[retrac]

> It's perfectly normal to wonder how can one administrate something when one doesn't understand it. Especially when there can be such debilitating effects.

A theoretical/principled understanding of how a drug works has never been required for useful medicine to happen. For example, we don't know how general anaesthesia works. We don't know why some people have extremely bad reactions to certain anaesthetics (and they do). And yet they are used every day, to enormous net benefit.

> finding the base neuro-transmitter levels in and out of psychotic phases for each patient before deciding on the posology of a treatment

Is it actually possible to measure that, non-invasively?

[aatd86]

The anaesthetic agent is not a drug that one is supposed to take for the remaining of their life and has no observed side-effects in general.

It's also treated with the utmost care and in most interventions, if there is a choice to do without, the patient is offered the choice. There is a lot more consent involved.

So it's not the same thing.

To answer your other question, yes, neurotransmitter levels can be measured in the blood or urine.

For someone under-treatment, it would only make sense to. Wait 4 or 5 times the half-life of the molecule. (that's the difficulty since once started, they are not even supposed to stop).

[horsawlarway]

> The anaesthetic agent is not a drug that one is supposed to take for the remaining of their life and has no observed side-effects in general.

This is notably untrue. General anaesthesia is associated with higher risks of dementia. Especially the older the person being treated.

While there's some disagreement here - short term cognitive decline is inarguable as a side-effect (called post-operative cognitive decline), and many suspect it's related to long term cognitive issues:

---

From: https://www.alzheimers.org.uk/about-dementia/risk-factors-an...

> There is a link between surgery and short-term changes in thinking and memory, called post-operative delirium or post-operative cognitive decline. This condition particularly seems to affect older people. Some studies have also found that these short term changes may be associated with higher risk of dementia later in life but other studies have found no association.

[aatd86]

I don't see how your link establishes that what I said is notably untrue.

[horsawlarway]

There are known side effects (short term cognitive decline). In addition - there are unresolved questions about whether those effects are persistent or not, and whether age plays a role.

What you said is: "[anaesthetic agent] has no observed side effects in general" and that's just not true.

As an aside - my grandmother had hip surgery at 86 and was never the same mentally afterwards. She could walk, but she couldn't remember who her family was. It was not particularly unexpected (she had an existing diagnoses of alzheimers) but the change post-surgery was notable enough that the entire family discussed it. It was like she had been slipping a bit, but the surgery threw her off a cliff. The difference between knowing who you are, but discussing the weather every half hour or so, to having no idea who the people around her were.

Personally - I would firmly place anesthetics into a fairly risky category of drug that we have a very poor understanding of. Which is decidedly not where you are placing it.

[MichaelZuo]

It has serious, observed, side effects for a sizable fraction of the population?

Yet your comment said "and has no observed side-effects in general."

[aatd86]

It's a well-known post-operation side effect that affects a few people transiently.

Maybe it's my fault for not being specific but in context, I was talking about long-term, possibly irreversible complications. While what you point out exists (every psychoactive drug has undesirable side-effects in general, even coffee can be dangerous), it is incomparable to the rate of occurences of side-effects such as tardive dyskinesia for neuroleptics for instance.

That's why I also added "in general" ...

[MichaelZuo]

> Maybe it's my fault for not being specific but in context, I was talking about long-term, possibly irreversible complications.

How is significantly increased rate of dementia among the affected population not long-term? It seems irreversible too?

[kbelder]

It isn't required for useful medicine, but it is useful for required medicine.