

2009's Top Threats To Science In Medicine - tokenadult
http://www.sciencebasedmedicine.org/?p=3201

======
DaniFong
"Even though we’ve invested $2.5 billion tax payer dollars and 10+ years of
time on studying complementary and alternative medicines – we have discovered
NO single breakthrough in medical treatment as a result."

What about the use of Neti pots for sinus hygiene?

<http://www.jfponline.com/Pages.asp?AID=1355>

My quality of life improved significantly... Maybe this doesn't count as a
breakthrough but that's a pretty high bar.

Also in the linked article:

"The lone exception: ginger capsules may help chemotherapy nausea."

"As for therapies, acupuncture has been shown to help certain conditions, and
yoga, massage, meditation and other relaxation methods may relieve symptoms
like pain, anxiety and fatigue."

It is useful to remind people that it takes nearly a billion dollars to bring
a drug to market, so if the public discovers a new use of equivalent efficacy
for a natural treatment or a drug already in the public domain for less than a
billion dollars it is a benefit.

Compare these alternative therapies to antidepressants, of which $11 billion
worth were sold in 2008, and appear to be barely more effective than placebos.

[http://www.healthyplace.com/depression/antidepressants/antid...](http://www.healthyplace.com/depression/antidepressants/antidepressants-
barely-more-effective-than-placebos/menu-id-68/)

It is simply hard to find treatments that work.

~~~
tokenadult
I thought that the Neti pot was a private enterprise project, not one
investigated through alternative medicine research funding by the federal
government. I see from the journal article link you kindly shared (thank you
very much for that) that "Support for this study was provided by the Small
Grant Program from the Department of Family Medicine, University of Wisconsin,
Madison." So one conclusion from this is that there will continue to be
funding sources for investigation of new therapies whether or not there is a
federal government agency specifically tasked with funding investigation of
"alternative" therapies.

 _It is useful to remind people that it takes nearly a billion dollars to
bring a drug to market, so if the public discovers a new use of equivalent
efficacy for a natural treatment or a drug already in the public domain for
less than a billion dollars it is a benefit._

That's a very good point. Economic issues matter. What I would like to know
more about is whether there has ever been, or ever will be, an "alternative"
therapy of comparable safety and effectiveness that will come to market at
less research expenditure than a "big pharma/mainstream medicine" therapy for
the same condition. Human subject safety and effectiveness studies are
inherently expensive, and until they are done, it is not clear that two
therapies from two different paradigms of treatment are comparable at all.

Thanks for the other link about antidepressant drugs. The best considered view
of the authors of the standard textbook on recurrent and bipolar depression

[http://www.amazon.com/Manic-Depressive-Illness-Disorders-
Rec...](http://www.amazon.com/Manic-Depressive-Illness-Disorders-Recurrent-
Depression/dp/0195135792/)

is that mood stabilizers (lithium, depakote, carbamazepine) are better first-
line drugs for depression with cyclic course than the SSRI drugs mentioned in
the link you shared, and that talk therapy, especially if based on cognitive
principles, is surely as effective as SSRIs and often needed in conjunction
with any drug treatment for depression. The new SSRI drugs for depression
indeed do not make mood disorder symptoms go away all by themselves, in the
majority of cases.

~~~
asciilifeform
> that mood stabilizers (lithium, depakote, carbamazepine) are better first-
> line drugs for depression with cyclic course than the SSRI drugs

When these "work," it is by removing emotional affect entirely.

And lithium _guarantees_ irreversible organ damage.

~~~
phren0logy
While we're talking about _science-based_ medicine:

1\. Lithium is a serious medication, but for many people it's their only
chance to live life on their terms rather than at the whim of their illness.
Some, but not all, experience emotional blunting.

2\. Some, but not all, get kidney or thyroid problems. The number increases
over time, but it's far from a guarantee.

I sometimes prescribe lithium for my patients. I wish there was something
unambiguously better out there, but every alternative has issues. It's not the
best choice for everyone, but it is the most evidenced-based choice, and the
only choice consistently shown to reduce suicide.

The best thing I can do for many of my patients is to make absolutely sure
they have bipolar disorder (and have a need for one of these medications). The
recent rate of growth of the diagnosis is concerning for over-diagnosis.

~~~
Sapient
I don't have have much to add here (downvotes accepted), but I love that this
post was made by someone called phren0logy.

~~~
phren0logy
Yeah, I picked that moniker when I started doing some fMRI research. It's been
criticized as "the modern phrenology" so I thought I would l33t it up a bit.

The history of phrenology is actually really interesting. Gall made some
genuine contributions to science regarding the localization of brain function.
It became what we now think of as phrenology, the wild and bizarre
pseudoscience, when cranks came crawling out of the woodwork offering simple
answers to hard questions and miracle cures in a bottle. Which brings us right
back to the OP...

