fragcula

27 ms·

1.
by fragcula 4y ago
> I think we're just disagreeing on different interpretations of the word effective. That's likely. I'm using the word in the sense of clinical efficacy, i.e. how likely an intervention is to produce the intended outcome.
2.
by fragcula 4y ago
Oh I see. No ECT is most certainly the most efficacious treatment for depression we have. Talking therapies have a respone rate in depression of circa 40% [0], probably just slightly higher for antidepressants up to about 50% and faster [1]
3.
by fragcula 4y ago
abelacimab in particular was quite worrying. The BMJ (the journal OP posted) contained a criticism of that. Similarly as you say is that because numbers are easy to think about antibody titres somehow took over the world when it came to cov
4.
by fragcula 4y ago
I'm not sure what part of what I said you disagree with. Nothing in the NICE guidelines explains how ECT works - because like the rest of the world NICE does not know. Once odd aspect with ECT is that it seems to transiently improve pa
5.
by fragcula 4y ago
We also don't know who CBT works for what it's worth. It's also fairly limited in suitability (good luck with someone with catatonic depression trying to get them do a hot cross bun), availability (thankfully online therapies
6.
by fragcula 4y ago
An extra foible is that many medications have psychiatric side effects. So even if you're prescribed a statin for the biochemical effect on cholesterol you might get some of the purported psychiatric effects.
7.
by fragcula 4y ago
The interesting bits, for me, are the imaging scans which are expensive and slow and you need more than one for comparison per subject. Secondly the 'covert treatment' aspect, and as far as I know only Hjorth et al. do in any reas
8.
by fragcula 4y ago
It's interesting that anyone other than the R&D arm of the pharma industry even cares how it works. From the medical side what's important is what risk/benefit which is independent. Antidepressant as a term is really only
9.
by fragcula 4y ago
It's a shame that the imagining is so expensive, because I'd love to see a true control arm with placebos and follow up scans. i.e. if you are on a placebo and are told you will get better how many do?
10.
by fragcula 4y ago
The psychiatrists themselves don't need to do both, as doctors practicing EBM they are interested in proven results. The decision to recommend a treatment (and to accept it) is based on the pros and cons only. What people really care a
11.
by fragcula 4y ago
> Other clinicians say, however, that the notion of depression being because of a simple chemical imbalance is outmoded anyway, and that antidepressants remain a useful option for patients alongside other approaches including talking the