I don't see any improvements in mental health ever having come about through psychiatry.
Quite obviously, you haven't been looking hard.
If nothing else, look at the clinical effectiveness of the various new drugs that are out there.
Antidepressants
work.
However, I'm quite prepared to be converted. Does anybody have details of any verifed predictions of psychiatry, double-blind trials, evidence of efficacy? If you'd care to post decent links, I'm more than ready to eat my words.
Citation 1 :
Methylation has been implicated in the etiology of psychiatric illness. Parenteral S-adenosylmethionine, a methyl group donor, has been shown to be an effective antidepressant. The authors studied the antidepressant effect of oral S-adenosylmethionine in a randomized, double-blind, placebo-controlled trial for 15 inpatients with major depression.
The results suggest that oral S-adenosylmethionine is a safe, effective antidepressant with few side effects and a rapid onset of action. S-Adenosylmethionine induced mania in a patient with no history of mania. S-Adenosylmethionine may be useful for patients who cannot tolerate tricyclic anti-depressants. These findings support a role for methylation in the pathophysiology of depression.
Citation 2 :
Agomelatine is a new antidepressant with an innovative pharmacological profile. It is a potent melatonergic agonist (MT(1) and MT(2)) and also has 5-HT(2c) antagonist properties. Agometatine's efficacy in treating major depressive disorder (MDD) was first described in a placebo-controlled, dose-ranging study with paroxetine as a validator. In a recent placebo-controlled study, 212 MDD patients were randomly assigned double-blind to receive placebo or agomelatine 25 and 50 mg/day.
There was a significant advantage for agomelatine after 6 weeks according to scores on the Hamilton Depression Rating Scale (HAM-D) (P = 0.026) and the Clinical Global Impression Severity (P = 0.017), with an improved response rate (P = 0.03). Robust evidence of agomelatine's efficacy in severe depression comes from analysis of a patient subgroup with baseline HAM-D scores >25. Analysis of pooled data from three different trials confirmed this observation and suggested that the agomelatine-placebo difference tends to increase with the severity of depression. Results suggest favorable tolerabitity of agomelatine compared with a serotonin and noradrenaline reuptake inhibitor, and agomelatine is associated with less sexual side effects that are troublesome with some antidepressants. As predicted from its pharmacological profile, agomelatine improves sleep quality without associated daytime drowsiness. Agomelatine was also shown not to induce a discontinuation syndrome. Agomelatine may fill the gap in the current therapeutic armamentarium by combining efficacy with a favorable tolerability profile and additional clinical benefits.
Citation 3 :
OBJECTIVE: This study investigated the efficacy, safety, and tolerability of the selegiline transdermal system (STS) administered in a dose range of 6 mg/24 hours to 12 mg/24 hours for treating major depressive disorder (MDD). METHOD: Patients meeting DSM-IV criteria for MDD (N = 265) were randomly assigned to blinded treatment with STS or a matching placebo patch for 8 weeks. Patients failing to meet or maintain protocol-defined therapeutic response criteria at predetermined time points had their STS (or placebo) dose increased. Assessments were conducted at weeks 1, 2, 3, 5, 6, and 8. Patients were not required to follow a tyramine-restricted diet. The study ran from September 2001 through August 2002. RESULTS:
Selegiline transdermal system treatment resulted in significantly greater improvement (p < or = .05) compared with placebo treatment on the 3 depression rating scales: the 28-item Hamilton Rating Scale for Depression (HAM-D28) (primary outcome measure), the Montgomery-Asberg Depression Rating Scale, and the Inventory for Depressive Symptomatology-Self Rated. The treatment effect measured by the HAM-D28 was modest, primarily due to insomnia side effects. The antidepressant efficacy of STS was substantiated further by the significantly greater improvement in core depression symptoms (HAM-D Bech-6 subscale). The side effects of highest incidence were application site reactions and insomnia. There were no safety concerns based on routine clinical laboratory and electrocardiogram monitoring, and there were no occurrences of hypertensive crisis. CONCLUSION: Results of this double-blind, placebo-controlled, dose titration trial provide evidence of short-term efficacy, safety, and tolerability of STS in the dose range of 6 mg/24 hours to 12 mg/24 hours for treatment of MDD. Selegiline transdermal system has an improved margin of safety compared with oral monoamine oxidase inhibitors and represents a useful addition to the existing array of antidepressants.
