Re:Too Many Medicines Simply Don’t Work
by ncmncm on Saturday June 01, 2019 @06:17PM
(#20072039)
The topic is not about opinions, it is about facts.
The epistemological difficulties around treatments for wastebasket diagnoses are very real, but it demonstrates a deep, fundamental confusion to conflate those difficulties with problems with the meds themselves. This failure of reasoning is only attractive to the inexperienced, hence my advice.
To understand the problem, consider the medieval diagnosis "ague". Numerous cases respond instantly to antibiotics. Others, viral, do not respond at all. Some can be prevented by variolation, some by refrigeration, some by hygiene, some by purifying drinking water, some with mosquito netting, some by quarantine, some apparently not at all. The only way to predict which will work for a particular outbreak is to know more details about the causative agent. Denigrating antibiotics because they fail to treat malaria is deadly foolishness.
Double-blind trials, where they work, are the cheapest way to obtain reliable information about a medication's effectiveness for a reliably identified illness. Where they do not work (for readily understood reasons) we are obliged to use more expensive, time-consuming, and idiosycratic methods to obtain the same information.
In the case of "depression", as for other similar diagnoses, such methods have been found necessary, and are used. Insistence that the so-called "gold standard" is the only arbiter of truth (because the name?) betrays ignorance of history and medicine that can be remedied only by deeper experience.
One does not always have time to explain all of the above in detail, and must distill the gist. The gist is better than nothing.
Agreeing with the person who outlines her viewpoints, just because she did so most recently, leads you to agree with falsehoods. Truth is not so easily discerned as agreeableness or articulateness, appealing as the idea may be. What matters is the facts, and to how many decimal places.
The epistemological difficulties around treatments for wastebasket diagnoses are very real, but it demonstrates a deep, fundamental confusion to conflate those difficulties with problems with the meds themselves. This failure of reasoning is only attractive to the inexperienced, hence my advice.
To understand the problem, consider the medieval diagnosis "ague". Numerous cases respond instantly to antibiotics. Others, viral, do not respond at all. Some can be prevented by variolation, some by refrigeration, some by hygiene, some by purifying drinking water, some with mosquito netting, some by quarantine, some apparently not at all. The only way to predict which will work for a particular outbreak is to know more details about the causative agent. Denigrating antibiotics because they fail to treat malaria is deadly foolishness.
Double-blind trials, where they work, are the cheapest way to obtain reliable information about a medication's effectiveness for a reliably identified illness. Where they do not work (for readily understood reasons) we are obliged to use more expensive, time-consuming, and idiosycratic methods to obtain the same information.
In the case of "depression", as for other similar diagnoses, such methods have been found necessary, and are used. Insistence that the so-called "gold standard" is the only arbiter of truth (because the name?) betrays ignorance of history and medicine that can be remedied only by deeper experience.
One does not always have time to explain all of the above in detail, and must distill the gist. The gist is better than nothing.
Agreeing with the person who outlines her viewpoints, just because she did so most recently, leads you to agree with falsehoods. Truth is not so easily discerned as agreeableness or articulateness, appealing as the idea may be. What matters is the facts, and to how many decimal places.