Use of drugs in the treatment of depression

Madam, - With reference to Dermot Ryan's letter (July 15th) I am most certainly not an apologist for drug companies and as a …

Madam, - With reference to Dermot Ryan's letter (July 15th) I am most certainly not an apologist for drug companies and as a clinical psychologist, do not utilise medication in my own practice. However, the weight of clinical evidence in favour of drug therapy as a supportive adjunct in the treatment of specific conditions is very convincing.

As I stated previously (July 9th) it is most effective when combined with cognitive behaviour therapy. As we are complex biological entities, it is reasonable to suggest that our emotions are underpinned by biochemical processes. This is not to say that a thorough understanding of emotions will emerge from a reductionist concentration on this area alone. Genetic variables, socialisation and personal history experiences, for example, must be included in any such endeavour.

Clearly depression is not due to a lack of prozac, no more than a headache is due to a lack of aspirin or paracetamol.

Effectiveness of such drugs must be determined by scientific investigation and the consequent data are what should inform our response with regard to appropriate usage. Counselling alone is ineffective in many conditions and medication may help to raise the mood of a person with severe depression, for example, to the point where psychotherapy can become very effective.

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Cure is not always achievable and in such cases we must look to helping the person to manage their condition and to live as full and productive a life as possible.

I must comment also on an aside contained in Mr Ryan's letter regarding atheism, brutality and man as a spirit. Brutality in the treatment of patients is abhorrent to all moral and ethical practitioners, regardless of their religious persuasion or lack of it. There is no objective evidence for spirit and belief in such an entity is informed by articles of faith and is outside the domain of science. I would have thought that in representing the Citizens' Commission on Human Rights, Mr Ryan would be more concerned with ensuring that his members and the public in general be accurately informed as to the scientific status of claims made with regard to healing and therapy. Only then will they be in a position to exercise those rights in choosing the best for themselves and their loved ones. - Yours, etc.,

PAUL O'DONOGHUE, Principal Clinical Psychologist, Highfield Road, Dublin 6.