Archive for the ‘Research’ Category

Skepticism

Wednesday, June 28th, 2006

In reflection on last week’s recitation of considerable adaptive change in clinical neurofeedback strategies over a fairly short period of time [a score of years], one must also observe the countervailing tendency within our field to value consistency and steadfastness in clinical approaches and theoretical models. With respect to such standards, rapid change in one’s clinical approach seems almost reckless. Stasis in one’s position perhaps has even a certain amount of intrinsic merit. Evidence accumulates in the support of one proposition and eventually the proposition becomes a fact. But it may also be true that some of this sense of stasis is a problem of observation. Let me illustrate with an example.

As dusk descends on the freeways drivers gradually turn on their lights, and over a fairly short period of time (say, the length of an average LA commute) one witnesses the transition from nearly all lights being off to nearly all of them being on. Yet one almost never catches sight of a car with its lights just turning on. Similarly, minds may be changing without it being terribly apparent except in the eventual end result. Moreover, while cars don’t mind being seen turning on their lights, scientists may be less willing to let it be known that they have been compelled to change their views, or even worse, that their views may be in a state of flux. (We know how politicians are savaged for the sin of changing their minds!) So it is perhaps unsurprising that we should not actually be able to identify many instances where someone in our field has actually “changed his mind” on some salient issue or another and said so publicly. Mostly, “they” have all been right all along. (more…)

A Critique of NIMH’s Major Study of Anti-Depressant Effectiveness

Wednesday, April 26th, 2006

On March 23rd the Washington Post reported in a front-page article on the findings just released from NIMH’s 35-million dollar “Sequenced Treatment Alternatives to Relieve Depression” study. The study results were met with mixed reviews. The url:
http://www.washingtonpost.com/wp-dyn/content/article/2006/03/22/AR2006032202450.html
The results from this study were published in three articles and discussed in an editorial in the New England Journal of Medicine (NEJM):

  1. The 1st article appeared in the January 2006 American Journal of Psychiatry (AJP) and focused on the initial response to citalopram (an SSRI) by 2,876 patients presenting with major depression in either a psychiatric clinic or primary care setting.
  2. The 2nd article appeared in last week’s NEJM and focused on the effectiveness of bupropion, sertraline, or venlaffaxine for patients who failed to respond to citalopram.
  3. The 3rd article appeared in last week’s NEJM and focused on medication “augmentation” by adding either bupropion or buspirone to citalopram for those patients who failed to respond to citalopram alone.

(more…)

 

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