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Jan. 2nd, 2005 01:32 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
milBritain Tightens Antidepressant Rules
LONDON (Reuters) - British health authorities tightened warnings on popular Prozac-type antidepressants on Monday, urging doctors to use them sparingly and consider non-drug interventions, such as counseling.
Journal Tells FDA Lilly Knew of Prozac Risk
LONDON (Reuters) - The British Medical Journal said on Friday it has sent documents to U.S. health regulators that appear to suggest a link between the antidepressant Prozac and suicidal behavior.
In its Jan. 1 issue, the journal said an anonymous source had provided "missing documents" that included reviews and memos appearing to show that officials at Eli Lilly and Co., the drug's maker, knew in the 1980s that it had "troubling side effects."
Now, normally I wouldn't put such faith in an anonymous source, except it the documents in question apparently have to do with activation syndrome, which is a direct result of the serotonin re-uptake inhibiting properties of the drugs themselves. I've always been a little suspicious that, knowing that the very name for them from the very beginning of this was "selective serotonin re-uptake inhibitors" (SSRIs), that no one bothered to study the effects of serotonin re-uptake inhibition before 2003. That's a bit ridiculous. Even an amateur would realize that large doses might result in anxiety or manic symptoms.
Is everyone genuinely so concerned with profit that they don't care about the consequences anymore? If one was in pharmaceuticals because it was their life's work, then the health of the end patients would be top priority. Causing harm would be a failure to research properly, and for me, at least, that would be a great, humbling shock. Or are the youth of today so enamoured of themselves that they seriously think that there is a quick fix biochemical cure, and that they are so brilliant that they will be the ones to find it (which would, logically, be a matter of statistics and luck and have nothing to do with brilliance at all), and that any evidence to the contrary is simply garbage?
I think perhaps children should be ushered into vocations where they, individually, would be satisfied with "mediocrity" (not in quality of work, but in recognition of it). I, for instance, would be perfectly happy to be a general surgeon of no consequence to the national media. In fact, I would prefer it that way. To have your friends, family, colleagues, and patients see you as more than competantly skilled is one thing. Being lauded on day-time talk-shows or the evening news is another thing entirely. If I wanted that, I wouldn't be going for medicine at all. Who knows what I'd be going for, but the fact is, most doctors don't become the slightest bit famous at all.
Or, perhaps, it's even deeper than that. I have noticed among doctors, especially among psychiatrists, a belief in their own infallibility. They can't ever admit to being wrong. They will pursue obviously unsuccessful treatments, beyond the point where they would even be effective under normal circumstances. In one example very close to me: mild depression, instead of being treated with 50mg of zoloft for six months (a normal dose), gets the treatment of 150mg of zoloft, 300mg of trazodone ("for sleep") for 2.5 years, and then, after a new breakdown, slight adjustment of the dosages and an added 8mg of perphenazine (an antipsychotic).
The 8mg of perphenazine would be a temporary hospitalization dose for a severe schizophrenic episode, while a normal maintenence dose would be 4mg at the highest. The patient in question does not have any symptoms of psychosis. In fact, a little research shows that the perphenazine was initially prescribed to "prevent obsessive thoughts of suicide".
At this point, I want to bash my head against the wall. You do not prescribe hospitalization doses of antipsychotics to a nonpsychotic patient to treat depressive symptoms. That's even worse than the trazodone, which is prescribed at six times the normal dosage "for sleep". Trazodone is an antidepressant with extreme drowsiness as a common side effect. You do not prescribe excess amounts of medicines for their side effects.
LONDON (Reuters) - British health authorities tightened warnings on popular Prozac-type antidepressants on Monday, urging doctors to use them sparingly and consider non-drug interventions, such as counseling.
Journal Tells FDA Lilly Knew of Prozac Risk
LONDON (Reuters) - The British Medical Journal said on Friday it has sent documents to U.S. health regulators that appear to suggest a link between the antidepressant Prozac and suicidal behavior.
In its Jan. 1 issue, the journal said an anonymous source had provided "missing documents" that included reviews and memos appearing to show that officials at Eli Lilly and Co., the drug's maker, knew in the 1980s that it had "troubling side effects."
Now, normally I wouldn't put such faith in an anonymous source, except it the documents in question apparently have to do with activation syndrome, which is a direct result of the serotonin re-uptake inhibiting properties of the drugs themselves. I've always been a little suspicious that, knowing that the very name for them from the very beginning of this was "selective serotonin re-uptake inhibitors" (SSRIs), that no one bothered to study the effects of serotonin re-uptake inhibition before 2003. That's a bit ridiculous. Even an amateur would realize that large doses might result in anxiety or manic symptoms.
Is everyone genuinely so concerned with profit that they don't care about the consequences anymore? If one was in pharmaceuticals because it was their life's work, then the health of the end patients would be top priority. Causing harm would be a failure to research properly, and for me, at least, that would be a great, humbling shock. Or are the youth of today so enamoured of themselves that they seriously think that there is a quick fix biochemical cure, and that they are so brilliant that they will be the ones to find it (which would, logically, be a matter of statistics and luck and have nothing to do with brilliance at all), and that any evidence to the contrary is simply garbage?
I think perhaps children should be ushered into vocations where they, individually, would be satisfied with "mediocrity" (not in quality of work, but in recognition of it). I, for instance, would be perfectly happy to be a general surgeon of no consequence to the national media. In fact, I would prefer it that way. To have your friends, family, colleagues, and patients see you as more than competantly skilled is one thing. Being lauded on day-time talk-shows or the evening news is another thing entirely. If I wanted that, I wouldn't be going for medicine at all. Who knows what I'd be going for, but the fact is, most doctors don't become the slightest bit famous at all.
Or, perhaps, it's even deeper than that. I have noticed among doctors, especially among psychiatrists, a belief in their own infallibility. They can't ever admit to being wrong. They will pursue obviously unsuccessful treatments, beyond the point where they would even be effective under normal circumstances. In one example very close to me: mild depression, instead of being treated with 50mg of zoloft for six months (a normal dose), gets the treatment of 150mg of zoloft, 300mg of trazodone ("for sleep") for 2.5 years, and then, after a new breakdown, slight adjustment of the dosages and an added 8mg of perphenazine (an antipsychotic).
The 8mg of perphenazine would be a temporary hospitalization dose for a severe schizophrenic episode, while a normal maintenence dose would be 4mg at the highest. The patient in question does not have any symptoms of psychosis. In fact, a little research shows that the perphenazine was initially prescribed to "prevent obsessive thoughts of suicide".
At this point, I want to bash my head against the wall. You do not prescribe hospitalization doses of antipsychotics to a nonpsychotic patient to treat depressive symptoms. That's even worse than the trazodone, which is prescribed at six times the normal dosage "for sleep". Trazodone is an antidepressant with extreme drowsiness as a common side effect. You do not prescribe excess amounts of medicines for their side effects.
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no subject
Date: 2005-01-02 02:54 pm (UTC)Although our experiences with psychiatrists haven't been as horrific as yours, we've certainly seen this attitude. We had one guy who essentially told us we and our entire family were batshit insane after a single half-hour session, another one who told us we'd probably have to be on medication for the rest of our lives. I think part of it, also, is because they quite literally have a huge investment in believing medication is a cure-all-- if you look at their offices, they've got different brand names all over their pens and notepads. They're being paid by the drug manufacturers to prescribe their stuff. (Most of the studies asserting the cure-all properties of various psychiatric medications are funded by pharmaceutical companies, also.)
You do not prescribe excess amounts of medicines for their side effects.
*points* That, in a nutshell, is a lot of what's wrong with modern psychiatry. There are increasing numbers of doctors who prescribe antipsychotics solely for their anti-anxiety side effects. There are even some who prescribe them in preference to anti-anxieties like Xanax because of the supposed 'highly addictive properties' of the anti-anxieties. (Yes, they can become habit-forming; yes, we once had to go through withdrawal from one when we overused it-- see below-- and it wasn't fun, but I'd still far rather take that than the potentially much more dangerous side effects of antipsychotics. And, of course, some of them are prescribed to deal with the side effects of other medications, or for problems that wouldn't be there if not for other medications the patient was taking.)
About previous studies on SSRIs and mania: we've actually heard about links between antidepressants and mania/suicidal behavior since the mid-90s, when we first started taking Prozac (at the lowest or near-lowest dose). But we had done a little research on our own and so we ended up actually watching ourselves for signs of suicidal impulses. I wish I could remember when we first heard about it. Apparently, though, there was no great publicity for any of these studies, or even for the cautions of psychiatrists who suspected a connection, until very recently.
As far as taking medications for the side effects, we did that once voluntarily and shouldn't have done it. During 2003 and the first half of 2004, we were taking Klonopin, an anti-anxiety drug in the same group as Ativan and Xanax, which had been prescribed to us because we were experiencing anxiety about our father being severely ill. (The son of a bitch tried to give us Thorazine for anxiety, but we managed to talk him out of it.) One of the things we found was that it helped us get to sleep, and so we started taking it as a sleep aid when we had insomnia. The problem was that we got habituated to it, to the point where we got some unhappy withdrawal effects when we finally went off it. Also, we were starting to lose our memory. Not just forgetting names and dates, but like, not being able to remember anything we did yesterday or for the entirety of the week before-- it was almost like 'classic MPD' in that sense. We'd have to check our IM logs with Astraea to remind ourselves of what had happened and if there was anything important we'd forgotten about. After we went off it, our memory gradually came back, so I think there was more than just stress going on there.
no subject
Date: 2005-01-02 05:35 pm (UTC)Is everyone genuinely so concerned with profit that they don't care about the consequences anymore?
Like our correspondent Sabrina said recently, everything has always been up for sale. It's why people shouldn't simply swallow everything they're told.
I have noticed among doctors, especially among psychiatrists, a belief in their own infallibility. They can't ever admit to being wrong.
They are coached in this belief system at medical school. I'm serious. It is very close to being a religion, or more specifically, a kind of mystic lodge. The insistence upon a "necessity" for animal experimentation in medical schools is partially based on the fact that vivisection is not just to study anatomy and how things work, but a kind of initiatory ritual; on a primal, hindbrain level, it amounts to a blood sacrifice.
Offlabel use of medicines in the way you describe has always existed, but today is increasing. The wonderful successes of some offlabel uses, as with Calan (a blood-pressure medicine that cures migraines), have led to the sheer lunacy you describe. It's like giving someone mint tea for a broken leg, but you can't tell that to them. They're doing this not to help people, but because they can.