why study neurology?
james at teoth.fsnet.co.uk
Tue Jan 15 11:14:52 EST 2002
mats_trash at hotmail.com (mat) wrote in message news:<43525ce3.0201150200.785083cf at posting.google.com>...
> Nick Medford <nick at hermit0.demon.co.uk> wrote in message news:<fiv4mCABx9Q8Ew4P at hermit0.demon.co.uk>...
> > In article <43525ce3.0201130613.6d731151 at posting.google.com>, mat
> > <mats_trash at hotmail.com> writes
> > > However most psychiatric drugs are based
> > >on "deterministic/reductionist" theory (what else could they be based
> > >on?!
> > These treatments are based on empirical observation- simply the
> > practical fact that they have been found to be useful- rather than any
> > philosophical stance.
> Initially yes, but new drugs are based on the findings of neurobiology
> - a reductionist approach to the brain/mind. New receptors are
> targeted, or the affinity and/or selectivity for a receptor known to
> be important is improved. No-one just throws them at patients and
> watches anymore.
Er, actually that's exactly how it is done.
We throw them at patients with a 'best guess' hunch, then when we find
it works, we construct the monoamine theory to explain it, then fiddle
around with similar molecules to see if they work. There is lots of
discrepancies when we find molecules which should work but don't and
molecules which shouldn't work but do. This is much more true in
psychiatry than in other fields.
Just look at clozapine and the atypicals. Or how about that
high-profile case a few months back with quinidine being used to
alleviate symptoms of CJD? No one has any real idea (just a couple of
hunchs) how it works, but it is proclaimed a scientific achievement.
More like a serendipitous discovery.
Then consider all those glutamate receptor antagonists, selective D4
antagonists, orexin analogues and whatnot which were specifically
designed to work but don't. Don't believe the hype of the biotech
companies, most drug discoveries were not preconceived ideas but a
"gosh, that's surprising."
> > >). SSRIs for depression and agents affecting the dopaminergic
> > >systems for schizophrenia have shown how these chemical systems in
> > >concert with others define 'us'.
> > This is a truly wild claim, up there with any religious crackpottery.
> Its only wild if you don't want it to be true. Of course current
> drugs are relatively blunt tools for changing the mind of a patient,
> but they do work and IMHO the targets of the drugs must therefore be
> involved in how the mind arises from the brain. (Its just empirical
> observation!) By your comments do you mean that you don't believe that
> dompinergic, glutamatergic and all the other systems in their
> particular anatomical forms are enough to account for the mind?
That's not what Nick said though...
To paraphrase him, he said that the deterministic/reductive approach
is next to useless when trying to find out what makes patients tick
and how to help them.
This puts it in a clinical context where the aim is to help people
with their psychological disorders. Mind-body dualism may be false,
but this framework is necessary when dealing with human beings.
Psychiatrists, neurologists and doctors won't be helping many people
by just giving them pills and sending them home while
cognitive-behavioural therapy has been shown to be as effective as
SSRIs in treating depression. In fact the very definitions of many
psychiatric disorders are so fuzzy and functional that to claim that a
pattern of chemical imbalances causes them is hard to believe.
Rhetorical questions for Mat:
1) Do you think the mind (as you understand that word, since we all
seem to be using it differently) is an emergent property of neuronal
firings, chemical changes and whatever else goes on in the material
2) If so, then it can have new properties that its constituent parts
do not, right? Then is it fair to say that treating at the level of
the emergent property directly may be more effective in producing
desired changes than treating at the level of the constituents in hope
that the emergent property changes?
> Re: Greenfield
> :) becuase she doesn't believe anything needs adding, its all there in
> the brain for us to investigate. At least she hasn't added a
> dualistic aspect
Let's not put words into her mouth. As far as I can recall Greenfield
has never explicitly stated that view, she has only ever said that the
scientific study of consciousness is a climbable mountain.
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