>Daily medication, which must be taken without fail in order to have a normal life, is a liability. It can be lost, stolen, or missed. It must be obtained on a regular basis, and carried around on trips.
I doubt these are a real problem for people who have a modicum of conscientiousness.
>A one-time, permanent cure is clearly superior
If you think that big bad pharma companies are keeping people from taking one-time cures for depression, by all means come up with a one-time cure on your own. How do you think one pill can create a permanent structural change in the brain that makes the just-so changes necessary to cure depression forever?
> I doubt these are a real problem for people who have a modicum of conscientiousness.
What does conscientiousness have to do with it?
You might need to travel or transit through a country which prohibits carrying them. Now you have to cancel the trip or go without the medicine.
> by all means come up with a one-time cure on your own
This is not helpful. People have the right to ask questions without being asked to devote a lifetime to develop some arbitrary authority (which would then in any case bias them to look for positive results).
Yes. You need to get permission to take a vast number of medications into UAE, including opioids and even common antidepressants.
I went through this process before COVID, with the intention of travelling to Dubai, and they knocked back my request about 10 times for spurious reasons, and were adament that I couldn't enter Dubai with a single pill more than was required for the duration of my time in Dubai. Which of course is completely unrealistic - I'd need some for travelling back, and a small buffer because of flight delays or whatever.
Honestly, travelling with certain medications is a major PITA.
Please have your strawman back as I said nothing about the feasibility of a one-time cure. I was backing up dTal's right to say that a one-time cure would be superior, without suffering a pointless ad-hominem rejoinder that why don't they find one if they're so clever.
One-time cures may be a sci-fi dream but they are highly desirable, as anyone who needs regular/prophylactic treatment for any severe ongoing condition knows.
> Now you have to cancel the trip or go without the medicine.
International travel is a minuscule thing to give up if you get effective depression (or pretty much any chronic condition) treatment in exchange. Heck most people can't justify the expense of international travel in the first place and the number of people who do it regularly for work and have depression is very small compared to the number of people who have depression. Practically nobody is going to let a chronic condition that affects their daily life go untreated because there's a short list of countries they can't have that treatment in.
What exactly are you arguing? That people should be happy with the flaws of the status quo, and that we should not follow up on promising new treatments that don't have those flaws, because...?
I thought my point was fairly clear and I'm not sure how you managed to derive the "people should be happy with the status quo and not follow up on promising new treatments with less flaws" from what I said. I'm arguing that "prevents international travel in some cases" is an inconsequential side effect for anything that treats an often debilitating chronic illness that is not even within the realm of consideration for the overwhelming majority of patients and that likewise "no negative effects on international travel" is not really a meaningful improvement over the status quo of treatments (all else being equal). Basically, if your biggest gripe with a treatment for a chronic illness is that you can't travel internationally then that's a pretty small gripe.
It was one example to illustrate one of the potential problems.
A much bigger issue is as pointed out by harimau777: prescriptions often don't get filled on time and sometimes not at all. Plenty of people run out of pills on holidays and have to suffer withdrawals, with suicidal ideation and actions being one of the symptoms of acute withdrawal from benzos.
Daily medication that requires a prescription is a huge problem for people that actually have to take it. What if they can't afford it at some point? What if their physician changes and the new physician doesn't want to prescribe it?
Why are we even defending daily medication? If there is any possibility of a permanent cure, obviously that is a much better choice of treatment.
His biggest gripe is that the pill has to be taken every day or very frequently. There are loads of circumstances which make that less desireable than taking a pill a few times a year instead. You've latched onto the travel example he gave.
> I doubt these are a real problem for people who [have good mental health]
Yeah. Funny thing about that. You're generally prescribed as low of a dose as is feasible, so by the time you're due to take your ADHD meds, antidepressants, antipsychotics, or whathaveyou, the last dose has worn off (especially first thing in the morning) and you're liable to miss a dose. So you get a pill minder, and fill it weekly, so at least you can check to make sure you don't forget and double-dose yourself. Chances are, you're taking several meds, so you have a highly detail-oriented chore you need to succeed at once a week on a specific day. If that's a bad day, you might not be able to muster the motivation and that throws off the whole week. Or you get most of the pills in but accidentally miss a day or a whole week's worth of a drug because you're juggling a handful of bottles and you're only human. Phone apps sound great, but depend on you being near your pills and your (charged) phone at a specific time of day, which has all sorts of failure modes.
And then there's the uncontrollable shit. You pack for a trip out of town. You're only supposed to be gone for a week, so you diligently pack a week's meds. Your ride home flakes, flight gets cancelled or whatever, and suddenly you're S.O.L. Or, your bag gets rifled by luggage inspectors at the airport and they pocket the goods (I've lost a nice pocket knife that way), it's stolen by hotel cleaning staff, pickpockets, or whatever. Good luck getting your prescription filled in a different country.
And once you miss a pill, you might hit a spiral that lasts a week or longer before you get back on track. It's a fucking liability.
At least for controlled substances, it is definitely not that simple. Patients can run into situations where pharmacies refuse to tell them if they are able to fill a prescription until it is actually written for them. However, if they are not able to fill it, the doctor is hesitant to write a new prescription for a different pharmacy because it could look like they are writing the patient multiple prescriptions for the same drug.
I found myself irritated enough to talk about conscientiousness.
I have a permanent medical condition which calls for a somewhat antique medication. It is typically used "as needed," certainly not every day. I have had a regular prescription for over a decade and it has certainly improved my quality of life. I refill like clockwork, I am responsible about using it. It comes time for a refill and ... my pharmacist at Walgreens regrets to inform me that they cannot seem to get it, and that the manufacturer has stopped making it.
This is worrisome. I remember life before the medication. I dig through the FDA databases, locating every organization which has applied to make the medication and been issued an NDC (National Drug Code) identifier. Each organization is tracked down: are they still in existence? Have they been bought out and if so, by what other company? I discover buyouts, shutdowns, press releases saying that they are "exiting" some market. I make phone calls, I send emails, and, when no other contact information is available, I send letters with self-addressed stamped envelopes. Almost everyone who has ever made it has stopped or been stopped in one fashion or another. Meanwhile, I begin to canvass the distributors: McKeeson, Cardinal, AmeriSourceBergen. Are there any remaining in stock? If so, which pharmacies in my area do they work with? Most pharmacies have a single distributor. These are organizations who do not like to be contacted by the hoi polloi, and I have quite a lot of "How did you get this number?" conversations.
At last, a hit: someone has just started manufacturing it. Out of all of them, there's only one. I dutifully take this to Walgreens. After a few go-rounds, they cannot seem to get ahold of it. They suggest Walmart. I have to hassle my poor doctor's office, now in COVID-panic like everyone else, to move my script, which one required a special paper. Walmart swears they have it, they have contacted their distributor, they have bottles in stock. Wonderful. And it does not arrive, they call again, and it does not arrive, and they call again. Finally, they shrug and give up. Right!
I call CVS; they are sure they can get it. I transfer the script, again. Off I go to CVS. CVS says that, yes, it is in stock at their distributor. Similar to Walmart, after a few weeks, they cannot get it. The pharmacist has called the corporate offices and only knows that there is a "corporate block" on it and that, despite being able to submit an order for a bottle of pills which are present at a distributor, they will never ever arrive. I am disappointed, and, out of a little curiosity, I submit a letter to CVS corporate (again with the self-addressed stamped envelope to remove barriers to reply) asking just what this block is ... not that I ever get a reply.
I try a small, local shop. I wince at having to call my doctor to have the script transferred yet again. Surely they will try harder rather than giving me the brush-off you can so often get from large organizations. No dice. The dance is now familiar to me.
Armed with yet more research and NDC codes and distributor phone numbers, I approach my original pharmacy again. Another script transfer, with all of the pain entertained in moving something with a low Schedule number around. With the new information I have gathered and a great deal of persistence, they manage to obtain it. The head pharmacist tells me that the sole other patient on it will be relieved, and that he has never had to work this hard to get a prescription before.
By the end of this two month period, I had lost approximately twenty pounds and was clumsily knocking things over due to my coordination degrading. Finally, I managed to fall hard enough that I was still limping two months later.
The moral of the story is this: being conscientious does not guarantee availability. One can do all of the right things and still not have it on hand. Being dependent on a medication, even weekly, can be a burden, even if you attend to the situation quite closely. I urge you not to be quite so flippant about it.
I doubt these are a real problem for people who have a modicum of conscientiousness.
>A one-time, permanent cure is clearly superior
If you think that big bad pharma companies are keeping people from taking one-time cures for depression, by all means come up with a one-time cure on your own. How do you think one pill can create a permanent structural change in the brain that makes the just-so changes necessary to cure depression forever?