Sunday, May 31, 2020

Comments by pigsfly

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  • Dear bcharris ~ what do you mean by your comment that it is a superstitious belief that double-blind, placebo controlled studies are the “best in treatment studies” despite the method being totally unverified???? My thoughts differ on this completely! Having been involved in Clinical trials for ~ 30 years at every level. We would not have so many drugs & treatments that have changed the face of medical practice in the world without them – take for example AZT for both HIV as well as to prevent transmission of the virus in pregnant women to the fetus, monoclonal antibodies for RSV etc and most especially the randomized clinical trial done by Dr. Bernard Fisher in PBG PA re breast cancer surgery. The man was vilified and the trial finally proved women did not do any better with radical mastectomy! Looking at psychiatry I find many flaws in clinical trials but will describe 2 – When reviewing data on antidepressants the trials are exceedingly short with little to no follow-up and thus the results are not adequate when most pts take antidepressants for years. You can’t even speak to side effects seen over time or lack of efficacy! Also there is a problem with the suffering that people endure if schizophrenic when on the placebo arm. On the other hand what about pts who died or suffered disease progression when on placebo for HIV trials? Mental illness is still thought of as a character defect in the USA and MD’s and psychiatrists have been very slow to advocate for the patients!!! How long have Insurance Companies discriminated between payment for medical illness VS psychiatric suffering until the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008? I wonder why patients and their families are left to fight alone and why practitioners aren’t working harder on behalf of this population? DO you know how many psychiatrists etc accept Medicare??? or reduced fees??? Exceedingly few in the huge city I live in ~ it’s strictlly pay for service and the practitioners get rich! Why aren’t professionals in the field trying to change things for their patients?