Newer Challenges , Newer Strategies
Moreover, we must also understand why there is in science this constant concern with the new. Just to go back
to our earlier example. It is not that lithium is not a good medication. In fact we must thank some researchers for pointing
it out relatively recently that it has indeed stood the test of time (Baldessarini and Tondo, 2000). When we say that 20-40%
of classical bipolar patients do not respond to lithium, we must not forget that it also means 60-80% of classical patients
do. And that is a pretty large number. But what we cannot also wish away is the fact that 20-40% of classical
patients, and the majority of nonclassical ones, do not respond. Moreover, a problem that is solved no longer bothers us,
but that which is not keeps rankling the mind. Patients who respond do not trouble us as much as those who do not. Both the
clinician and the researcher are concerned, and feel challenged, (and rightly so), to find ways and means of resolving their
difficulties. Hence the search for newer molecules, and newer treatment strategies, must legitimately be pursued. The pharmaceutical
industry and the superspecialist researcher can no longer remain whipping boys when viewed in this perspective, can they?
Also, let us not forget, that the number of non-responders swells over the years, and that further adds to the discomfort,
not only of patients and care-givers, but also of clinicians, researchers and their ancillaries. Moreover, subtle nuances
of an illness, its processes and outcome, are only laid bare over a length of time. And newer challenges needs newer strategies.
The same must happen with bipolar disorders, lithium and the newer medications. Or, for that matter, with any disorder and
any treatment strategy. Not just in psychiatry, but in medicine as a whole. And, come to think about it, in all scientific
fields in general.
Mens Sana Monographs [MSM]: A Mens Sana Research Foundation Publication