Dr. Carlat reviews Anatomy of an Epidemic

[palm]

I thought this exert was of particular interest:

In addition, it's certainly true that psych drugs have many side effects, and that side effects can cause certain disabilities. But this is true for all drugs in all fields of medicine. Antipsychotics are effective at reducing delusions and hallucinations, but they can also cause weight gain, diabetes, tremor, etc.... It's up to the doctor and the patient to decide together whether the side effects are so disabling as to overwhelm the benefits. But this does not mean that psych drugs cause worsening psychiatric disabilty, any more than blood pressure drugs cause worsening blood pressure.

To read the rest, go to http://carlatpsychiatry.blogspot.com...-epidemic.html

When I am feeling more coherent tomorrow, I will post a comment on his blog. I encourage other people to do the same.

It will be interesting to see what how his usual crew of commentators responds, particular the folks who rant against us anti psychiatry folks.

Palm

[scotty]

I have a few problems with Dr. Carlats review:

Cause #1: There are more disorders to diagnose.

There's plenty of room for debate about whether all these "new" disorders are truly new or valid, but my point here is that, valid or not, the rise in diagnosis has been largely driven by changes in disease classification and subsequent training--not by toxic medications.
Many of the "new" diagnosis' have been created as a result of the effect of psychiatric drugs or reactions to those drugs. ie. bipolar III. So to dismiss the drugs as a contributory possibility for the increase in diagnosable mental illness isn't seeing the whole story. How many are diagnosed bipolar in withdrawal? Another aspect to consider.

Cause #2: There are more treatments available, so clinicians have a greater incentive to look for diseases.

I don't take this as a good thing, and yes it can cause an increase the the "diagnosed". It begs the question, are we diagnosing life as a disease? And what happens to those who fall into this trap....they get a drug that can be extremely hard to come off of. So, once again, the drug ultimately can cause that diagnosis to be expanded.

Cause # 3: Changes in federal law have encouraged more people to seek disability status.

Fact, but being on a drug is almost always required to obtain this disability status....and is the drug helping or creating/worsening the problem.

His evaluation of the situation has some good points and I'm sure have added to the mental illness rolls, but he admits not reviewing the actual studies that the Whitaker book is taken from. Without reviewing that data his speculation is just that. He totally dismisses the possibility of drugs being at least part of the situation, which we all know is naive.
I don't believe that drugs are the whole problem, but I do believe they play a part.

[ray34iyf]

What fantasy world does he live in? Sure, it may be ideal if doctor and patient work together like that but it doesn't seem to work like that in the real world. And if it did, there would be farrrrrrrrrrrrrrrrrrrrr fewer people on these pieces of crap ssris.

[scotty]

Some very interesting comments on his blog. Hmmm, have to work on one!

[Zoloft25]

Just another guy who cant fully come to believe that these drugs do very little for mental disorders and can actually worsen a person. It was the same with the medical community with cocaine, and heroine. But finally the truth was shown, I believe one day SSRI, Benzos, and antipsychotics will be in the dust bend of medical history along with cocaine and heroine. I don't know when, but trust me, IT WILL HAPPEN!!! The truth has no agenda


SHANE

[palm]

Originally Posted by scotty

Some very interesting comments on his blog. Hmmm, have to work on one!

Oh, I hope you do

I tried writing something yesterday but I found nothing inspiring to say. All my arguments sounded stale.

If you feel inspired, can you respond to Dr. Allen's comment that seems to be inferring that people who have concerns about psych meds are incapable of reading studies and only read analysis' of people who have an anti psych med agenda?

I found that very insulting but unfortunately, I couldn't think of anything great to say.

Palm

[prhiannon]

just to review the list of studies cited by Whitaker:
http://www.robertwhitaker.org/robert...epression.html

if that's useful

[prhiannon]

well, I posted a comment. Thanks for this thread. We'll see if my comment gets put up.

[scotty]

Commented...lets see if it gets approved for publishing.

[scotty]

Originally Posted by scotty

Commented...lets see if it gets approved for publishing.

Approved and posted.

[cinephile]

Laurie, what a great post! You so succinctly and devastatingly plead the case for all of us psych med users. Nothing short of heroic. Some of my favorite bits of your post, with some of my commentary:

"Almost no suicider has a prescribed medication in him"
Really?....that is an amazing stat, false, but amazing.

LOL! I'm glad you picked up on this whopper. I found that statement pretty hard to swallow too, along with the same poster's assertion, "Half [of the suiciders] are legally drunk, as are half the murderers, and half the murder victims. Today, the majority of psychotic symptoms stem from the irresponsible, uninterrupted, and all out partying of patients." Oh really? Where's the stats to back that up? Yowza.

"Most have no idea what so ever as to any risks or what limited evidence supports long term benefit. When I tell them these things they are horrified. Some choose to remain on them but most ask me how they can come off or just quit them altogether."

Another key point. Historically patients have relied on their doctor to give them the information about the drug that is being prescribed. The "my doctor just told me to take it" is something I hear in my practice every single day. No one told patients that the rules have changed, and now they are responsible for doing the research and if they do quite a few psychiatrists will tell them to stop going to the internet(even if these are medical studies). So on one hand psychiatry subscribes to the "just listen to me I know best" way of practicing, and when things fall apart they change to the "the patient should have known to read about the drug before taking it". One can't have it both ways. I talk to psychiatric drug users everyday and the first sentence uttered is usually "I had no idea this drug could do this to me".

BINGO. I've become painfully aware of this observation of yours throughout nearly EVERY doctor/psychiatrist interaction where a prescription was involved. Patients simply don't have a choice but to refer to the internet for detailed information and patient stories on the safety of a drug, and when we tell our doctors our findings, it's all dismissed as internet blather. THIS ISSUE MUST BE ADDRESSED IF DOCTORS ARE TO PRESCRIBE SAFELY.

A final question for you Laurie: How is your philosophy on psych meds accepted by your health care peers? Do they believe and respect your opinions, or do they just tolerate it and roll their eyes? I truly hope they accept it and adopt your mindset. The revolution has to start somewhere.

I have also made a post of my own and hope it is approved. I feel it is nothing short of my duty to make my experience known as a patient. I encourage other PP members to do the same, as this is a rare arena where we can directly interact with psychiatrists.

[scotty]

Originally Posted by cinephile

A final question for you Laurie: How is your philosophy on psych meds accepted by your health care peers? Do they believe and respect your opinions, or do they just tolerate it and roll their eyes? I truly hope they accept it and adopt your mindset. The revolution has to start somewhere.

Those that I work with closely are very much on board with my findings...to the point where one of the docs had a family member prescribed Lexapro 30mg. This family member told him it was a "very low dose", and the doc asked me what I thought. I explained that the dose was 10mg higher than the highest recommended dose. He got on the phone, called this family member and I spent about 30 minutes talking to him about risks and benefits. He decided to find a therapist instead.

[cinephile]

Wow, that's awesome Laurie! I hope someday all health care professionals will take your (our) attitude towards psych meds.

And, on a related note, my blog post was approved and is now up on the blog. I'd like to give kudos to Dr Carlton for not censoring my post in any way. This is exactly the kind of patient/professional discourse that is so tragically missing from psychiatry today. I honestly think this blog is a step in the right direction.

[Lucy]

Your comments on the blog were great. And thanks to palm for letting us know about this review.