4 ms·

"The dirty little secret of psychiatry isn't that SSRIs don't work; it's that everything sort of works, but any single thing doesn't work very well for most pat

"The dirty little secret of psychiatry isn't that SSRIs don't work; it's that everything sort of works, but any single thing doesn't work very well for most patients, and there's no validated model that predicts which treatment is likely to work for which patient." I sometimes wonder if all long term improvement in all treatment modalities can be attributed to The Placebo Effect, poorly designed/collated drug/treatment studies, and the brain repairing itself with time? My view on Psychiatry is if you don't have the money to see one; you just might be better off on the long run?(That is assuming you are not suicidial, or psychotic?) I wish the profession well, but you have not come a long way baby! I do think any patient that has been on a psychotropic drug(especially the addictive ones) a long time, should be able to get that particular drug without seeing a Psychiatrist. I know that will never happen on the U.S. After hearing that Robin Williams committed suicide and the last tabs open on his IPad were the side effects of the various drugs he was taking, I wonder if he would still be alive if he didn't have access to the best Psychiatrists?

ta-026d16b2 12y ago
> I sometimes wonder if all long term improvement in all treatment modalities can be attributed to The Placebo Effect, poorly designed/collated drug/treatment studies, and the brain repairing itself with time? Some cases probably can, but it's not very plausible that such things explain all treatment effects, which are occasionally quite dramatic. Also, many studies include a "waiting list" group to control for the effect of simple passage of time. There are of course many, many, many poorly-designed studies out there; this is not by any means unique to psychiatric drugs, or even medicine in general. > I do think any patient that has been on a psychotropic drug(especially the addictive ones) a long time, should be able to get that particular drug without seeing a Psychiatrist. I know that will never happen on the U.S. As far as I know, any licensed MD/DO can prescribe psychotropic drugs in the US. Some choose not to prescribe some classes of drugs (e.g. antipsychotics, MAOIs) because they tend to have more risks associated with them. However, the same can be said for psychiatrists. There are a few psychiatrists who explicitly refuse to prescribe drugs at all, except in the process of discontinuing a pre-existing treatment. Many doctors will also refuse to prescribe the more addictive drugs out of fear of enabling addiction (this is a huge problem for people with chronic pain, as is the FDA's requirement of "abuse-resistant" pills for oxycodone that just happened to be announced on the same day as the original OxyContin patent expired...) > After hearing that Robin Williams committed suicide and the last tabs open on his IPad were the side effects of the various drugs he was taking, I wonder if he would still be alive if he didn't have access to the best Psychiatrists? There's a risk of iatrogenesis for treatment of virtually any condition. But I think it's far more likely that the drugs in question simply didn't work for him, or stopped working suddenly (this can happen after long periods of treatment with psychotropic drugs, and as far as I know most patients aren't warned about it; I certainly never was).
- DanBC 12y ago
  > Many doctors will also refuse to prescribe the more addictive drugs out of fear of enabling addiction (this is a huge problem for people with chronic pain, Most long term pain should not be treated with medication. That medication should be used short term to allow the sufferer to take part in rehabilitation. Addiction to painkillers that do not work is a big problem for people with chronic pain, and now they not only have the chronic pain but also an addiction. There's a segment on this radio programme where they visit a pain clinic in Bristol (UK) to talk to people who are taking huge amounts of opiod pain killers and not getting any relief from their pain. http://www.bbc.co.uk/programmes/b04wv052 http://www.bbc.co.uk/programmes/b04wv052

ta-026d16b2 12y ago

> I sometimes wonder if all long term improvement in all treatment modalities can be attributed to The Placebo Effect, poorly designed/collated drug/treatment studies, and the brain repairing itself with time? Some cases probably can, but it's not very plausible that such things explain all treatment effects, which are occasionally quite dramatic. Also, many studies include a "waiting list" group to control for the effect of simple passage of time. There are of course many, many, many poorly-designed studies out there; this is not by any means unique to psychiatric drugs, or even medicine in general. > I do think any patient that has been on a psychotropic drug(especially the addictive ones) a long time, should be able to get that particular drug without seeing a Psychiatrist. I know that will never happen on the U.S. As far as I know, any licensed MD/DO can prescribe psychotropic drugs in the US. Some choose not to prescribe some classes of drugs (e.g. antipsychotics, MAOIs) because they tend to have more risks associated with them. However, the same can be said for psychiatrists. There are a few psychiatrists who explicitly refuse to prescribe drugs at all, except in the process of discontinuing a pre-existing treatment. Many doctors will also refuse to prescribe the more addictive drugs out of fear of enabling addiction (this is a huge problem for people with chronic pain, as is the FDA's requirement of "abuse-resistant" pills for oxycodone that just happened to be announced on the same day as the original OxyContin patent expired...) > After hearing that Robin Williams committed suicide and the last tabs open on his IPad were the side effects of the various drugs he was taking, I wonder if he would still be alive if he didn't have access to the best Psychiatrists? There's a risk of iatrogenesis for treatment of virtually any condition. But I think it's far more likely that the drugs in question simply didn't work for him, or stopped working suddenly (this can happen after long periods of treatment with psychotropic drugs, and as far as I know most patients aren't warned about it; I certainly never was).

DanBC 12y ago
> Many doctors will also refuse to prescribe the more addictive drugs out of fear of enabling addiction (this is a huge problem for people with chronic pain, Most long term pain should not be treated with medication. That medication should be used short term to allow the sufferer to take part in rehabilitation. Addiction to painkillers that do not work is a big problem for people with chronic pain, and now they not only have the chronic pain but also an addiction. There's a segment on this radio programme where they visit a pain clinic in Bristol (UK) to talk to people who are taking huge amounts of opiod pain killers and not getting any relief from their pain. http://www.bbc.co.uk/programmes/b04wv052 http://www.bbc.co.uk/programmes/b04wv052