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Originally Posted by ganstaman
Go for it now. Until then, there's no reason to believe you as much of what you say is wrong, misleading, and as you admitted based on assumptions.
Ok (what was it? Can I do Amitriptyline vs Mirtazapine then?). The problem is that what I say is a net sum of much exposure, I would feel like I have to produce lots of work. I have addressed things simply and you don't see to counter things which obviously prove your errors and this only reinforces you prove the thesis. TO sum up the problems I am describing, it is that game theory has only barely seeped into Pyschiatry on an overt level. Much of what is going on is covert. I was under the impression your exposure involved 1:1 self practice and you was giving counsel or therapy. It's all good saying what you see reported in the media and in the literature over huge macro levels.
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Just because I don't comment on everything you say doesn't mean I don't realize you're saying things. It's just that much of what you say is nonsensical, and other parts seem irrelevant so I just respond to whatever I like. You can assume, if you'd like, that the parts of this post I didn't respond to I just didn't understand what you were saying. I don't know if you attempting to clarify would help, however.
The problem is I can find very basic and simple sentences which you ahve not responded too, and I have simply provided logical justification. If you want me to write in harvard language then it is much better for me to be producing my own stuff that gives me +ev in real life. You could at least pretend I am correct or maybe you understand the pitfall of my logic because you have found that pitfall the hard way. But no. There is no progression if you cannot amend any of your own thinking because of the online avatar int he way.
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But if you really want to force this other example, that's fine. Only Clozapine has been shown to be better than other antipsychotics,
You keep saying this 'better antipsychotic'.There is no such thing as an anti psychotic as I have said, it is only branding. They have physcial functions and clearly these functions differ in value from one drug to the next. Your ignorance on this should imply that they only give the cheapest drug to everyone unless there is a -ev risk in terms of $ and reputation, not wellbeing.
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but due to side effects and mandated lab tests, it's not ideal and therefore is second line. In one large trial, patients stayed on Olanzapine longer than other antipsychotics, but it's not clear that this means it's any better.
What are you on about second line? Clozapine is used when weaker and safer drugs do not work. It is not better it just contains more potent ratios whether they manifest chemically or behaviorally. That is all. Not that is not all, it is also damn expensive, just to put observational safeguards in place against adversity is costly.
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So then which one to choose comes down to the same things I mentioned for antidepressants: considering drug-drug interactions, considering other medical comorbidities, and then weighing the various side effect potentials to see which is most favorable for the specific patient and doctor.
All they do is look in a prescribing manual and then use the functioned accounts to connect the dots, then over time they start to remember the patterns and use the prescribing manual less.
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Often, it's hard to say that any choice is really the right one, and one could justify a different choice without either being wrong.
Ok now please explain this 'some'. (Whole range - 'often' range).
I do agree, some decisions are trivial. i.e Small initial trial, stat dose. But when they are taking into account these other considerations, they have personal value sets which they apply, and because they do not use an impartial game theory application every time their systems get ****ed. Just think about when someone has Parkinson morbidity, social morbidity, financial morbidity, chronic psychotic disorder, bowel issues, leg and feet ulcers, migraines, insomnia. Do you really think their assessments in reality are comprehensive enough and do you really think that societies value system is currently adequate? It is a nice world you are in.
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There is no conspiracy against you. You're just not good at posting in SMP because you make a lot of assumptions, seem more confident than knowledgeable, and have an interesting grasp of English. This combination leads many of your posts to being unintelligible in parts, wrong in others, and overall provocative.
This is an opinion. I suppose it is difficult to be constructive in response to me when I am faulting constructs you use. Those that say 'I am not good at posting at SMP' are likely related somehow within their own value sets. Feel free to proclaim the arrogance. How would I be deemed provocative when it is always someone who initiates character judgement first. Look at this process and it confirms my stereotypical associations are correct. I can see many different ways in how I can perceive what I write. You are stuck in transactional role/gradient of using this 'inferior:superior' complex. It is random 2+2 thread where people are typing stuff. You are provoked this easy?
Last edited by Mt.FishNoob; 07-24-2014 at 11:18 AM.