Peter D. Kramer Profile picture
Author of Ordinarily Well, Listening to Prozac, Spectacular Happiness, Against Depression, & more
13 Feb 19
@NYTObits writes of John Gunderson: "He was adamant over the years that psychiatric drugs did not help resolve #borderline symptoms." nyti.ms/2E6UmHv This statement is narrowly true. In lectures, he specified circumstances that warrant the use of a range of medications...
6 months ago, while arguing against widespread use of lamotrigine in #BPD, Gunderson wrote, "Clinical experience has shown that medications can help build an alliance, can relieve states of distress, and can sometimes be helpful for comorbid disorders." ajp.psychiatryonline.org/doi/10.1176/ap…
He spoke of instances when mood stabilizers, #SSRIs, and even antipsychotics might be of use. He spoke out against the overuse of medication but saw a role for judicious use in clinical management. ucdenver.edu/academics/coll…
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27 Jan 19
1/ Thread: New study forthcoming on whether #gene-testing can help guide #antidepressant selection for #depressed patients who have failed to respond to 1 or (on average) 3-4 trials of medication. bit.ly/2LQU75I I have been skeptical: mostly, scant added value…
2/ & I found the reporting of this study annoying. On the primary endpoint, improvement in average #depression rating scores, the gene-testing failed. Patients whose MDs chose new meds w/o help of gene tests did just as well—& yet news reports suggested that tests can help…
3/ That's because the gene testing led to a choice of new meds that led to significantly more remissions (patient no longer depressed) and responses (halving of symptom burden). In general, in drug trials, response/remission shows antidepressants to better effect…
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25 Jul 18
1/ Important study on #antidepressants & #heartdisease. 6 months of Rx for even minor depression in #cardiac patients offers protection against adverse events (heart attack, death, etc) seen for many (8+) years out. bit.ly/2LBZPuM @JAMA_current # of interesting points...
2/ The effects of meds on mood were the same as those in many other studies, 2-3 points difference on symptoms, NNT to remission between 5 & 6, effect size under .4 …& this difference, often dismissed as minor, was associated with marked benefits in terms of overall health...
3/ it looks as if treating about 10 patients early on prevents one heart attack, w & other benefits for heart (& overall) health. Benefits were larger in those whose mood disorder remitted & those who completed the trial. So: good news. Brief inexpensive Rx w lasting benefits...
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