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Archive for July 16th, 2010

Wherever you look in the research literature, you will see research articles praising cognitive behavioral therapy (CBT). Despite the best efforts of the pharmaceutical industry, the academic researchers have managed to maintain enough independence to challenge the assumption that drugs are the best way of treating any disease or disorder. But it’s all very well for researchers to write articles. This is only useful information if the world changes a little. The are two key changes required. The first comes in the attitude of hospitals and the top physicians. The healthcare services industry is built on a for-profit model that makes the most efficient use of the smallest number of employees to deliver care to the maximum possible number of patients. Unfortunately, one-to-one therapy is an expensive way to use the time of any senior member of staff. Unless you create a new departmental empire for the senior staff to run, they will not support the move to provide CBT, and the hospital will refuse because it will not make enough money unless. . . The second change would have to come from the health insurance industry. The insurers have been hit by regularly increasing medical costs, all of which have been passed on to you as higher premiums. The insurers would have to adjust their payment strategies to prefer short-term therapy costs to long-term drug costs.

So what exactly is CBT? In a way the label is the answer. “Cognitive” = thinking. “Behavior” is easily defined. This is a short-term therapy designed to give you strategies for coping in your present circumstances, i.e. you focus on what you need to do “now”. You are encouraged to look for the cause and effect of what you think and how you act. This is not the same as classical psychological analysis which looks back in time for the deep-rooted causes of problems. This is a practical survival course. If you have a phobia, how do you overcome it? If you cannot go into a crowded room because of social anxiety disorder, what can be done? This makes it good for moderate anxiety states and it has proved a cheap way of helping people learn basic survival skills.

Like all emerging disciplines, it has been staking out its claim for leadership in the field of therapy and counseling. It has therefore made enemies. They accuse it of making exaggerated claims for its success rates. Quick fixes are just that, i.e. if you think of a car, a “fix” is often only good for a short time before full repairs have to be made. Nevertheless, CBT is rising to the top of the heap because it’s more positive. It reacts to situations rather than merely offering general advice as counseling.

In all this, there’s still a place for drug therapy. Because CBT resources are in short supply right now, there can be delays before getting an appointment. During this time, using Valium over the short-term keeps your anxiety under control and gives the therapist a better chance once the first appointment comes around. One of the first things that will be discussed is whether you will continue the Valium. It’s a high priority to taper off your reliance on drugs as soon as possible. That way, you can have a strategy for life without Valium or any comparable drug.

Every now and again, Wikipedia is useful. Wondering when sliced bread was introduced, the cloud tells us the greatest step forward in baking took place in 1928. The bread, of course, stayed the same, preserved in its waxed paper wrapping to preserve its moisture level. At the time, this was hailed as the best possible evidence of US inventiveness. The Brits still use the phrase,”The greatest thing since sliced bread!” in ironic fashion to describe any development of form rather than substance. But the marketers are immune to irony and are always quick to jump on even the smallest change as a major breakthrough. With its new woggle, the widget is now unbeatable. Something it’s always a relief to know. Thanks to the addition of Z2134, your toothpaste is better than before. This is a miracle ingredient, converting the ordinary into the spectacular.

So, by way of introduction to the latest wondrous development, we need to open a dictionary because, this time, those bringing the news have broken out into new ground. Meet the word, “orodispersible”. This usually refers to tablets that do something very clever (assuming you ever do find new technology clever). They are designed to melt in the mouth and not in the hand. No, wait a minute, that’s one of those candies. Well, this is a different application of the same principle. These tablets will disintegrate when they come into contact with saliva. The sweat from your fingers should not affect them (famous last words) but, with the right chemical mix of bonding agents, some are soluble in water, i.e. you can drop one in a glass of water and it will dissolve. Why bother to change? As it stands, the tablets are designed to melt in the hydrochloric acid lurking down in your stomach. Once broken down into the basic chemicals, the bits supposed to do us good are absorbed into the bloodstream. This is a steady process, very reliable and, if you have just eaten a heavy meal with a high fat content, it can take more than an hour before you start to feel the effect of the medication. If the pill disintegrates in the mouth, it is immediately absorbed into the saliva and swallowed. Some of the active ingredients will be absorbed through the tongue and through the esophagus before they reach the stomach. Thus, no matter how many burgers you might have wolfed down, the drugs will entering you bloodstream before you finish swallowing.

Welcome to the future of Levitra. The FDA has just approved an application by Bayer for an orodispersible version that will significantly cut down on the waiting time before you can expect an erection. No one has yet said what the flavors will be. Perhaps banana would be appropriate. Anyway, with the formality of approval out of the way, the marketers will no doubt be burning the midnight oil to devise the campaign. Ready for action? Slip this tablet into your mouth and you’re ready to go! A slight exaggeration, of course. But marketing is all about bending the truth, except no bending can be associated with Levitra. The erection must always be hard enough for penetration. So you can expect the launch later this year. Remember the name. This version of Levitra will be called Staxyn.