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Schizophrenia drugs may have been off target for decades, study finds

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Re: Schizophrenia drugs may have been off target for decades, study finds

#41

Post by AmericanChopper »

mtlmtlmtlmtl wrote: post #24
hinkley wrote: post #19

Earlier quoted context omitted.

The serotonin model of antidepressants just doesn’t pass a sniff test. Something else is going on there. How they say they should work would mean they work in the first dose and possibly that don’t require tapering off. But that’s not what happens in the real world. If we understood what’s really happening we could target pathways better.

The "serotonin model", actually called the monoamine hypothesis, hasn't really been taken seriously in the field for decades, except by naysayers like yourself who continue to use it as a strawman.

> hasn't really been taken seriously in the field for decades, except by naysayers like yourself who continue to use it as a strawman.

…and by basically the entire general public. Big pharma did a great job on the “depression is a just a chemical imbalance…” awareness campaign, but absolutely dropped the ball on the “actually we were wrong about that” campaign, so that’s still what most members of the public tend to believe.

Re: Schizophrenia drugs may have been off target for decades, study finds

#42

Post by pigeonhole123 »

mtlmtlmtlmtl wrote: post #24
hinkley wrote: post #19

Earlier quoted context omitted.

The serotonin model of antidepressants just doesn’t pass a sniff test. Something else is going on there. How they say they should work would mean they work in the first dose and possibly that don’t require tapering off. But that’s not what happens in the real world. If we understood what’s really happening we could target pathways better.

The "serotonin model", actually called the monoamine hypothesis, hasn't really been taken seriously in the field for decades, except by naysayers like yourself who continue to use it as a strawman.

There seem to be practitioners still taking this seriously, and I expect them to continue to do so until they die. According to this article from 2022 it's still "influential": https://www.nature.com/articles/s41380-022-01661-0

Re: Schizophrenia drugs may have been off target for decades, study finds

#43

Post by Pixie_Dust »

winrid wrote: post #15

One of the more popular Schizophrenia drugs also cause diabetes :(

> One of the more popular Schizophrenia drugs also cause diabetes :(

Not to mention, weight gain leading to type two diabetes, thyroid problems leading to fluid retention in the legs and memory loss. Not much of a cure :(

Re: Schizophrenia drugs may have been off target for decades, study finds

#44

Post by retrac »

aatd86 wrote: post #25
whats_a_quasar wrote: post #5

The brain is really complicated, and all psychiatric medications affect multiple receptors and subsystems. Framing this study as "antipsychotics were off target" is an editorial choice. The title could just as easily have been "Improved understanding of antipsychotic action means we may be able to design better antipsychotics." Edit: It also ought to be noted that the study was on mice that had been given amphetamine…

I think you might miss the point slightly, moving too far the discussion on the other side. It's perfectly normal to wonder how can one administrate something when one doesn't understand it. Especially when there can be such debilitating effects. In clinical settings, things are way less clear than you make it seem. All psychosis are not equal and even all diagnostic of a same patient are not equal. There is a lot mo…

> It's perfectly normal to wonder how can one administrate something when one doesn't understand it. Especially when there can be such debilitating effects.

A theoretical/principled understanding of how a drug works has never been required for useful medicine to happen. For example, we don't know how general anaesthesia works. We don't know why some people have extremely bad reactions to certain anaesthetics (and they do). And yet they are used every day, to enormous net benefit.

> finding the base neuro-transmitter levels in and out of psychotic phases for each patient before deciding on the posology of a treatment

Is it actually possible to measure that, non-invasively?

Re: Schizophrenia drugs may have been off target for decades, study finds

#45

Post by hinkley »

wk_end wrote: post #31
hinkley wrote: post #19

Earlier quoted context omitted.

The serotonin model of antidepressants just doesn’t pass a sniff test. Something else is going on there. How they say they should work would mean they work in the first dose and possibly that don’t require tapering off. But that’s not what happens in the real world. If we understood what’s really happening we could target pathways better.

How antidepressants work doesn't seem especially germane to a discussion of antipsychotics?

Neurochemistry isn’t relevant?

Re: Schizophrenia drugs may have been off target for decades, study finds

#46

Post by m_0x »

11235813213455 wrote: post #32

I was diagnosed with schizophrenia, given some strong antipsychotics, it was a disaster I could barely talk or hand-write properly, gained 15kg. Fortunately I didn't listen the advices and stopped after 4 months, my therapy now is just walking, running, cycling, outdoor, trees, vegetable, minimalism

Pardon my ignorance and prejudice, but how are you not a danger to the people that surround you?

Or is schizophrenia a spectrum very much alike as autism?

Re: Schizophrenia drugs may have been off target for decades, study finds

#47

Post by thrw238592 »

justsomeguyhere wrote: post #11

So I've tried half a dozen antipsychotics, here are my 2 cents: The only things those drugs did to me were making me comatose, poop my pants, sleepy, dumb and hungry. You can't be declared psychotic or paranoid, when the only thing you can do is sleep, drool, poop yourself, and make 3 words sentences, so lazy doctors think these drugs work. But they don't, there was zero change in my beliefs, fears, anxieties, I was…

[dead]

Re: Schizophrenia drugs may have been off target for decades, study finds

#48

Post by astrange »

dontknowwhyihn wrote: post #40
mtlmtlmtlmtl wrote: post #24

Earlier quoted context omitted.

The "serotonin model", actually called the monoamine hypothesis, hasn't really been taken seriously in the field for decades, except by naysayers like yourself who continue to use it as a strawman.

Don’t people still talk about “low seratonin levels?” I always found it suspect that we say someone’s levels are low without actually measuring them.

Yes, and psychiatrists never believed it was "low serotonin" at all, or at least claim to have never believed it.

For ADHD, stimulants actually do treat it by fixing "low dopamine"… in specific areas of the brain. But "low dopamine" is also a description of Parkinson's disease.

But SSRIs don't work like stimulants do; they take a lot more than half an hour to take effect. We don't actually know how SSRIs work in the people where they do work.

Re: Schizophrenia drugs may have been off target for decades, study finds

#49

Post by aatd86 »

retrac wrote: post #44
aatd86 wrote: post #25

Earlier quoted context omitted.

I think you might miss the point slightly, moving too far the discussion on the other side. It's perfectly normal to wonder how can one administrate something when one doesn't understand it. Especially when there can be such debilitating effects. In clinical settings, things are way less clear than you make it seem. All psychosis are not equal and even all diagnostic of a same patient are not equal. There is a lot mo…

> It's perfectly normal to wonder how can one administrate something when one doesn't understand it. Especially when there can be such debilitating effects. A theoretical/principled understanding of how a drug works has never been required for useful medicine to happen. For example, we don't know how general anaesthesia works. We don't know why some people have extremely bad reactions to certain anaesthetics (and the…

The anaesthetic agent is not a drug that one is supposed to take for the remaining of their life and has no observed side-effects in general.

It's also treated with the utmost care and in most interventions, if there is a choice to do without, the patient is offered the choice. There is a lot more consent involved.

So it's not the same thing.

To answer your other question, yes, neurotransmitter levels can be measured in the blood or urine.

For someone under-treatment, it would only make sense to. Wait 4 or 5 times the half-life of the molecule. (that's the difficulty since once started, they are not even supposed to stop).

Re: Schizophrenia drugs may have been off target for decades, study finds

#50

Post by TeaDrunk »

m_0x wrote: post #46
11235813213455 wrote: post #32

I was diagnosed with schizophrenia, given some strong antipsychotics, it was a disaster I could barely talk or hand-write properly, gained 15kg. Fortunately I didn't listen the advices and stopped after 4 months, my therapy now is just walking, running, cycling, outdoor, trees, vegetable, minimalism

Pardon my ignorance and prejudice, but how are you not a danger to the people that surround you? Or is schizophrenia a spectrum very much alike as autism?

Schizophrenia can be more or less severe. A schizophrenic with very mild symptoms, a stable life, access to food and shelter, no unhandled trauma, etc. can function and even thrive without medication. The disease can also get better with age.

Consider: you can hear voices and choose not to respond to them. You can have delusional beliefs and not act on them. There's no functional difference between talking with your mom on the phone and talking with an alien that has replaced your mom on the phone if you're willing to play along or simply acknowledge "hi schizophrenia, funny idea, that".

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