Though the efficacy versus other antidepressants has been limited in
high quality meta-analyses this new antidepreszant may have value for
certain patients because of the reduced side effects (at least what's
noted in the Wikipedia page) and effects on sleep regulation. It also
works faster and fewer patients drop out of trials from the side effects.
What's fascinating is that it works on a totally different set of
neurotransmitters to conventional antidepressants yet the effects in trials.
This is where I wonder and ponder about the validity of the measures of
depresssion and the diagnostic criteria. The cluster of symptoms
approach lumps in a lot of different types of depressiion into one group
which is meant to be homogenous. Essentially using this approach the
expectation of treatment is that one size does fit all. There are many
theories of depression and cause, for example exogenous and endogenous
depression (though this may be sorted out by the whole adjustment
disorder thing...I'm really not sure about this part), and may types of
depression but they're all lumped together in the research as one thing.
It's sort of like going all shiny metals are the same thing. Be it gold,
fool's gold or any other shiny substance a very basic chemist might
consider them all the same. With our advanced knowledge of modern
chemistry we know that different shiny materials are made of different
things - either elements or combinations of elements called compounds
(or amalgams and other stuff but essentially they're either combined
elements or mixed elements).
Let's say the basic chemist decided to try to take away the shininess of
a shiny substance using an acid. Without being able to understand that
the shiny substances were different they'd find similar results to what
antidepressant trials at the moment find. Even if they tried different
acids they'd find similar levels of effect. Some of the shiny substances
would lose their shininess and some wouldn't.
A modern chemist would understand why and perhaps, in the far distant
future, a mental health professional might understand too. There are
different depressions and different combinations of factors.
This antidepressant has a significantly different neurobiological action
to other antidepressants but doesn't really show itself to be much
better and, with time, I'm sure it will be shown to be only as good as
other antidepressants given the current methods of the pseudoscience of
mental health.
Perhaps if there was Major Depressive Disorder with a sub-type of
significantly disturbed sleep this drug might work better than SSRIs.
But there isn't. There's just one diagnosis for lots of different
experiences of misery.
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