Ssris - Is Continuing To Prescribe Them A Contravention Of "do No Harm"?

[Anarchy]

Hi @Lizio I don't know. He had been studying in Manchester, but his parents home was near Birmingham, so it could have been either. His old mother is still alive and still very much with her faculties in her 90s. I'll see if she can remember. I have already asked a few people who knew him, where it was, and haven't found out yet.

I'd love to see bastards like that answer for their crimes - but the way that the system is organized, they pretty much have impunity to continue.

If the institutions were private businesses, then the news media and everyone else would be baying for the filthy profit seeking capitalists behind them, to be dealt with. and rightly so.

However with the state sector, these are somehow portrayed as being "our" institutions, and seeking to do the best for us in an ethos of "public service", "people need to help each other" or some such obfuscatory BS

When instead, they are a predatory priced, coercive monopoly, and the "regulation" of professionals that gets sold to us as "protecting consumers", was a way of cartelizing practitioners and excluding the entry of competitors. so that the incumbents could earn high wages, due to an artificial scarcity of supply.

If we had competitors. we might actually prefer to use them, and they would have an interest in pointing to malpractice in other institutions, and preventing it in their own.

One of the things that was pretty clear, years ago when I was dating a nurse, was that if a nurse blew the whistle on malpractice, or even rocked the boat - she'd never get to work in the British NHS ever again. there were no competitors that she could go to work for. So they kept their gobs shut.

ok rant over

 

[Queen Boudica]

Thanks @Anarchy. I know what happened to my sister. I have the reports. I know about every single drug and I know she should not have been on that combination or those amounts or prescribed a months supply. They knew she was abusing those drugs. Her psychiatrist states it in the coroner's report, blaming her for using them to zone out; yet they continued to prescribe her them. The combinations she was on, and drugs that were not supposed to be prescribed long term or for anyone with her condition. They were contrary to her condition, yet they prescribed drug upon drug upon drug. Unbelievable. But that was 15 years after the original abuse when they misdiagnosed her and doped her up with antipsychotics. And forced them down her. Wrecked her. A 17 year old girl. One day. One day. I will write a book. But no you don't stand a chance with the system. I wonder how many have died. I think an awful lot. Only no-one cares because they were mentally ill. I hate it so much. It is worse than the Catholic church. There will be no inquiry because every one is afraid to speak up and have been sold a pack of lies.

 

[Ocean5]

I've tried 2 SSRI. Currently getting off Zoloft. Was on Lexapro before. I will say it's hell with both for me. Like why was I given this?? Then to see all the changes in my life are "just side effects".

Yes, and also how doctors damned me when I was pro-active.

Good for you! I will tell you I will never trust another doctor again. And I will never fill another prescription before I research fully. Every time I was given something new I always asked, "Is it like Lexapro? Could be it make me worse like before?"

But I was so bad off when given Zoloft I didn't ask - huge mistake!

 

[SeaQuel]

I couldn't read all of the posts, but just to say I recently attempted to discuss the issue of treating PTSD with SSRIs with my psychiatrist. I explained the developing science to him (if that sounds counterintuitive, it is), and he essentially hung his hat on the fact that "other" studies have shown an improvement in symptoms for some people. I then stated that every medication for every illness will show an improvement in a certain percentage of the population and that doesn't scientifically substantiate anything. (Not discounting the reality that some meds help some people with some symptoms. Just talking about the use of SSRIs for treating PTSD.)

Granted, my psychiatrist does not specialize in PTSD; if I wanted someone who did, I would have to pay of pocket, even then, who knows how in front of the science the specialists would even be. I've only been seeing a psychiatrist for a few months, at my therapist's encouragement, and would dump him if I didn't still need sleep meds. Once I get that regulated on my own, I won't look back.

Both my therapist and psychiatrist are still adherents to the serotonin chemical imbalance theory. However, at least my therapist has admitted this is outside of her area of expertise and that she made a choice (way back when) to study/practice psychology, because that's how she felt she could provide the most amount of help to people. She and I have also had some good discussions about what the brain is starting to tell us about PTSD. It helped me hear her explain that the neuroscience is still so new (not that I feel the pharma industry or psychiatrists are any less negligent, however).

She and I are also in agreement that it is very possible we will come to find out that PTSD is on a spectrum as a disorder. So, different therapies and medications will be prescribed depending on the PTSD you're diagnosed with. This, I believe, is a contributing factor for why some people respond better to somatic experiencing and some to EMDR, for example. Combat and non-combat PTSD labels are totally useless IMO. Slightly more useful are "simple" and "complex." Sorry for the tangent.

 

[Anarchy]

Hi Dancing Bull, congratulations for having the guts to challenge them, and drag them (kicking and screaming) into looking at some science.

he essentially hung his hat on the fact that "other" studies have shown an improvement in symptoms for some people. I then stated that every medication for every illness will show an improvement in a certain percentage of the population and that doesn't scientifically substantiate anything. (Not discounting the reality that some meds help some people with some symptoms. Just talking about the use of SSRIs for treating PTSD.)

Exactly.

Somewhere in around the mid 40s percent of people with PTSD will respond with any "treatment", including a sugar pill.

To that extent, SSRIs can be considered to "help" some people, but they are harmful drugs that are not helping any more than an absolutely harmless placebo would help.

Bessel van der Kolk discusses a clinical trial which he did comparing EMDR, prozac and a placebo, from around the 40 minute mark here

 

[SeaQuel]

@Anarchy Well thanks, but I don't know about the "looking at some science" part. Despite my efforts to make them aware of a number of such studies and articles (provided by @anthony @joeylittle and others on this site) proving that the chemical theory was garbage, neither my therapist nor psychiatrist has read them to my knowledge.

My therapist initially asked me to email them to her, which was encouraging, but has since said she hasn't time to read them and ultimately recommended that I engage my psychiatrist on the issue. Fair enough. (I do think my therapist will read them at some point, but I'm ok with it if she never does. She is well-read on most everything else that I need her to be and her lack of awareness on this particular issue only troubles me so far as when she provides an opinion about medication.

My psychiatrist, on the other hand, really didn't seem prepared/willing to engage in the topic at all, per my earlier post, and we never got to the stage of me offering to provide him with the data. I probably would have brought that up myself if I thought he was a true partner in my treatment; the reality is he's mediocre at best and I'm only seeing him as long as I have to stay on sleep meds for. I think he has other "interests" that he probably does research, but that doesn't appear to include PTSD.

but they are harmful drugs that are not helping any more than an absolutely harmless placebo would

I agree you with you 1,000 percent.

 

[anthony]

Therapy is a qualification, mandatory only development when required, and is otherwise just a business nowadays. It doesn't surprise me therapists don't remain current with journals and such, which all this information has been published within prior, directly or cited in other works.

The psychiatrist is correct though, and I did outline this in my post, in that they do have an effect range on some people, thus if they work for 30% of people to some degree without too many side effects, should that rule them out because they fail on 70%? The issue is the trial and error on the 70% to find they don't work for them, which is typically found in the first few weeks, though when the patient complains about x, y or z, the shrink discards it, ups the dosage and tells them to keep pushing forward and they will eventually get used to it. I think that is the issue with prescribing SSRI's, not the 30% or so that they do work upon more effectively.

There are people who have zero issues taking them from the get go, and they work for them from the get go. Working without issue is the sign IMHO that the person is a candidate for them. Anyone presenting with issues, they should be removed immediately and not told to keep pushing onwards and upwards for dosage.

 

[SeaQuel]

@anthony is the 30% efficacy for treating PTSD or for treating comorbid diagnoses?

 

[anthony]

Well... one could argue that many different ways. I honestly wouldn't know, and the percentage is an approximate based on study results.

It is well documented that treating depression only can assist a PTSD sufferer dramatically in their healing and day to day functioning. I guess you would have to consider many facets, which really steps into the realm of criterion G: "The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning."

Whether the SSRI works for a person to treat the anxiety component, depression or other component, if functional improvement is made in criterion G area's, then I would say it's a success for that person.

If the SSRI treats something effectively, then success. If the SSRI turns you into a zombie, you suffer considerable side effects, and even to the point of having additional medication prescribed to treat side effects that never existed prior, I would say the SSRI is a negative in your treatment regime.

That is my personal opinion.

 

[joeylittle]

Whether the SSRI works for a person to treat the anxiety component, depression or other component, if functional improvement is made in criterion G area's, then I would say it's a success for that person...If the SSRI turns you into a zombie, you suffer considerable side effects, and even to the point of having additional medication prescribed to treat side effects that never existed prior, I would say the SSRI is a negative in your treatment regime.

@anthony, this is perfectly, succinctly said.

I put that line in bold to underscore the importance of tracking the actual effect medication has on the user. More psychiatrists should engage their patients in this, but anyone can do it. List your symptoms. Give yourself a baseline, using any system you like, SUDS is good. Then, rate yourself a couple of times a day when you start the med.

Find some measures in there that you can rate objectively. Hours of continuous sleep, tearful periods, hunger pangs - track yourself.

It is good personal practice anyway, to develop skills in evaluating your own state from as neutral a position as possible.

 

[Ocean5]

@anthony,
Find some measures in there that you can rate objectively. Hours of continuous sleep, tearful periods, hunger pangs - track yourself.

I agree with this. As I reduce medicine I now keep journal of doses/changes. Then when I noticed changes in me...look at notes and realize I've reduced to quickly. But I'm sensitive to medicines I've learned in past year.

Other things to notice....loss of appetite (3 meals a day to forcing yourself to eat once a day), gagging/vomiting, changes in thought patterns, tremors, not being able to stay out of bed (...realizing you keep going back to bed to control tremors. Even though before you couldn't even nap) List goes on.

Just notice and pay close attention to your body.

I'm very glad for the people helped by SSRIs. But some just shouldn't be on. Just wish more doctors realized it's not the "fix/solution" they think it is.

 

[PinCushionPrincess]

Maybe I am lucky in the GP I have found (actually, I know I am, fantastically intuitive woman), but she has always listened to my own opinions and desires when it came to drugs. My psych, not so. Now, I do see him less often and have less of a relationship with him than her, so he doesn't know me that well, so maybe that's it. But when I decided to stop taking sertraline - the anti depressant I've been on the longest - my GP was very supportive, if apprehensive, while the psychiatrist was simply horrified. That was 6 weeks ago, and I think I've made the right decision. The withdrawal effects have passed, and shock horror - I can feel! Sure, that includes feeling anxious at times, and down at others, but it also means I feel happiness sometimes, and excitement and love, things I felt I had lost (along with my memory!!) on SSRIs.

both the literature, other people's experiences and my own have made me conclude that these drugs have a purpose in some cases, but for most people they are, at best, as effective as a placebo, at worst, dangerous. Drs - here at least - prescribe them because it's the best of a list of bad options, and they need to tide you through until you can get some proper therapy (6th month waiting for me...)

I do think received wisdom will eventually change so that these drugs will not be the first line for everything, but for now it is either up to the patient to do their own research, or to rely on the luck of finding a supportive, sympathetic, engaged Dr willing and able to give time that they are so pressed for.

IWas lucky in that SSRIs were not ruining my life, as they did others, but they weren't saving it (if anything, I feel they were blocking it - making me numb and emotionless), now I am off them I have my bad days, and they're pretty regular, but now I trust that if I'm feeling better it is because I *am* feeling better, and not somehow prompted by the drugs...