“While only half of these trials had formally significant effectiveness, published reports almost ubiquitously claimed significant results. "Negative" trials were either left unpublished or were distorted to present "positive" results.”
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2412901/
If this is true, then many people who currently take antidepressants may actually be better, not worse, without them, since at least they’d avoid the side effects.
Further, the “chemical imbalance” theory that is propagated through paid advertising has no applicability to a doctor prescribing an antidepressant, since the doctor has no way of measuring and monitoring that imbalance should one exist.
I've never seen a pharmaceutical ad that used that term. The only thing I recall from the ads is them distinguishing clinical depression from feeling blue.
Example, probably the most the most recognizable anti-depressant ad ever (at least in the US): https://m.youtube.com/watch?v=twhvtzd6gXA @ 0:20
Funny thing about psychosis — when you’re psychotic, your erratic and extreme behavior doesn’t feel abnormal. You don’t feel like anything has changed. This happened to me on Prozac — the most commonly prescribed antidepressant — and it took me 3 years to put my life back together after all the damage I did to my personal relationships during that period.
The anxiety I was dealing with was crippling, but it didn’t dismantle my life the way the side effects of that drug did. The treatment was absolutely worse than the disease. If they had done a genetic test first, they would have seen a red flag and avoided SSRIs all together.
This testing exists today, but it’s only used in patients who show strong resistance to pharmacological intervention. It should be standard.
TED talk by Jack Gallant https://www.youtube.com/watch?v=Ecvv-EvOj8M
recreating vision: https://www.youtube.com/watch?v=nsjDnYxJ0bo
another ted talk by John-Dylan Haynes https://www.youtube.com/watch?v=mMDuakmEEV4
paraphrased: "wireless non-contact mind reading tech may be cheap and mass producible within the next 50 years."
the only rate limiting step with his method of decoding thoughts is that it takes time under a high energy device to pair associations in the brain.
Think of how much screen time we currently use. If we could pair a wireless 'headset' like headphones while looking at pictures on a screen it would be possible to build a brain bank of children->tenenagers. Currently we just need a lot of processing power and reserved bandwidth on the internet to do some cool stuff.
1. Our understanding of the brain is poor, and I think that will be necessary to have good machine decoding. In principal, a machine learning algorithm does not need to know how the brain works to make an accurate decoding prediction, but I suspect understanding will be needed to help construct and constrain machine learning models learn to deal with the myriad of mental states, intentions, emotions, etc that can occur. While we can train classifiers better than chance to identify whether one or another item is observed, remembered, etc, these training are quite constrained to a type of information or class. I imagine those classifiers are hopeless when you start performing another activity or mental state, and the machine would need to recognize the new state and apply different decoders.
Second, yes there is too much noise in most available methods (EG, fMRI, MEG) and the information is not dense enough (spatial, temporal resolution) and not specific enough to the type of activity (excitation, inhibition, chemical diffusion, etc). Electrodes have done cool things, but I suspect that even millions of wires would not provide enough information and types of information to provide a full fledged brain interface.
However, I'll admit, tech is moving so fast...
So many cancer treatments go into clinical trials with only the evidence that it shrinks tumors, and tends to kill tumors faster than it kills the rest of your body. Side effects are expected to be severe since most cancer treatments are quite literally killing any cells that divide... tumors just divide faster and thus get hit harder. The end result is cancer treatment often has very poor quality of life.
Clinical researchers _do_ perform analysis to see if survival increases relative to other treatments. But often you don't know until you've already tried it on a cohort of patients (with their consent, obviously).
There is push-back in the medical field in areas for what you suggest. For example, colonoscopies are becoming widely recognized as causing more problems than they solve. The complications they can induce tend to lead to a poorer patient outcome than missing colon cancer because you didn't screen (e.g. survivability is not affected by finding/treating colon cancer early).
I just don't think it's fair to paint cancer treatments with the same brush strokes, since dealing with terminal diseases is a totally different ball game.
Edit: I should say, there are some parts of cancer treatment which is moving towards the dont-treat opton. For example, there is growing evidence that treating prostate cancer is not necessary, since you'll probably die of something else long before prostate cancer kills you (it is very slow growing on average)
Is it possible to do this kind of thing oneself with 23andme style SNP tests and a google scholar search, or does it involve more than that?
https://slatestarcodex.com/2019/05/07/5-httlpr-a-pointed-rev...
As far as negative results being "distorted" to present "positive results" is concerned, yes it is quite common to take a patient population that overall fails to show statistically significant benefit and see if there is a subset that does in fact show a statistically significant benefit. One could call that p-hunting, but as long as it is followed up and confirmed, it doesn't seem like a nefarious thing to do.
We had 4 decades for doctors to get interested in them, study them, and make protocols for them for the public.
Only now are we, timidly, talking about them. It was considered hippie stuff at best, cult/lunatic ideas at worst.
But turning an entire nation into drug addict is apparently fine.
What they want is the doctor to provide a pill to fix whatever the immediate issue is, so they can get back to their life. When providers push back on this and try to suggest lifestyle changes, many patients get _angry_. Like, yelling, shouting, complaining to administrators that the provider isn't "listening to them" or "not taking their problems seriously". People want to be fixed, not fix themselves.
There's plenty of blame to go around, but a healthy share falls on patients themselves.
Source: SO is a medical provider. My faith in humanity falls daily and I can't believe the crap providers have to put up with. It's like a service job dealing with irritated people all day long, except these people read a blurb on WebMD and think they are an expert.
Yes, but it's also very hard to do. I took me 30 years to actually have a nervous and hormonal system that was not fucked up.
Before that, I tried for decades to restrain myself and exercise, and it was just not sustainable. I had to read so much, go through so many experiments, meet and talk to so many people to find all the stuff I needed to actually fix myself. And the work is far from over, I have yet a lot to do.
I was kind of expecting medical professionals to pick up on what I needed, and actually helped me on the way. 2 did a little, out of probably 30. And I met them only because my close ones were atypical, and know original people.
Our health culture is failing big time here.
Stream-of-consciousness about these (sorry a bit off topic):
1) Detach yourself from "culture" and try to meditate, do breathwork, some people get into this zone better while doing stuff like Tai Chi, Yoga or Chi Gong. Go slower!
2) Exercise but find something that your body responds well to and don't over do it (many people exercise mindlessly)
3) Be social, you are a mammal and need to be touched and feel other peoples breath, warmth and voice close to you - it's a part of tribal nature, and balances your sympathetic nervous system
4) Get out in the sun and stroll around without purpose sometimes just walking, thinking, exploring the city/forest - again we are wanderers in our genetic heretage (you often think better when walking without purpose - french people call it Flâneur)
5) Create more than you consume: write, work, plan, set goals. Without a plan you are walking aimlessly and will run out of resources, feel left out and wither.
6) Eat and drink well. (fast sometimes, less junk food, more vegetables, enough protein for activity level, more organ meats if meats at all)
7) Be brutally honest towards yourself, but acknowledge that self image is malleable and mysterious like the rest of the universe. So always have an echo of awe in the back of your mind. This reality is amazingly absurdly weird, wonderful, mysterious, dreamlike, filled with obscure esoteric symbols of knowledge and history and tradition and truth in an all encompassing and infinite web all around you and your consciousness.
8) Read challenging fiction, do math, play and instrument. (or some one of these, it has to be difficult)
Understand this key is a chain where all parts are equally important like:
Learn to imagine so you can make a plan or have a vision. Imagination is a precursor to planning, and meditation and unplugging is a precursor to to this imagination. If your mind is clouded the first plan is to eat well, rest, and slowly introduce exercise until your mind is in a state of clarity, and you can actually feel "something" in your gut (ie intuition or your second brain), then you feel what you "want" in you gut, and create your plan with your non-clouded mind.
- my testosteron was low, and that I was missing omega 3, d vitamin and magnesium.
- my digestive system was in crisis.
And fix that.
Without it, you can't find the energy and motivation to do the rest all year round.
After a while, they help each other.
The next step is to cut out on sugar.
They based their initial "he's ok" on a single temperature check after I'd taken Panadol. I get it, when a doctor hears hooves they think horses. It's just frustrating.
That’s the problem with all this experimentation.
He just wants a silver bullet.
And yes, most psychiatrists don't want the liability of weaning somebody off a medication.
You are right, it doesn't make any sense--it certainly is not good for patients.
But believe me there are bad doctors out there (your specific case) so you'll have to switch.
The problem is not with individual doctors, it is that the structure {legal, economic} surrounding mental health favors getting people on medication, but doesn't create good paths for them to get off (at least in the US).
I’m sure there will be/are places where these databases are run by private companies with no accountability and no way to issue a complaint.
When I was in my 20's I tried various SSRIs - at least three, possibly four different ones - and my pattern was always the same, which was to take them for six months, get frustrated because they didn't do anything but make my hands shake, etc., then flush them down the toilet and quit cold turkey with no ill effects. Same thing with Ritalin. I was taking it for a few years because it (shockingly!) made me a more prolific computer programmer, then my doctor moved to California and I never got a new prescription. No withdrawal whatsoever that I noticed.
My personal, subjective, anecdote-based take on this is the stories of withdrawal are as overblown as the stories of effectiveness for a lot of these.
Some drugs are relatively benign to quit cold turkey (a sizable percentage of people may run into irritating side effects like nausea, etc) but it won't kill you.
Other drugs like benzos can be fatal to quit without tapering. And other classes can induce serious side effects even when properly tapering, let alone quitting cold-turkey (e.g. hallucinations, psychosis, insomnia, etc etc).
Just look up the video where Feynman is describing how two different people count to 100 in two completely different ways.
A few days later, I came back from taking the trash out to find her on the floor, gray and wheezing and totally unresponsive, having suffered from a serious seizure due to medication withdrawal. On waking up, she had serious amnesia (couldn’t remember the year, who the president was, etc.) for a couple of hours.
Please don’t assume that anecdote == data, or that your personal experience with one medication is generalizable to other people and other medications.
Those several weeks were hell. I was having anxiety attacks all the time.
I initially thought something else was wrong and didn’t even consider withdrawal (since the doctor had said I should have no issues) but later googling revealed withdrawal was pretty common with the drug I was on.
I’m just glad it’s over.
https://www.nytimes.com/2019/03/05/health/depression-withdra...
"In a paper published Tuesday in Lancet Psychiatry, the authors argued that any responsible withdrawal regimen should have the patient tapering off medication over months or even years, depending on the individual, and not over four weeks, the boilerplate advice."