Evidence-based treatments... WTF does that mean ?

The chemical imbalance theory for depression and schizophrenia is unfounded, but medicine can very well be evidence-based without correcting chemical imbalances.
What chemical imbalance does antiepileptic medication correct? Prevention of seizures is one of the criteria used to select them.
Medications are selected because it is thought that they are effective, independent of the explanations of effectiveness.
To be approved by the FDA, a drug has to be shown superior to placebo in two trials. They don’t need to correct chemical imbalances.
The chemical imbalance and the diabetes analogy are only used to make drugs acceptable to patients. But if no chemical imbalance is corrected it doesn’t mean that medication is useless.

Guangxi wrote:The chemical imbalance theory for depression and schizophrenia is unfounded, but medicine can very well be evidence-based without correcting chemical imbalances.

So they're lying? so they use this 'evidence' based thing when it suits them? If they have no evidence, what else are they hiding?

Medications are selected because it is thought that they are effective, independent of the explanations of effectiveness.

This bit is concerning. In a compassionate world you don't mislead people when you give them drugs that cause brain damage and various other neurological conditions and defiantly not because you 'think". You defiantly don't give them those drugs without being sure of what your dealing with.

Imagine a doctor says 'i think you have cancer' and he then books you in for chemo without bothering to check...

You seem to think that doctors are gods and all their shortcomings are done intentionally. Medicine just isn’t perfect. It only needs to give the best possible therapy given the current evidence; it can’t wait until it has perfect knowledge and in the meantime let people die.
Sometimes it is cheaper to start therapy without checking. For example if medical personal accidentally is pricked with a needle containing blood of a HIV patient he/she will receive anti-HIV medication independent of HIV detection in their blood (http://www.torrentbit.net/torrent/1731980/USMLE-+Goljan+Audio+Lectures+Medical/)
Often is only after tissue removing possible to say if it contains a malignant tumor or not. And sometimes during the operation it becomes clear that the operation is hopeless.
If a patient has certain symptoms it can be preferable to remove a blind gut than to first check if that is really the problem.
After new evidence, medical opinion can change so that physicians come to believe that in the past they removed too many blind guts or tonsils.
Sometimes it is possible to find out what the cause is, but if the outcome of the test doesn’t change the therapy, they don’t have a reason to perform the test.
Sometimes you should criticize doctors for making the wrong decision given the current evidence. For overly enthusiastically applying therapy of which you can’t expect an overall positive outcome if all evidence is taken into consideration. Doctors also don’t form a monolithic block; they differ in opinion amongst themselves.
“There is obviously little point in continuing a drug that has had little effect, yet it is remarkable how often this is done.” (Shorvon (2009), p. 227).


Shorvon, S. (2009). Epilepsy and Related Disorders. In C. Clarke, R. Howard, M. Rossor, & S. Shorvon (Eds.). Neurology: A Queen Square Textbook (pp. 189-243).
http://ebookw.net/ebook/science/45225-neurologya-queen-square-textbook.html

The view that medication corrects a chemical imbalance can maybe foster the expectation that the effect of medication will have an overall positive effect. If it is said that your thyroid gland is damaged and can’t produce enough thyroxin anymore and eating thyroxin will bring the thyroxin concentration in the blood to normal, it is perhaps easier to believe that it doesn’t have strong negative side effects.
On the other hand, substances naturally in the body also have strong effect when they become too high. So thyroid gland function is regularly tested in people receiving thyroxin.
Only because of regular blood test, you can be confident of an overall positive effect.
The diabetes metaphor is especially strange, because type 2 diabetes is the most common form of diabetes and its cause isn’t too little insulin, but low insulin sensitivity. Mostly they don’t take insulin and it can often be treated by drastically restricting food intake and increasing physical exercise. Maybe this brought people to the idea that physical exercise is effective against depression.
People with type 1 diabetes have to inject Insulin to bring their blood glucose level within normal limits. A little bit too much insulin can cause death or brain damage, which was a regular result of insulin coma therapy for schizophrenia.
Because insulin sensitivity is constantly changing, type diabetic patients have to measure their glucose level a few times a day.
Correcting a chemical imbalance without regular testing is a risky business.

What is the test for a chemical imbalance?

The term 'chemical imbalance' is sufficiently vague to be all encompassing, whilst still being sufficiently technical sounding to fool laypersons into the belief that they understand the problem. An analogy would be if a mechanic were to see a puddle of liquid under a car and diagnose it with a fluid imbalance, except that it would be a far more accurate description.

Drug companies in Australia are banned from advertising directly to consumers, but in the United States more than $1.5 billion a year is spent promoting antidepressants. Marketing has focused heavily on the chemical imbalance theory since it was first posited in the early 1950s after tubercular patients in a New York hospital were given a new drug, iproniazid, and experienced ''awakenings'', completely transforming their depressed mood.

The thinking was that the drug had helped correct malfunctioning neurotransmitters in the brain by strengthening the serotonin signal between nerve cells. It gave psychiatry, until then a largely psychoanalysis-based ''talking therapy'', newfound legitimacy, elevating it to a discipline that could promise tangible medical treatment for ills of the mind.

The chemical imbalance theory really took hold in 1987, when Prozac - one of the first of a new generation of antidepressants known as selective serotonin reuptake inhibitors (SSRIs) - went on sale. It became the most widely prescribed antidepressant in history. By 2007, 54 million people worldwide were taking it.

http://www.theage.com.au/national/healt ... 20h25.html

Again, what is the test for a chemical imbalance? where is the peer reviewed studies of this? what is the test after medication has been introduced? you would think on a forum such as this, many a member would be sharing what that test is, if they had it? if the test existed.

What about the effects on patients who have been misdiagnosed with a chemical imbalance, where is those studies?

I apologize, I responded to your question yesterday, but apparently it didn't go through.

Bin ladened wrote:Again, what is the test for a chemical imbalance?

Currently there are no conclusive tests for any chemical imbalance. This chemical imbalance theory was made up by the drug companies to promote more drugs. Psychiatrists went along with this because they got more kickbacks from the drug companies for the more psychiatric drugs they prescribed.
Try this link for further reading, otherwise a simple google search will give you many answers to your questions:
http://s395229360.onlinehome.us/Articles/LeoLacasseMediaandChemicalImbalance.pdf

i asked a straight forward question, you've answered it here in the same manner. appreciate the lack of politics.

so what else is #######4? this is one big lie, in fact as big as they get, are people to afraid to go there? the evidence they collect on the effectiveness of the medications, are we to believe them? How many side effects that those drugs cause are put down to the chemical imbalance they claim, but don't test for?

I've seen a chemical balance test on an alternative medicine site that tests hair analysis kryptopyroles etc but yeah its really expensive like 200+dollars...funny enough they didn;t mention it to be used for dopamine balance only serotonin and the others...they also offered alternative treatments but not so much for psychosis but anxiety and stuff that would help therapeutically with psychosis

sorry I will have a look to find the site but not sure if I will find it

-- Sat Feb 23, 2013 5:05 pm --

the test wouldn;t prove much once you're already on an AP....I wonder if it would show up as deficiency of dopamine,,thats how the $#%^ works by causing a chemical imbalance that makes you passive apathetic and withdrawn from having anything to say, cognitive deficits that seems to recover thought disorder because the brain isn't as active in processing so many god damned ideas when you;re exposed to the ludicrous and arrogant industry