|Couples Diets Brain Science Challenging Cases Mary Jo Barrett Wendy Behary William Doherty Clinical Mastery David Schnarch Anxiety The Future of Psychotherapy Men in Therapy Attachment Future of Psychotherapy Mindfulness CE Comments Trauma Couples Therapy Clinical Excellence Alan Sroufe Community of Excellence Mind/Body Great Attachment Debate Attachment Theory Narcissistic Clients Ethics Symposium 2012 Etienne Wenger Gender Issues Linda Bacon|
|Clinician's Digest - Page 2|
Not so fast, says Talbot, who questions the assumptions of the neuorenhancers' advocates in her New Yorker article. Do we want to live "in a society where we're even more overworked and driven by technology than we already are, and where we have to take drugs to keep up; a society where we give children academic steroids along with their daily vitamins?"
When Newer Isn't Better
New medications are the lifeblood of pharmaceutical company profits (see Bookmarks, page 59). As older medications go off patent, new meds—typically much more expensive than the old—bring in millions of dollars. Marketing the new medications effectively depends upon convincing people that the're better—not a hard sell in a culture that usually equates newer with better.
The marketing strategy for atypical, or second generation, antipsychotics has been to claim that they have more moderate side effects and are more effective at reducing the symptoms of schizophrenia and other severe disorders than were the old standbys, such as Haldol and Thorazine. Up to now, the case has been so convincingly made by their manufacturers that the SSRI and SSNRI antidepressants are more effective than the MAOI or tricyclic antidepressants at alleviating depression and causing fewer side effects that the newer drugs have virtually pushed the older drugs out of pharmacies and psychiatrists' consciousness.
Recently, however, two metanalyses have found that the atypical antipsychotics and the new SSRI and SSNRI antidepressants aren't necessarily better choices, and suggest that the main wonder of several of the new wonder meds is that they've been so widely prescribed. Unlike clinical trials that used narrow measures of efficacy for their outcomes, the metanalyses looked at a combination of efficacy, side effects, and price—exactly the kind off cost/benefit analysis physicians should make whenever they prescribe drugs.