Posted by JohnL on February 9, 2000, at 3:59:45
In reply to Info on stimulants?, posted by Paul Jay on February 8, 2000, at 9:57:12
In my opinion a doctor's first and foremost responsibility is getting the patient well. And, just my opinion, psychiatric theories of what is better for this or that are after all just theories. All that really matters is what actually works for each particular patient.
There are risks and benefits with all treatments. Most drugs have liver damage risks in the long run. Lithium has kidney risk. TCAs have heart risk. There are rash risks and other strange complications of all imaginable kinds. Suicide risks. Blood disorder risks. On and on and on. With stimulants the primary risk is addiction. But what's worse, an addicted patient who is well for life, or an unaddicted patient who is undertreated with the wrong drug and subtherapeutic for life? If a stimulant works in a particular person, the benefits seem to me to far outweigh the risks.
There are doctors out there who are in love with their work and strive for the career satisfaction that comes from making distressed people completely well. They don't allow theories or red tape to get in the way. All that matters is what works. Personally I would not even consider staying with any doctor who limits the use of the entire universe of psychiatric drugs in attempting to get the patient well. The patient and the doctor together can weigh the risks and benefits of a particular treatment as a team in partnership just fine without having Univerisity type theories influencing treatment options. And quite frankly, when it comes to ADHD, there is no stronger track record in the world than stimulants for treatment. Any newer findings have a long way to go before proving any benefit over established treatments.
Stimulants gently correct NE/dopamine failure. No other drugs can do that. There should be no reason to refuse this treatment to anyone if it works. And if addiction happens to be a concern, there are alternatives in the stimulant class that have fewer or no addiction potentials. Basically I just get real bothered by any doctor who limits treatment options based on personal preference, theory, or red tape. All that matters to me is getting the patient well for a full productive happy life. Medication reactions--good or bad--should guide treatment. Not theories.
One final thought, who pays who anyway? I the customer want the service provider to get me well. If they restrict the options in doing that, then I will seek another service provider who has my wellness as priority number one. JohnL
poster:JohnL
thread:20767
URL: http://www.dr-bob.org/babble/20000128/msgs/20871.html