5 ms·

While I'm sure you mean no harm, you are - quite simply - wrong. There are plenty of people who live lives they would never be able to live without medication,

While I'm sure you mean no harm, you are - quite simply - wrong. There are plenty of people who live lives they would never be able to live without medication, and without many of the harmful side-effects being discussed. It's incredibly frustrating seeing people who acknowledge they have no specialized knowledge in a field make sweeping statements about it, encouraging psuedo-scientific beliefs about psychiatry (which is, make no mistake about it, more of an 'art' than a science, but so was the beginning of many now-scientific fields). Nobody tries to tell a cancer patient how to treat their cancer, yet so many people feel obliged to opine about mental illness. What this article is discussing is the (unquantified) subset of people who experience serious side-effects from anti-psychotics. The key takeaway from the article: > “For some people, remaining on medication long-term might impede a full return to wellness,” Insel wrote. “For others, discontinuing medication can be disastrous.” > The problem is that we do not know who is in which group. > Some people can learn to talk themselves down from delusional thoughts. And some people might choose hearing voices over being 30 pounds overweight and tired all of the time. The point is that this is not a choice I should be making for my patients; it is a choice I need to make with them. Of course, if somebody is having a psychotic break or mentally unstable, you can't even begin to have that conversation about their available options because they will be unable to focus or make rational choices. You pretty much need to start with the medication, then work from there to figure out which group they're in, and adapt their treatment accordingly (i.e. stick with meds or drop them but help them learn how to manage it). I found the article to be a long-winded way of saying "psychiatrists ought to seriously consider dose reduction in their treatment regime", which is something that I doubt anybody would argue against. The devil is in the details (for some people, dose reductions can be incredibly dangerous), and the article does not delve into what a sensible strategy would look like.

stevoski 13y ago
> Nobody tries to tell a cancer patient how to treat their cancer, Oh I wish that was true. My gf had cancer and every crackpot we knew was advising on nonsense causes and treatments.
- ubercore 13y ago
  How many involved marijuana?
  - DerpDerpDerp 13y ago
    From the cancer.gov website, run by the National Cancer Institute, part of the National Institutes of Health [0]: 6. Have any preclinical (laboratory or animal) studies been conducted using Cannabis or cannabinoids? Preclinical studies of cannabinoids have investigated the following activities: Antitumor activity Studies in mice and rats have shown that cannabinoids may inhibit tumor growth by causing cell death, blocking cell growth, and blocking the development of blood vessels needed by tumors to grow. Laboratory and animal studies have shown that cannabinoids may be able to kill cancer cells while protecting normal cells. A study in mice showed that cannabinoids may protect against inflammation of the colon and may have potential in reducing the risk of colon cancer, and possibly in its treatment. A laboratory study of delta-9-THC in hepatocellular carcinoma (liver cancer) cells showed that it damaged or killed the cancer cells. The same study of delta-9-THC in mouse models of liver cancer showed that it had antitumor effects. Delta-9-THC has been shown to cause these effects by acting on molecules that may also be found in non-small cell lung cancer cells and breast cancer cells. A laboratory study of cannabidiol in estrogen receptor positive and estrogen receptor negative breast cancer cells showed that it caused cancer cell death while having little effect on normal breast cells. A laboratory study of cannabidiol in human glioma cells showed that when given along with chemotherapy, cannabidiol may make chemotherapy more effective and increase cancer cell death without harming normal cells. Stimulating appetite Many animal studies have shown that delta-9-THC and other cannabinoids stimulate appetite and can increase food intake. Pain relief Cannabinoid receptors (molecules that bind cannabinoids) have been studied in the brain, spinal cord, and nerve endings throughout the body to understand their roles in pain relief. Cannabinoids have been studied for anti-inflammatory effects that may play a role in pain relief. So it's not like the marijuana people are entirely making it up - cannabis definitely helps with pain relief and appetite (serious issues during cancer treatment), and may help with treating cancer directly. [0] http://www.cancer.gov/cancertopics/pdq/cam/cannabis/patient/page2 http://www.cancer.gov/cancertopics/pdq/cam/cannabis/patient/...
Helianthus 13y ago
>encouraging psuedo-scientific beliefs about psychiatry (which is, make no mistake about it, more of an 'art' than a science, but so was the beginning of many now-scientific fields) This back-pedaling is where you begin to lose steam. > Nobody tries to tell a cancer patient how to treat their cancer, yet so many people feel obliged to opine about mental illness. Including the psychiatrists who admit to 'more art than science.' >You pretty much need to start with the medication, then work from there to figure out which group they're in, and adapt their treatment accordingly (i.e. stick with meds or drop them but help them learn how to manage it). Sounds essentially like just guessing. Now let's look at your first statement. >While I'm sure you mean no harm, you are - quite simply - wrong. While I'm sure psychiatrists mean no harm, that doesn't mean they're right.
yetanotherphd 13y ago
Both experts and non-experts should be able to refer to studies of effectiveness of various kinds of treatment, that don't rely on the personal experience of individual psychiatrists. Even though I am a strong advocate of individual liberty, and I think that except in the most extreme cases people should have the right to choose their treatment, a cursory browsing of wikipedia suggests that there is strong evidence for the effectiveness of antipsyichotic medication.
stiff 13y ago
There are plenty of people who live lives they would never be able to live without medication, and without many of the harmful side-effects being discussed. As far as I know, almost all people taking medications for serious mental illness suffer serious side effects from them, that's just a fact. I am not trying to convince anyone to stop taking medication, some people might really be even worse off without them, I am just saying that it is a very difficult decision for a good doctor whether to put someone on psychiatric drugs or not, and whether to keep somebody on them. I speak from my personal observations of close family and friends who had mental health issues and were put on drugs, and from reading summaries of current research e.g.: http://en.wikipedia.org/wiki/Antipsychotic http://en.wikipedia.org/wiki/Antipsychotic Antipsychotics are associated with a range of side effects. It is well-recognized that many people stop taking them (around two-thirds even in controlled drug trials) due in part to adverse effects. -- In people with schizophrenia less than half (41%) showed any therapeutic response to an atypical antipsychotic, compared to 24% on placebo, there is a decline in treatment response over time, and potentially a biases in the literature in favor of these medication. ... If you have another opinion, I would love to hear where does it come from, do you have any kind of evidence that would counter what I said?
- enkephalin 13y ago
  > As far as I know, almost all people taking medications for serious mental illness suffer serious side effects from them, that's just a fact. EVERY drug can cause side effects. and it seems that drugs meant for treating severe conditions, also have the most severe side effects. e.g. take a look at cancer medication. these meds are for a very serious condition, and simultaneously come with some of the worst side effects i know of. but the thing is, they can help. they can save lives. the same is true for psychiatric medication. psychiatric conditions often show drastic mortality rates (25%-50% of people diagnosed with bipolar disorder attempt suicide at least once, with of course many succeeding[1]). and there are plenty of other such disorders with very high mortality rates. In people with schizophrenia less than half (41%) showed any therapeutic response to an atypical antipsychotic, compared to 24% on placebo.. numbers like these may seem low, but looked at alongside the mortality rates of many psychiatric disorders, these numbers can save A LOT of lives. [1] http://www.ncbi.nlm.nih.gov/pubmed/10826661 http://www.ncbi.nlm.nih.gov/pubmed/10826661
obstacle1 13y ago
>While I'm sure you mean no harm, you are - quite simply - wrong. There are plenty of people who live lives they would never be able to live without medication, and without many of the harmful side-effects being discussed. He isn't "quite simply wrong", by your own point. It could just as easily be the case that the severely mentally ill only couldn't live because of their interactions with "non-ill" people as it could be the case that severely mentally ill people would up and off themselves en masse by virtue of their 'illness' alone. The only life a severe schizophrenic can't live (for example) is one in a society which demands non-schizophrenic behavior, else death/shunning/exile/whatever. I here note that in order to determine that someone is mentally "ill", a defining criteria for diagnosis is being diagnosed by someone confirmed to be not ill.

stevoski 13y ago

> Nobody tries to tell a cancer patient how to treat their cancer, Oh I wish that was true. My gf had cancer and every crackpot we knew was advising on nonsense causes and treatments.

ubercore 13y ago
How many involved marijuana?
- DerpDerpDerp 13y ago
  From the cancer.gov website, run by the National Cancer Institute, part of the National Institutes of Health [0]: 6. Have any preclinical (laboratory or animal) studies been conducted using Cannabis or cannabinoids? Preclinical studies of cannabinoids have investigated the following activities: Antitumor activity Studies in mice and rats have shown that cannabinoids may inhibit tumor growth by causing cell death, blocking cell growth, and blocking the development of blood vessels needed by tumors to grow. Laboratory and animal studies have shown that cannabinoids may be able to kill cancer cells while protecting normal cells. A study in mice showed that cannabinoids may protect against inflammation of the colon and may have potential in reducing the risk of colon cancer, and possibly in its treatment. A laboratory study of delta-9-THC in hepatocellular carcinoma (liver cancer) cells showed that it damaged or killed the cancer cells. The same study of delta-9-THC in mouse models of liver cancer showed that it had antitumor effects. Delta-9-THC has been shown to cause these effects by acting on molecules that may also be found in non-small cell lung cancer cells and breast cancer cells. A laboratory study of cannabidiol in estrogen receptor positive and estrogen receptor negative breast cancer cells showed that it caused cancer cell death while having little effect on normal breast cells. A laboratory study of cannabidiol in human glioma cells showed that when given along with chemotherapy, cannabidiol may make chemotherapy more effective and increase cancer cell death without harming normal cells. Stimulating appetite Many animal studies have shown that delta-9-THC and other cannabinoids stimulate appetite and can increase food intake. Pain relief Cannabinoid receptors (molecules that bind cannabinoids) have been studied in the brain, spinal cord, and nerve endings throughout the body to understand their roles in pain relief. Cannabinoids have been studied for anti-inflammatory effects that may play a role in pain relief. So it's not like the marijuana people are entirely making it up - cannabis definitely helps with pain relief and appetite (serious issues during cancer treatment), and may help with treating cancer directly. [0] http://www.cancer.gov/cancertopics/pdq/cam/cannabis/patient/page2 http://www.cancer.gov/cancertopics/pdq/cam/cannabis/patient/...

Helianthus 13y ago

>encouraging psuedo-scientific beliefs about psychiatry (which is, make no mistake about it, more of an 'art' than a science, but so was the beginning of many now-scientific fields) This back-pedaling is where you begin to lose steam. > Nobody tries to tell a cancer patient how to treat their cancer, yet so many people feel obliged to opine about mental illness. Including the psychiatrists who admit to 'more art than science.' >You pretty much need to start with the medication, then work from there to figure out which group they're in, and adapt their treatment accordingly (i.e. stick with meds or drop them but help them learn how to manage it). Sounds essentially like just guessing. Now let's look at your first statement. >While I'm sure you mean no harm, you are - quite simply - wrong. While I'm sure psychiatrists mean no harm, that doesn't mean they're right.

yetanotherphd 13y ago

Both experts and non-experts should be able to refer to studies of effectiveness of various kinds of treatment, that don't rely on the personal experience of individual psychiatrists. Even though I am a strong advocate of individual liberty, and I think that except in the most extreme cases people should have the right to choose their treatment, a cursory browsing of wikipedia suggests that there is strong evidence for the effectiveness of antipsyichotic medication.

stiff 13y ago

There are plenty of people who live lives they would never be able to live without medication, and without many of the harmful side-effects being discussed. As far as I know, almost all people taking medications for serious mental illness suffer serious side effects from them, that's just a fact. I am not trying to convince anyone to stop taking medication, some people might really be even worse off without them, I am just saying that it is a very difficult decision for a good doctor whether to put someone on psychiatric drugs or not, and whether to keep somebody on them. I speak from my personal observations of close family and friends who had mental health issues and were put on drugs, and from reading summaries of current research e.g.: http://en.wikipedia.org/wiki/Antipsychotic http://en.wikipedia.org/wiki/Antipsychotic Antipsychotics are associated with a range of side effects. It is well-recognized that many people stop taking them (around two-thirds even in controlled drug trials) due in part to adverse effects. -- In people with schizophrenia less than half (41%) showed any therapeutic response to an atypical antipsychotic, compared to 24% on placebo, there is a decline in treatment response over time, and potentially a biases in the literature in favor of these medication. ... If you have another opinion, I would love to hear where does it come from, do you have any kind of evidence that would counter what I said?

enkephalin 13y ago
> As far as I know, almost all people taking medications for serious mental illness suffer serious side effects from them, that's just a fact. EVERY drug can cause side effects. and it seems that drugs meant for treating severe conditions, also have the most severe side effects. e.g. take a look at cancer medication. these meds are for a very serious condition, and simultaneously come with some of the worst side effects i know of. but the thing is, they can help. they can save lives. the same is true for psychiatric medication. psychiatric conditions often show drastic mortality rates (25%-50% of people diagnosed with bipolar disorder attempt suicide at least once, with of course many succeeding[1]). and there are plenty of other such disorders with very high mortality rates. In people with schizophrenia less than half (41%) showed any therapeutic response to an atypical antipsychotic, compared to 24% on placebo.. numbers like these may seem low, but looked at alongside the mortality rates of many psychiatric disorders, these numbers can save A LOT of lives. [1] http://www.ncbi.nlm.nih.gov/pubmed/10826661 http://www.ncbi.nlm.nih.gov/pubmed/10826661

obstacle1 13y ago

>While I'm sure you mean no harm, you are - quite simply - wrong. There are plenty of people who live lives they would never be able to live without medication, and without many of the harmful side-effects being discussed. He isn't "quite simply wrong", by your own point. It could just as easily be the case that the severely mentally ill only couldn't live because of their interactions with "non-ill" people as it could be the case that severely mentally ill people would up and off themselves en masse by virtue of their 'illness' alone. The only life a severe schizophrenic can't live (for example) is one in a society which demands non-schizophrenic behavior, else death/shunning/exile/whatever. I here note that in order to determine that someone is mentally "ill", a defining criteria for diagnosis is being diagnosed by someone confirmed to be not ill.