Скачать или смотреть The SCIENCE Behind Choosing the RIGHT Medication

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This video debunks the notion in psychiatry that, because it is never possible to predict a particular patient's response to a given medication trial, all such trials are by definition empirical. This is not to suggest that a "we'll-just-have-to-wait-and-see" attitude is ever justified, or that the selection of medication is not bolstered by hard science. Clinicians can, and should, always be able to predict with a high degree of certainty which target symptoms will respond, and in what manner, to the manipulation of an individual's biochemistry, even if the ultimate expression of a person's response to a given medication is too complex to fully foresee.

As an aside, because there are so many variables–many of which have nothing to do with a given medication's intrinsic efficacy–expensive bloodwork (pharmacogenomic testing) purported to be able to help a clinician make that selection is a huge waste of time and money, in my professional opinion. Those assays are best at predicting tolerability, but the "start low, go slow" philosophy that should be employed in every case makes mitigating adverse effects slow metabolizers are apt to experience, like those at risk of drug-drug interactions, a no-brainer (pun intended).

00:00 Defining Empiricism
01:53 Properly Identifying Target Symptoms
02:15 Medication Adherence?
04:15 Not Efficacy, but Tolerability
06:44 The Ideal Patient
07:04 Manipulating Thresholds: Serotonin
09:09 There ARE Guarantees...
10:34 More Methodical than Empirical
12:42 When to Run For the Hills!
13:35 The Gauntlet Course
14:06 Debunking Pharmacogenomic Testing
14:48 Debunking the Empirical Approach
16:26 Syndromes and "Antidepressants"
18:31 Improvement Timeframes
21:38 It's Not an Experiment
24:09 Patients Who Have Been on Everything
24:49 Retroactively Evaluating Med Trials
28:16 Are We Missing Something?
30:56 Some Things Are Given