Posted by SLS on September 20, 2015, at 5:40:49
In reply to Re: Young people on SSRI's commit more crimes?, posted by Hello321 on September 19, 2015, at 23:51:28
The penicillin example: You either did not understand the concept of analogy or you have never been prescribed a drug without being shown the PDR by your doctor. Can you think of any instances when you have taken a drug without opening the PDR or its facsimile on the Internet? Antibiotic? Laxative? Aspirin? Hypoglycemic? Antihypertensive? Diuretics. Anticonvulsants? Antinociceptives? Choose a drug that you have taken other than one used for psychiatric purposes. We can then use RxList as a reproduction of the package label and see how you feel about the drug afterwards.
Would you agree that sufferers of mental illness are often plagued by cognitive impairments, poor judgement, psychoses, and an inability to comprehend information and make decisions?
As much information should be presented to the patient as makes sense in the clinical setting. It does not make sense to loan them a copy of the Physician's Desk Reference.
If you were a doctor, how would you present Prozac to your patient?
You know, if you can learn and process new information such that you can understand all of the side effects listed in the PDR, then you are not ill enough to be treated. I would argue that the patient who remains mute or dissociated or too severely psychomotor retarded in the doctor's office, and wants to leave as soon as possible, is precisely the one who needs the most aggressive treatment. There is irony there somewhere. Do I really believe that you don't need to be treated? Well, I imagine you are affected severely enough to want to turn to ECT, which you believe will damage your brain. Sometimes, one's verbal gifts can leak through enough to mask even the worst of depressions. If you add a little passion, someone's writing can seem perfectly fine and unaffected. Perhaps you fit into this category. Certainly, you are a good debater.
I am not a doctor, of course, and I wouldn't know where to strike a balance for each person needing treatment. I believe I would learn such balance after years of clinical experience and in communicating with colleagues and attending conferences, symposia, and CME. I would probably treat each person differently depending upon my clinical impressions of their illness, current mental state, and capacity to understand perspective. I would not tell them everything appearing in a PDR simply because they would not know how to interpret the information, and this may have a deleterious effect on compliance.
So... My answer is that I would not teach each patient everything there is to know about a drug. Neither would I stand mute writing on my prescription pad and having them leave with nothing more than a little blue piece of paper. Doctors learn more than just anatomy and physiology. They learn how to interact with patients of many different types of illness and illness severities. Optimized bedside manner should treat and inform. How and what to inform is the professional choice of the prescriber.
Regarding your writing letters, I think that's a good idea. I think it would help insure that doctors understand that there is an obligation to provide some information regarding the drugs they prescribe. Even though I don't agree with the extremes with which you would mandate such obligations, I think it would offer some new perspectives.
> But really, i just want sick people to be allowed to make the final decision based on a complete picture. And yes, every situation should be treated uniquely.
You can't have it both ways.
You either inform people about ALL adverse effects or you don't. In the latter case, a good doctor will draw from his clinical experience exactly what to teach each patient.
The black box warning on drug labels is justified in my opinion. We now see it for drugs that are not categorized as being psychotropics. The precipitation of suicidality is not limited to the realm of antidepressants. Until medical science can do better, these are the drugs we have to work with, and I thank God everyday for them. 100 years ago, I'm pretty sure I would have committed suicide before age 24. I also convey to God my anger for not being born 100 years from now, when medical science will have found a way to cure or produce life-long remission from bipolar depression. In the meantime, my immediate goal is to function well enough to return to employment. I still have a little ways to go. I will live a life of more mental energy, but be denied the recovery or improvements in interest, motivation, anhedonia, sex-drive, clarity of thought, sharp memory, animated affect, etc. That is no way to experience a life of limited years.
I have already tried ECT, but failed to respond to it. However, that was in 1991. The procedure has changed. Perhaps you will get lucky.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1082509
URL: http://www.dr-bob.org/babble/20150901/msgs/1082720.html