Had a patient once who was a airline pilot. He had to be admitted because of severe depression and started an antidepressant. Soon he wanted to get out of the hospital as fast as possible. Within one week he was back home. He was afraid the medical service of his airline would find out. That would cost him his job.
Most airlines don’t allow their pilots flying when on antidepressants. In Australia they have a better attitude to this problem, because to my opinion it is better to have a pilot on antidepressants than a depressed pilot.
A study presented at a conference of the World Psychiatric Association in Melbourne on Friday found no statistical difference between medicated and non-medicated pilots in terms of their safety record.
She said professionals most likely to let this happen fitted into three groups – depressed men who were going through difficult times and were more likely respond to an adoring client, the bad eggs who “prey” on vulnerable clients and the “ego maniacs”.
There is very little detail about the research from which these conclusions were drawn, so lets be careful out there.
Bruce E. Levine thinks that depression is a normal, albeit painful, human reaction. Because no biological markers for depression have been discovered, scanning techniques delivers conflicting results and the serotonin hypothesis of depression can’t be proved we shouldn’t consider depression being a disease. According to his post Why I Don’t Disease Depression in the Huffington Post.
Don’t know the man but is he a left over from the seventies of the previous century? Where has he been? Following his line of reasoning all other psychiatric diseases would also be a painful reaction. PTSD? Sorry but that are the consequences when you go to war, shit happens. Schizophrenia well bad luck either. Back to the Anti psychiatry? Again questioning the existence of psychiatric diseases.
Even most somatic illnesses lack biological markers nor signs on CT scans.
An insulting post to all of them suffering from depression
This is a list of items that our forum members said they would find especially helpful when they are going through a rough time during the holiday season. It includes thoughtful gifts in every price range.
A very short but accurate list of 5 questions to ask yourself when faced by this decision. From Johns Hopkins Health Alert.
Answers to other three important questions on the site of The Royal College of Psychiatrists 1. How is ECT given 2. The Pros and Cons of ECT 3. Controversies in ECT
Sinterklaas and Saint Nicolas in French, is a holiday tradition in the Netherlands and Belgium, celebrated every year on Saint Nicholas’ eve (December 5) or, in Belgium, on the morning of December 6. The feast celebrates the name day of Saint Nicholas, patron saint of, among other things, children.
Special candy is made for this event such as chocolate characters and pepernoten. These chocolate characters come in all varieties and all kinds of chocolate. Dr Shock prefers the dark chocolate type. What kind of chocolate do you like? My hypothesis is that medbloggers like dark chocolate. If you want to participate in this observational study please vote on the top right of this blog.
On Saint Nicholas Eve gifts are given to mostly the children but also other invited parties. These gifts are usually ingeniously wrapped, and are therefore called surprises. They are also mostly accompanied by a poem. This poem is usually an occasion to have a laugh.
Pepernoten (Spice nuts?) are a cookie-like kind of candy, traditionally associated with the Sinterklaas holiday in the Netherlands and Belgium. You will see the pepernoot in two varieties, one light brown, randomly shaped and made from the same ingredients as taai-taai, but is very hard like a nutshell, where the name originated from (nut = noot). The other variety is nowadays more common and uses the ingredients that are used for speculaas. That one is not as hard as the first one. Peper, means spiced in this case.
Sinterklaas is the basis for the North American figure of Santa Claus; the Dutch colonial town of New Amsterdam maintained a Sinterklaas tradition, long after it was occupied by the English and renamed New York City. The name Santa Claus is derived from older Dutch Sinte Klaas.
24 patients would need to be treated with a dual-action antidepressant drug instead of SSRIs in order to obtain one additional responder. This is called a Number Needed to Treat (NNT) of 24. A number of 10 or lower is considered relevant, so 24 is way above it and not relevant although the authors of this review do their out most to let us believe otherwise.
This is the conclusion of a large meta-analysis published in Biological Psychiatry. The assumption is that antidepressants that simultaniously enhance noradrenergic and serotonergic neurotransmission might benefit depressed patients more than antidepressants working on just one neurotransmittor: serotonin.
They indcluded as much data as possible. The did not only search medline/pubmed and EMBase but also clinical trial registries, program syllabi from major psychiatric meetings held since 1995, and documents from relevant pharmaceutical companies. These last options means also including non peer reviewed work in their search and analysis.
They included 93 trials (n= 17036 patients)for analysis. All comparing a SSRI and a dual action antidepressant: venlafaxine, duloxetine, milnacipran, mirtazepine, mianserin, or moclobemide. Even these so called dual action antidepressant vary much in mechanism of action, their action is not solely based on the inhibition of reuptake of serotonin and noradrenalin.
Duloxetine was apparently less efficacious compared to the others and SSRIs.
Especially important in a meta-analysis is a test for heterogeneity of trials. From the article it is not clear which test they used for heterogeneity, their conclusion was that there existed no heterogeneity. All trials were comparable.
Heterogeneity: Trials studying the same question are unlikely to have the same outcomes on the basis of sampling error. A difference between trials may be due to chance. It is important to know whether discrepancies between trials are greater than we would expect by chance. With heterogeneity the results of various trials are more different than one would expect by chance alone. In short the trials are different.
Article Discussed Biol Psychiatry. 2007 Dec 1;62(11):1217-27. Epub 2007 Jun 22.
Are Antidepressant Drugs That Combine Serotonergic and Noradrenergic Mechanisms of Action More Effective Than the Selective Serotonin Reuptake Inhibitors in Treating Major Depressive Disorder? A Meta-analysis of Studies of Newer Agents.
Papakostas GI, Thase ME, Fava M, Nelson JC, Shelton RC. PMID: 17588546
Very detailed pictures of the human body in 3D. These pictures can be rotated and viewed from different directions – giving doctors the greatest possible help in looking for signs of abnormalities or disease. You can see animated images from this super scanner on BBC health.
A new scanner has been unveiled which can produce 3D body images of unprecedented clarity while reducing radiation by as much as 80%.
The new 256-slice CT machine takes large numbers of X-ray pictures, and combines them using computer technology to produce the final detailed images.
It also generates images in a fraction of the time of other scanners: a full body scan takes less than a minute.
Horrifying story from a Dutch Medblog written in English. Dr Lutser who has a famous Dutch Medblog reports about an Italian Doctor Simoncini. This Doctor Simoncini is well known for his assumption that cancer is a fungus and should therefore be treated with sodium bicarbonate.
By the beginning of October 2007 Dr. Simoncini flew to the Netherlands and started treating Sylvia with intratumoral bicarbonate injections. He was supported by an Italian male assistant who is a doctor as well. She received up to 20 injections in her breast tumor. Shortly thereafter she became sick and contacted the general practitioner who prescribed something for diarrhea. While getting worse every day, her friend contacted Simoncini’s assistant who diagnosed ordinary flu over the telephone.
