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Re:Why Antidepressants Don't Live Up to the Hype by tokenadult on Thursday May 07, 2009 @02:44PM (#598441)
AFTER EDIT:

research on antidepressants which unambiguously make you feel better - namely, dopamine reuptake inhibitors - was outlawed

Do you have a citation for a law or policy statement that shows that there is indeed such an outlawing? I see Google Scholar citations that suggest that research is ongoing, and there is more planned.

http://www.ajp.psychiatryonline.org/cgi/content/abstract/163...

/AFTER EDIT

There are more than 100 countries in the world, and they would have to be united in banning a certain direction of research for there to be no research on that subject. But dopamine reuptake inhibitors, based on ongoing research in various places, are a risky approach to treating major mood disorders.

"DRIs are notorious for their high abuse potential and ability to cause addiction and dependence. Pure DRIs such as cocaine and combination releasers such as amphetamine and methamphetamine are widely abused throughout the world."

http://en.wikipedia.org/wiki/Dopamine_reuptake_inhibitor

"NDRIs approved to treat depression

"Here is the only NDRI that has been approved by the Food and Drug Administration specifically to treat depression, with its generic, or chemical, name followed by available brand names in parentheses:

    * Bupropion (Wellbutrin, Wellbutrin SR, Wellbutrin XL)" 
. . . .

"Safety concerns with NDRIs

"Bupropion can increase blood pressure in some people, so regular monitoring is important. The risk of developing high blood pressure may increase if you also use nicotine replacement therapy, such as a nicotine patch, to help you stop smoking.

"There's a small chance that taking bupropion can cause a seizure if you've had previous seizures, a head injury or a nervous system tumor, or if you've had an eating disorder, such as bulimia or anorexia. Because of that, don't take this medication if you have a history of seizures or eating disorders or if you're abruptly discontinuing use of alcohol or sedatives. Be sure to tell your doctor about your past medical issues.

"Also, because of potentially dangerous medication interactions, be sure your doctor knows about any current or previous use of monoamine oxidase inhibitors (MAOIs). Tell your doctor also if you have severe liver cirrhosis, because Wellbutrin can cause liver problems. In addition, don't take Zyban while you're being treated with any form of Wellbutrin."

http://www.mayoclinic.com/health/antidepressants/MH00068

Re:Why Antidepressants Don't Live Up to the Hype by asciilifeform on Thursday May 07, 2009 @02:50PM (#598450)
Notice how Wellbutrin - the 1970s state of the art - is what we're stuck with. Precisely because research has been curtailed - yes, internationally. Progress stands still.

Also compare the side effects you listed with those of the wildly popular SSRIs.

And yes, any hypothetical drug which reliably makes you feel better will be addictive in some sense of the word. Deal with it, and move on with life. Addiction is only the bugaboo it is claimed to be when the thing you are addicted to is actually harmful. Most people don't consider themselves "drug addicts" for using caffeine, for example.

The focus should be on developing drugs which do the mood-lifting job, don't produce tolerance, and don't damage your internal organs. There is no evil spirit which manipulates the universe to make this goal impossible. It is simply considered undesirable by our Puritan rulers (and the outposts they have built inside our own heads.)

Reply to Edit:

> Do you have a citation for a law or policy statement that shows that there is indeed such an outlawing? I see Google Scholar citations that suggest that research is ongoing, and there is more planned.

Check out the Federal Analogues Act (US) and its foreign equivalents. Any drug which is chemically similar (with a very liberal definition of "chemically similar" that provokes howls of laughter from chemists) to a currently banned drug is instantly placed into "Schedule I" - "no medicinal use" - and is outlawed, in such a way as to make research nearly impossible and certainly unprofitable. But the real problem lies with our society's perception that a drug which gives you pleasure is an unambiguous and unmitigated evil all in itself, regardless of whether it has harmful side effects. Few of the research drugs in the papers you've seen will be permitted on the market, for this reason. Certainly none of the ones which actually work will be.

By deliberately marketing antidepressants which only work subtly and sometimes, the pharmaceutical industry continues to uphold the ruse that they are actually treating an ordinary disease, like leukemia. But we know how to build antidepressants which work on everyone. It isn't being done because if it were, the smoke would clear, and we would be forced to admit that we are actually treating unhappiness. Unhappiness caused by stimuli which ought to make a sane person unhappy.

Re:Why Antidepressants Don't Live Up to the Hype by tokenadult on Friday May 08, 2009 @03:46PM (#600141)
But we know how to build antidepressants which work on everyone.

It took me a while in my offline personal life for the very evident counterexample to come to mind. In fact, it is well known that human mood can go wrong in two ways: by being too low (depression) but also by being too high (mania). To date, there isn't any medication that reliably raises the mood of individuals in normal mood states without subjecting some of those individuals to severe risk of psychotic mania. Anyone proposing policy reform as to this issue should be aware of this fact. Here are some reading references for HN participants who would like to know more about the medical research on mood disorders:

Depression: Causes and Treatment, 2nd Edition

http://www.amazon.com/Depression-Treatment-Aaron-T-Beck/dp/0...

(a very recent book, by the inventor of cognitive therapy)

or

http://www.amazon.com/Manic-Depressive-Illness-Disorders-Rec...

(a very authoritative textbook with extensive references to primary research literature).

Re:Why Antidepressants Don't Live Up to the Hype by anigbrowl on Thursday May 07, 2009 @05:56PM (#598760)
That's all true. But nobody says 'oh, you're addicted to blood pressure regulators or (other medication for chronic conditions)'. Informally, my experience is unhealthy levels of dependence seem to manifest in people who don't have a deficiency in the first place. Unless one's neurological deficiency is really severe, one often develops a methodology to live with it. Absent that know-how, it's a lot easier to overdo it and end up in the ditch.