NICS the anti-depressants

In my Google alerts, I came upon a link to The Center for Science Writings at the Stevens Institute of Technology. John Horgan, a professor on the blog, received an e-mail from a former student commenting on the future of anti-depressant therapy:

Introducing “pharmacogenomics,” the latest and greatest addition to the ever-growing collection of pseudoscientific portmanteaus. According to a recent article in the New York Times written by Richard A. Friedman, M.D., there will soon be psychological medication that is custom-tailored to a patient’s DNA and genetic structure to ensure maximum effectiveness.

He makes his case with an example: his patient Laura. Laura was depressed, so Friedman gave her Lexapro, a common selective seratonin reuptake inhibitor (SSRI) anti-depressant. But Laura was still depressed, so he switched her to Zoloft, another SSRI. Still depressed, Laura switched to Wellbutrin, a non-SSRI anti-depressant. No dice. Dr. Friedman was frustrated; after three months he still couldn’t find an effective treatment for Laura. Then, Laura decided that since Prozac (also an SSRI) had helped her father with depression, she wanted to give it a shot. And voila, it worked!

If only Laura’s genes were able to reveal that Dr. Friedman should have prescribed Prozac, arguably the most well-known anti-depressant in America, from the very beginning, that would have saved a lot of hard, aggravating diagnosis work on everybody’s part.

But wait! There might be salvation on the horizon; according to Friedman it will soon be possible for doctors to analyze a patient’s unique genetic profile and prescribe the appropriate medicine so that time and money would no longer be wasted on the circuitous trial-and-error process of expert diagnoses.

No, what “melted away” Laura’s depression was good, old fashioned SSRI Prozac. But Friedman doesn’t see the contradiction. Instead, he claims that this new process of genetic-based medical treatments, “pharmacogenomics” will revolutionize the medicine, allow doctors to enhance their already astute diagnosing skills, and reduce the pharmaceutical industry to a withering dinosaur.

But what about Laura? What about the Prozac? Could it be that she was genetically predisposed to a specific brand of medicine? Are we all designed to respond to one drug label instead of another? If indeed that’s the case, there is only one logical conclusion to draw: God exists and He’s a Big Pharma shareholder.

Somehow, I’m not so convinced. — Suhas Sreedhar

I'm with Suhas. I skimmed Dr. Friedman's article and the whole process sounds weird. I think Laura probably – haha – psyched herself into thinking that Prozac would work since it worked for her dad.

While genes play a role in generational and familial health, I'm not completely convinced that psych meds would affect a father in the same way as it would affect his son or daughter across the board. Even if it really did work for Laura, I am skeptical that the method could be applied to any psychiatric patient. If a patient doesn't have any family, there we go with trial-and-error. Or we could just search our future FBI DNA mental health database and see if the patient matches up with anyone currently on meds.


Last week, Attorney General Alberto Gonzales called upon the remaining 27 states who don't report mental health files to the  NICS to do so. (That was an awful sentence.)

Speaking during a meeting of the nation's state attorneys general, Gonzales urged [states] to participate in the National Instant Criminal Background Check System, more popularly known as "NICS."

Then the article (linked to above) jumped to protecting the public from sex offenders:.

Gonzales also called for ideas on how to protect the public from convicted sex offenders.

Mental health experts, however, say Gonzales is overreacting. Sex offenders are less likely to repeat the same type of crime than other criminals, only about 13 percent within the first five years, said Dr. James Stark, former president of the Georgia Psychological Association.

"The whole country is in a predator panic. They've gone crazy," said Stark, who treats sexual disorders at the Marietta and Ellijay clinics of Psychological Forensic Associates.

"There are very few sex offenders who are actually dangerous," he said, adding that most of the 13,000 people on Georgia's registry of sex offenders are there for flashing, being a peeping Tom or having consensual sex with an underage girlfriend.

Maybe I'm overreacting. If a sex offender isn't dangerous, why is he or she a sex offender to begin with? Yup, peeping Toms don't ever turn into psychos. On that matter, try watching Alfred Hitchcock's movie, Psycho. (Please don't watch the remake. You'll be better off for it.)

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