Evident Exception in Clinical Practice Not Sufficient to Break Traditional Hypothesis 英文参考文献.docVIP

Correspondence Why Did the FDA Approve These Advertisements? correct chemical imbalance in depression caused by a lack of serotonin. The authors argue that serotonin de?ciency in depression is scienti?cally unsupportable; therefore, statements about the lack of serotonin should not be used. I agree with the authors. Nevertheless, I would like to add information about another drug that supports their arguments. I believe this drug should be mentioned in every article describing the serotonin system and depression. The drug is not authorized in English-speaking countries (see Micromedex Health Series at http:??), and this may possibly explain why the information about its controversial mechanism is not largely shared in scienti?c literature. The name of this drug is tianeptine. It has been used for over one decade in several European and some other countries (e.g., Brazil, India, Russian Federation, Thailand, Turkey, etc.) to relieve depression. Tianeptine increases serotonin reuptake; therefore, it has the opposite effect on the serotonin system compared with that of SSRIs (see Micromedex Health Series at http:??www.micromedex. com) [2,3]. The antidepressant ef?cacy of tianeptine versus tricyclics and SSRIs has been demonstrated in several studies [2,3]. Because of this opposite action on the serotonin system, it has a different adverse event pro?le; e.g., the elevated frequency of sexual dysfunction commonly seen after SSRIs is not so frequently observed with tianeptine [4]. The mechanism of tianeptine’s action is dif?cult to understand, but comparing this drug with other antidepressants provides us with an intellectual challenge [5]. David Oaks I would like to thank PLoS Medicine for publishing Lacasse and Leo’s important and methodical Essay that debunks the “chemical imbalance” advertisements for psychiatric drugs [1]. Why would the United States Food and Drug Administration (FDA) approve such ads? Our human rights group, MindFreedom International, has been ask