A frank psychiatric perspective on SSRI drugs

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Its a blog ran by an american psychiatrist if I understand correctly. I would suggest reading this entry, I know its long.

Why? Because is offers invaluable insigh on why sometimes SSRI (like luvox) get prescribed for patients who seem not to have any formal disorder, or taht the disorder is "thumbed up from thin air" to justify the medication, not the other way around.

I'll just quote some more juicy fragments, but please read teh whole article yourself:

Quote :

In an attempt to manage the mass of poverty that has been relabeled "psychiatric", it must necessarily sacrifice the 10-90% of people who may be able to force themselves up.  Another way of putting this: if, instead of medications and psychotherapy I instead spent the time tutoring all these kids in math, what would be the outcome on the entire community?
(...)
Which brings us to the N=1 popular media execution of all this: there's a doctor, a Medicaid doctor, who is handing out Adderall to poor kids for the specific purpose of-- sit down for this--  getting them better grades
(...)
Why is "inappropriately" giving Adderall to kids to get them better grades morally superior to "inappropriately" prescribing Abilify to a guy so he doesn't punch his girlfriend during the monotonous downtime of SSI?   What's the difference?  "Well, they're both wrong."  Then what should be done instead?
(...)
The question of whether ADHD or bipolar "exists" is loudly debated because it is utterly meaningless, in battlefield psychiatry no one is treating the diagnosis regardless, we are all treating symptoms; and we're not treating symptoms, we're calling them symptoms because otherwise we don't get paid, you don't get the med, somebody's going to get punched and somebody's going to get sued because somebody didn't "manage the underlying psychiatric process that mediated the assault" which doesn't exist but for some weird reason is widely prevalent in poor blacks and hispanics and whites with calf tattoos.  

If you are convinced that SSRIs don't work and antipsychotics are dangerous and meds are all prescribed off label, conduct for yourself a little experiment: tell a Medicaid patient you're not medicating him.  I'll be in the chopper, where apparently it is safe.

I've said this before and I will repeat it here, you can blame the overuse of medication on anything you want and you will all be completely wrong, the most important reason a medication was used is that the patient showed up, and they showed up because that's where the state told them to go.  In 100% of the cases when a psychiatrist in urban camo tells me he doesn't use antipsychotics or stimulants, I know that all of his prescriptions say "Xanax" and "[You must be registered and logged in to see this link.]".  And I don't fault him, how could I?  It works for what it's for, and what it's for is not punching your girlfriend in the face, which is the same reason other guys use Abilify or Zyprexa or whatever.

So yeah.

Perhaps there is a very simple answer to the question: "Why Eric was prescribed Luvox?" and the answer might be: "Because soemone did not want to be punched in the face" or that someone "did not want to be blamed for undermedicating a potentially violent patient".

There you have it. Go read that blog entry, its worth its lenght in gold.

SSRIs are pure poison. My doctor had me off and on them for a year because he wasnt capable of realizing my depression wasnt a "typical" type. It took me going full blown hypomanic before he stopped pushing them on me. Don't get me wrong, I know some people who they really do help. Those people are more sad than truly depressed though. The problem is the fact that doctors see so many diffrent patients monthly. Sometimes its easier to label a whole group of patients as depressed without digging into their problems individually. I have no doubt though that the Luvox played some part in Eric's urge to go NBK because I've felt the illogical anger SSRIs can create. Very few people seem to realize that SSRIs and psychedelics (LSD, shrooms, mescaline) come from the same family of chemicals. They can seriously fuck a person up mentally and its a real problem how often they're prescribed.

SSRIs are not poison to me, they are a lifesaver. I've basically been on them since I was 15 (so about 11 years). I did go off of them when I was around 19 because I figured I was fine. What a mistake that was, I spent a few years barely being able to function in everyday life. I was an absolute mess and beyond miserable by the time my mother dragged me to the doctor on account of my inability to function due to my anxiety/OCD/depression.

These are complicated drugs. They will affect people differently, and the different drugs will affect the same individual differently. I tried a few that made me worse or gave me terrible side effects. And I know they all pretty much say the risks are higher with teens.

And from what I know, they are easy to get and overused. There are people on them that don't really need them. But I guess that's true with all drugs.

I know I've read that Eric would purposely go on and off the drugs because of the effect it had on him. If that is true, that most certainly affected him negatively, going on and off will mess with your mind even if the drugs are helping you. And I'm not claiming they did help him as I don't know. They very well could have made him worse.

I wouldn't blame the drug so much as I would blame the people who failed to monitor the effect it had though. Or monitor that it was being used correctly.

ellie z wrote:

I wouldn't blame the drug so much as I would blame the people who failed to monitor the effect it had though. Or monitor that it was being used correctly.

I know that Eric at some point early 1998 was on a different drug, then complained to his psychiatrist about negative effects/

From what I gathered these effects included homicidal intrusive thoughts, or at least the psychiatrist had the impression that these are intrusive thougts (from what we know these might have been just fantasies and not intrusive at all) and that's when Eric was takenoff that other drug and presceibed luvox.

I was not aware that Eric was taking himself on and of the drug. I do rememebr the autopsy found luviox in his system and the dosage suggested he was taking it regularly in assigned doses for at least a few months before the shooting. Obviously, whatever effects it migth have had on Eric, it certainly did not help him as far as homicidal thoughts were concerned.

I knew he had been on a different drug before, I think it was Zoloft but could be wrong. I don't mean to necessarily accuse the psychiatrist of not doing his job, even if the luvox increased Eric's homicidal thoughts he could have been hiding it from his doctor. I would just hope they would very closely monitor someone who has admitted to homicidal thoughts on multiple occasions and is on a drug known to increase those thoughts in some people. I definitely wonder what all Eric divulged to the psychiatrist.

I don't have a source regarding him going on and off the medication. It's something I've read various times and various places so assume it could possibly be true, but wouldn't want to present it as absolute fact. I also don't know to what extent he would have been doing it, even missing a dose or two here and there can have extreme side effects for some people.

I knew it was found in his system consistent with his prescription but was not aware they'd be able to tell he'd been taking it regularly for months. Can they really tell that much? That is surprising to me as I wouldn't think a few skipped doses would make much difference for that long. But I wouldn't claim to know much about those kinds of things.

ellie z wrote:

I knew it was found in his system consistent with his prescription but was not aware they'd be able to tell he'd been taking it regularly for months. Can they really tell that much? That is surprising to me as I wouldn't think a few skipped doses would make much difference for that long. But I wouldn't claim to know much about those kinds of things.

I think it was a doctor on some documentary. Now its my time to admitt that I do not have the source at hand, but I remember it being mentioned.

I know for a fact many drugs can be measured reliably in a long term perspective after a single blood test. I have a family member who takes meds against epilepsy and I know that drug long-term intake can be measured with a single blood test.

Kep in mind I studied psychology,not psychiatry and am in no way an expert on meications or at least to a far lessed degree than what I know abotu mental conditions.

Some of us ended up getting into a discussion about SSRIs in [You must be registered and logged in to see this link.] thread quite a bit back, if anyone is interested.

ellie z wrote:

SSRIs are not poison to me, they are a lifesaver. I've basically been on them since I was 15 (so about 11 years). I did go off of them when I was around 19 because I figured I was fine. What a mistake that was, I spent a few years barely being able to function in everyday life. I was an absolute mess and beyond miserable by the time my mother dragged me to the doctor on account of my inability to function due to my anxiety/OCD/depression.

These are complicated drugs. They will affect people differently, and the different drugs will affect the same individual differently. I tried a few that made me worse or gave me terrible side effects. And I know they all pretty much say the risks are higher with teens.

And from what I know, they are easy to get and overused. There are people on them that don't really need them. But I guess that's true with all drugs.

I know I've read that Eric would purposely go on and off the drugs because of the effect it had on him. If that is true, that most certainly affected him negatively, going on and off will mess with your mind even if the drugs are helping you. And I'm not claiming they did help him as I don't know. They very well could have made him worse.

I wouldn't blame the drug so much as I would blame the people who failed to monitor the effect it had though. Or monitor that it was being used correctly.

Glad to hear you had success with them. I was so sure they were working, but the shift kind of happened without me fully realizing it. I still don't believe theyre the right course of treatment for a good deal of the population. Doctors hand them out like its nothing and because they aren't in the abusable narcotic category its seen as being ok. Of course I'm of the belief that a good deal of people diagnosed as being depressed arent really afflicted with it. I've also noticed that attention seekers love to claim they're depressed. I see it all the time and it makes me sick. When you've been emotionally numb for years on end its insulting to hear someone complain because they've had a bad week. That of course is a whole other topic I won't get into.

Thanks. I do completely agree that they are entirely too easy to get; I think many doctors will give them to anyone who asks and many don't do much follow up with patients.

I feel you on the topic of people claiming depression when that's not really their problem. And it doesn't help when people think they are in your same shoes and try to tell you how to deal with something like anxiety or depression by just ignoring it or forcing yourself to move past it because that's what they do and they're fine.