Top Tweets for #OrdinarilyWell
Early report of small study suggests that #stroke survivors given SSRIs make better language recovery.
Findings v-much in line with ones I discuss in Against Depression & #OrdinarilyWell.
Larger trial is planned.
https://t.co/fZIohTRNf4
#antidepressant #aphasia
@AllenFrancesMD @MarkLRuffalo @PsychToday @DrEdwardShorter @DrWinarick @gikkos1 I've written about these issues in #AgainstDepression & #OrdinarilyWell. I favor psychotherapy for depression. But in the short term, meds are especially effective for dysthymia/chronic low-level depression—outperform psychotherapy in some studies.
2/This paper finds that med maintenance prevents relapse (tho' not especially well), and that added CBT did nothing in the way of prevention. The findings tend to confirm my reading of the acute-phase results, which I reviewed in some detail in my book #OrdinarilyWell.
@CoyneoftheRealm I wish that the author had read #OrdinarilyWell. Would have added to his store of arguments/reasoning, & obviated some of the concessions he makes.
@TJOttawa Yes--sure. But you might look at my chapter on meta-analysis in #OrdinarilyWell. When gold standard large trials of treatments with clear outcomes (survival vs death) appear, prior meta-analyses combining small trials look to be at best slightly more reliable than coin tosses.
Interesting that Alan Schatzberg voices worries about patients' relapsing while still on #ketamine or #esketamine. As my TL (and #OrdinarilyWell) shows, my most constant concern about ketamine has been the risk of #tachyphylaxis (hard-to-treat relapse). https://t.co/mHtE8TJtqj
@SurvivingADs (a) In #ListeningtoProzac, I discuss what 'well' means & warn about ethical problems arising w meds that can take patients beyond prior baseline. (b) In #OrdinarilyWell I review & update research evidence on #antidepressants & better-than-well outcomes in #depressed patients.
@joshwhitkin I discuss this issue at length in #OrdinarilyWell. Drug tests entail extraordinary levels of attention & social support—& often enroll v-disadvantaged patients. More volunteers with better social support on their own would help.
@lithub When my books move to publication, I try to avoid subtitles (Exception=Spectacular Happiness: A Novel). Recently, the stumbling block has been Web searches. #OrdinarilyWell doesn't signal #antidepressants as a topic. Subtitles aid the search—so I'm guessing we're stuck with them.
@notchuraverage1 @MHCurious @HengartnerMP @seanluomdphd @SameiHuda @NEJM I review the material in #OrdinarilyWell. FDA liked that nefazodone promised to have different side effects than earlier #antidepressants—less loss of sex drive. To minimize side effects, drug company tested low doses. Approval required a generous reading of outcome trial data
PET scan data reflect the clinical impression I (& colleagues) had arrived at—the one that I shared in #OrdinarilyWell: For patients who have been on #antidepressants for years, ultraslow tapers minimize withdrawal effects. I write about planned tapers of 15 months or more.
How to Quit Antidepressants: Very Slowly, Doctors Say https://t.co/XIBTZCronl
@HengartnerMP @notchuraverage1 @CEP_UK Many reasons. For one: look at chapters in #OrdinarilyWell on additivity. If what is called a placebo effect is largely a psyrx effect, & if psyrx & med effects are not additive, then when meds work, benefits will be more due to inherent efficacy than your #s suggest.
@notchuraverage1 @CEP_UK @HengartnerMP I disagree on most issues, starting with the framing, based in the notion that academic psychiatry tends to deny objective evidence. In #OrdinarilyWell I question formulations (which I find misleading) like "88% of the drugs’ treatment outcome is accounted for by placebo effect."
#Antidepressant prescribing is associated with #HipFractures, but the risk peaks 16-30 days BEFORE the Rx is filled! https://t.co/2KYO62RcJW Result echoes one I discuss in #OrdinarilyWell: Falls in nursing homes peak 4 days before Rx for a new/additional psychotherapeutic med.
Just read @PeterDKramer chapter on the folly of additivity in evaluating antidepressant effects when there’s a placebo effect. Mind blown open. #ordinarilywell
#OrdinarilyWell was my attempt to counter fake news abt #antidepressant efficacy in #depression—parallel to the case for #statins in this @nytopinion piece by @haiderwarraich. & yes, supplementing data w #storytelling is often the way to get points across https://t.co/W1vGpOHPaP
Further work on idea that #SSRIs mostly help people do well in favorable environments https://t.co/anbvvzb7RJ. The guiding theory resembles one I discuss in #OrdinarilyWell, from Philip Cowen @OxPsychiatry: #antidepressants correct emotional bias but do not alter mood directly.
I've had it with @nytimes reporting on #depression. It's ahistorical. This new study looks promising but not unprecedented. There's a body of research (I sample it in #OrdinarilyWell) on #qualityoflife after treated episodes. #QoL can be good, even when symptoms linger.
Most research on depression focuses on the afflicted, a new paper argues, overlooking a potentially informative group: people who have recovered https://t.co/bRN8rBfPx8
@notchuraverage1 No. That's a separate issue I try to sort out in #OrdinarilyWell (in index, see tachyphylaxis). BTW, patients can suffer relapses on meds for chronic recurring illnesses (eg: epilepsy, bipolar disorder) even when the meds are working, ie, lengthening interval between episodes.
Unfortunately, the essay repeats the #canard that for as many as 30% of #depressed patients medications provide no relief. That figure comes from a sample of patients who on average had been depressed 15 yrs & were in their 7th episode. Many were also #alcoholic. #OrdinarilyWell
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