I can't resist posting this article from the Bonkers Institute.
Socioeconomic disadvantage is well established as a risk factor for 
depression and other psychiatric disorders, but psychiatry and its pal the 
pharmaceutical industry monotonously emphasise chemical imbalances (for 
which the evidence is very shaky - see Lacasse & Leo 2005 
http://medicine.plosjournals.org/perlserv?request=get-document&doi=10.1371/journal.pmed.0020392), 
not socioeconomic imbalances.
Of course even better than individual treatment of poverty would be 
population-level prevention of poverty!
Melissa

Therapeutic Efficacy of Cash in the Treatment of Anxiety and Depressive 
Disorders: Two Case Studies
Methodius Isaac Bonkers, M.D., Principal Investigator
Bonkers Institute for Nearly Genuine Research
bonkersinstitute.org
Depression and anxiety are the most common mental disorders in America, 
affecting more than 60 million patients every year. Pharmacological 
interventions dominate the medical management of these disorders and may 
include selective serotonin reuptake inhibitors (Prozac), norepinephrine 
reuptake inhibitors (Strattera), monoamine oxidase inhibitors (Emsam), 
benzodiazepines (Valium), azaspirodecanediones (BuSpar), and any number of 
similarly efficacious drugs or drug combinations prescribed in accordance 
with strict FDA guidelines, or not, based on the treating physician's better 
judgment.
Since mental illness is a lifelong condition with no known cure, the 
successful psychopharmacological management of a mental disorder such as 
depression or anxiety is challenging. Treatment with medication almost 
inevitably results in side effects requiring additional medications leading 
to additional side effects necessitating still more medications, in a 
self-perpetuating cycle that finally ends when the patient dies or the 
insurance runs out.
This report discusses two cases in which complete symptomatic relief was 
achieved following the administration of large sums of money to the 
patients. The comparative safety, efficacy, and tolerability of cash is 
assessed. Based on our findings, the clinical utility of monetary incentives 
in the form of cash deposits or lump sum payments directly to patients 
should be reappraised as a viable alternative therapeutic modality for the 
treatment of mild, moderate or severe cases of anxiety with or without 
co-occurring depression. Cash payment should also be considered the 
treatment of choice for all major depressive disorders including mild, 
moderate and severe clinical or sub-clinical depression, depressed moods, or 
any and all dysthymic, cyclothymic or depressive symptoms appearing with or 
without comorbid anxiety disorders.
Case report 1:
The patient is a 52-year old male with a history of depression. He reported 
feeling sad at various times throughout his life but did not seek treatment 
until age 51, when the factory where he had worked for 23 years was 
permanently shut down, costing him his pension and health insurance the same 
year his wife was diagnosed with terminal cancer. The patient was initially 
prescribed Paxil 20 mg, but after complaining of sleeplessness and 
expressing suicidal ideation, the dosage was increased to Paxil 40mg and 
Ambien 10mg was prescribed for insomnia. Depressive symptoms improved 
somewhat, but constant diarrhea, headache and nausea grew intolerable, so a 
switch from Paxil to Zoloft 50mg was tried. Within 5 weeks the therapeutic 
effects of Zoloft became readily apparent: the patient stopped worrying 
about the future and no longer seemed concerned about his wife's failing 
health. Numerous treatment-emergent side effects were observed but the 
patient was reassured by his physician that chest pain, skin rash, 
constipation, tremor, dry mouth, hypertension and palpitations were not life 
threatening. One month later, pharmacotherapy was discontinued because the 
patient refused further treatment, claiming to be cured after winning 
$200,000 in the Illinois State Lottery. A computed tomographic brain scan 
confirmed the patient had indeed fully recovered (see images below).
Brain scan of depressed patient.
Case report 2:
The patient is a 27-year old female diagnosed with generalized anxiety 
disorder. She reported feeling nervous and fearful most of the time, 
constantly worried about one thing or another, and doubted her fitness as a 
single mother of four children aged 1-4. The patient responded well to Xanax 
0.25mg with only minor side effects including dizziness, impaired 
coordination, and blurred vision. One month into treatment, the positive 
therapeutic effects of Xanax 0.25mg diminished noticeably, but symptoms 
again improved when the dosage was doubled to 0.5mg. Two weeks later, 
following a traffic accident for which she was ticketed, the patient 
reported feeling more anxious than ever, complained of nausea and vomiting 
in addition to increased dizziness and blurred vision, and now exhibited 
signs of depression as well. After several difficult weeks the patient was 
weaned off Xanax, and combination therapy with Lexapro 10mg and Cymbalta 
60mg was initiated. At the regularly scheduled 3-month follow-up 
examination, all symptoms of anxiety and nervousness had completely 
disappeared. The patient reported zero medication side effects, explaining 
that she had discarded the unopened packages of Lexapro and Cymbalta upon 
learning she had inherited $250,000 from a distant relative. Laboratory 
tests were unable to verify any causal link between the inheritance of a 
quarter of a million dollars and the patient's subsequent recovery, but 
ongoing clinical evaluation and comprehensive reassessment confirmed 
significant improvement from baseline. Positive outcome was corroborated by 
visual examination of a mood ring worn by the patient (see images below).
Suffering from chronic anxiety, patient's mood ring appears green, 
indicating tension.After inheriting $250,000, patient's mood ring appears 
blue, indicating tranquility.
Analysis and Conclusions
The brain chemistry of depression and anxiety is not fully understood. 
However, a growing body of evidence supports the view that people with these 
disorders have an imbalance of the brain's neurotransmitters. (Lexapro 
Product Brochure, Forest Pharmaceuticals, 2007.)
Psychiatric medications relieve symptoms of depression and anxiety by 
restoring chemical balance within the brain, but exactly how these drugs 
restore the brain's chemical balance while simultaneously wreaking havoc on 
every other organ in the body remains a mystery. Equally mysterious is the 
mechanism by which cash payments provide therapeutic benefit to depressed 
and anxious patients. The receipt of a large sum of money may somehow 
stimulate, increase, block, adjust or otherwise act upon the level, supply, 
transmission, inhibition, secretion or excretion of dopamine, serotonin, 
norepinephrine, gamma aminobutyric acid or some other chemical yet to be 
discovered.
Elation and euphoria are the most common side effects associated with cash. 
The favorable side effect profile and high response rate compared to placebo 
are the main advantages of cash over standard pharmaceutical treatment, 
while the major disadvantage of cash would appear to be its prohibitive 
cost. However, retrospective analysis supports the hypothesis that over the 
long haul cash is not only safer but also more cost-effective than any 
medication currently on the market.
A depressed and/or anxious patient is typically maintained for an indefinite 
period of time on two or more psychiatric drugs simultaneously, in addition 
to numerous other medications prescribed to control side effects ranging 
from diabetes to high blood pressure to urinary incontinence to insomnia to 
everything in between. The cost of maintaining a patient on a standard 
treatment regimen of half a dozen or more prescription drugs might easily 
surpass $1,200 per month, amounting to roughly $150,000 over the course of 
ten years, or nearly $300,000 after 20 years. Seen in this light, a lump sum 
payment of $100,000 or even $200,000 would be a genuine bargain by 
comparison. Cash-strapped state Medicaid programs, squeezed by escalating 
pharmaceutical costs, would be well-advised to adopt formulary guidelines 
and preferred drug lists allowing pre-approved cash payments as a treatment 
alternative.
In a random survey, 3,964 Medicaid patients were asked whether they would 
prefer to receive various combinations of prescription drugs for the rest of 
their lives, or a single lump sum payment of $250,000. The vast majority 
(just under 99.93%) chose the cash option. A total of 3 patients (slightly 
more than 0.07%) elected to continue receiving medications in lieu of cash. 
All three of these patients appeared to be truly sick, and in each case the 
illness was due to iatrogenic causes (i.e., resulting from treatment).
Latest studies from the Bonkers Institute:
·         Schizophrenia Treatment in Seven Easy Steps
·         Addictive Properties of Shiitake Sesame Vinaigrette
·         Utilization of Placebo Rat Poison in Controlled Clinical Trials
·         Chemical Imbalance Not Otherwise Specified: Useful Diagnostic 
Category?
·         Science Made Simple: Shopper's Guide to Mental Disorders
Therapeutic Efficacy of Cash in the Treatment of Anxiety and Depressive 
Disorders
© 2007 Bonkers Institute for Nearly Genuine Research
http://www.bonkersinstitute.org:80/cash.html 

-------------------
Problems/Questions? Send it to Listserv owner: [log in to unmask]


To unsubscribe, send the following message in the text section -- NOT the subject header --  to [log in to unmask]

SIGNOFF SDOH

DO NOT SEND IT BY HITTING THE REPLY BUTTON. THIS SENDS THE MESSAGE TO THE ENTIRE LISTSERV AND STILL DOES NOT REMOVE YOU.

To subscribe to the SDOH list, send the following message to [log in to unmask] in the text section, NOT in the subject header.

SUBSCRIBE SDOH yourfirstname yourlastname

To post a message to all 1200+ subscribers, send it to [log in to unmask]
Include in the Subject, its content, and location and date, if relevant.

For a list of SDOH members, send a request to [log in to unmask]

To receive messages only once a day, send the following message to [log in to unmask]
SET SDOH DIGEST

To view the SDOH archives, go to: https://listserv.yorku.ca/archives/sdoh.html