talk therapy is that they are what Tylenol is to a headache, they don't actually cure the condition, they simply mitigate the symptoms. Which works for a lot of people. We don't know what causes a number of mental health issues. Research is being done but a lot of it hasn't gone anywhere. The human body is complex and there are firm ethical limitations to what methods we can use to understand it. Experimenting on people is fraught with hazards and abuse. We have use what works with the evidence we have because there isn't a better solution for people who need help now.
- didibus 5y ago
  > We have use what works with the evidence we have because there isn't a better solution for people who need help now Except in the case of the article, where there is an alternative that shows promise to a better solution, but struggles to find funding or legitimacy, where the reason it struggles to find legitimacy is because of "lack of data", where the data can't be created because of "lack of funding" justified by "lack of legitimacy". So one of my criticism is in the priorities. My second criticism is in the lack of acknowledgement of how primitive our mental health understanding and treatments are. I feel there should be more humility there. Yes a psychiatrist has studied hard for many years, but after those many years of studies, they should still be able to say, even after all this hard work studying, I cannot tell you what you have, why you have it, and how to fix it, but I can help you through a process of trying various drugs that have various effects to hopefully find a mixture that helps you cope with your disease. And I understand that doctors are wary of other people selling snake oil, someone else saying well I know what you have and can cure it, and then go in to explain things with made up stuff and provide unproven treatments. But at the same time, the humility should create a curiousity around all such claims, what if they are on to something, after all, we know that we don't know, what can we do to know more? Especially when such claims are made by medical researcher in the fields like in this article.

maybelsyrup 5y ago

> I think my issue with conventional psychiatric drugs and talk therapy is that they are what Tylenol is to a headache, they don't actually cure the condition, they simply mitigate the symptoms. It's actually a bit worse than this, and that's saying something. Have a look at this article from 2019 summarizing the lay of the land in research on mental health treatment: https://pubmed.ncbi.nlm.nih.gov/31474241/ https://pubmed.ncbi.nlm.nih.gov/31474241/ There's a link inside to a free full text version of the article. I encourage you to explore the citations in the paper, too, they lead down some fun rabbit holes. Keep in mind too that the authors largely stay away from the potential iatrogenic harms of both prescribed psychotropics and talk therapy, both of which are terribly under-researched.

deleted 5y ago
[deleted]

Broken_Hippo 5y ago

I think my issue with conventional psychiatric drugs and talk therapy is that they are what Tylenol is to a headache, they don't actually cure the condition, they simply mitigate the symptoms. The same is true of insulin, though, and many, many other drugs. Somethings just slow down a disease (drugs for autoimmune disorders often do this). I find it completely unfair to expect everything to be a cure: Treating symptoms doesn't make the drugs bad. Treating symptoms is better than not treating them - this helps people not suffer. Actual cures are much, much harder to come by, especially when we don't know what causes them or what to fix to cure them. Medicine doesn't have to be perfect or ideal to be helpful.

didibus 5y ago
I don't think I negated anything about that. But here you've got a situation where a treatment that appears to cure a condition, and which has a root cause explanation of the problem, and addressing the root cause shows remission of the symptoms. And yet they are struggling to find funding for more research into it. Now personally, I think research should prioritize those leads over some other brain numbing pill. Also, I do think it's very different in psychiatry. Your example of insulin for diabetes is very different than my example of Tylenol for a headache. We know that your pancreas is failing to produce insulin, we often know why it is, but we can't repair it, so we need to manually do the job that it should be doing, and that will restore your body to a more normal state. It isn't a cure, but it also isn't simply masking symptoms, it's taking over the functions of the body through some other mechanism, for which we understand the bodily function well enough to supplement them ourselves. I don't believe psychiatry is at this point. We don't know why you have schizophrenia, we don't even know what in the body or brain is wrong, we simply observe symptoms, and we find that some pills which have effect on your brain mitigate your symptoms, often by producing other mental changes that distract from them. That's a farcry from our understanding of diabetes and its treatments.

JoeAltmaier 5y ago

That objection in particular (contributes to drug-resistant bacteria) seems deliberately obstructive. People all over the world are being overdosed with antibiotics. These few children with this issue are a drop in the ocean of antibiotic use. It is cruel and venal to throw that excuse in the way of a possibly effective therapy.

kayodelycaon 5y ago

> I think my issue with conventional psychiatric drugs and talk therapy is that they are what Tylenol is to a headache, they don't actually cure the condition, they simply mitigate the symptoms. Which works for a lot of people. We don't know what causes a number of mental health issues. Research is being done but a lot of it hasn't gone anywhere. The human body is complex and there are firm ethical limitations to what methods we can use to understand it. Experimenting on people is fraught with hazards and abuse. We have use what works with the evidence we have because there isn't a better solution for people who need help now.

didibus 5y ago
> We have use what works with the evidence we have because there isn't a better solution for people who need help now Except in the case of the article, where there is an alternative that shows promise to a better solution, but struggles to find funding or legitimacy, where the reason it struggles to find legitimacy is because of "lack of data", where the data can't be created because of "lack of funding" justified by "lack of legitimacy". So one of my criticism is in the priorities. My second criticism is in the lack of acknowledgement of how primitive our mental health understanding and treatments are. I feel there should be more humility there. Yes a psychiatrist has studied hard for many years, but after those many years of studies, they should still be able to say, even after all this hard work studying, I cannot tell you what you have, why you have it, and how to fix it, but I can help you through a process of trying various drugs that have various effects to hopefully find a mixture that helps you cope with your disease. And I understand that doctors are wary of other people selling snake oil, someone else saying well I know what you have and can cure it, and then go in to explain things with made up stuff and provide unproven treatments. But at the same time, the humility should create a curiousity around all such claims, what if they are on to something, after all, we know that we don't know, what can we do to know more? Especially when such claims are made by medical researcher in the fields like in this article.