Posted by Cam W. on August 13, 2001, at 2:27:00
In reply to Shelli et al, Cam too if you're reading this » shelliR, posted by Elizabeth on August 12, 2001, at 6:02:13
Shelli and Elizabeth - Shelli, you were correct about others things bothing me when I wrote the following post to Sal, but he is pretending to be an expert. He never refutes that claim, except to say that he has taken all of these drugs (hardly an objective opinion), usually in megadoses, and has access to all of the world's medical journals.
http://www.dr-bob.org/babble/20010725/msgs/72674.html.
I feel that his statements are tantamount to the Beatles taking LSD to attain nirvana. Sorry, knowledge comes from studying the facts, and knowing how to properly read these facts. That takes training (not necessarily formal training); Sal has never shown anywhere that he has done the work to be able to substantiate his claims. He picks and chooses abstracts that might happen to be on topic. I don't think that he pays attention to the vested interests involved in the writing of the article; nor does he take into account articles with theories contrary to the abstracts he posts; and several other factors that must be kept in mind when making a choice.
Another thing that bothers me, is that Sal expounds the benefits of every drug, as he has taken all of them. If these drugs were so beneficial, why isn't he still taking them? How does he know that a person should take a specific sort of drug? He does this "prescribing", without taking into account the person's medical history (which, I know that I sometimes do and am occasionally left with egg on my face). I try to stick to answering questions which I am comfortable answering and if I make a suggestion of a drug, it is the same suggestion I would give to a doc; and I also say to ask the doc if this would the correct treatment for that person (the doc's patient; our poster).
Many of Sal's pharmaceutical suggestions are based on his limited knowledge of reductionistic neuropharmacology. When I read an article propounding certain neurotransmitters for certain conditions, I must sit back and try to see system, then the whole picture. (ie. seeing side effects as only drug effects, and how these drug effect add to or take away from treatment).
For example, if a person is not sleeping after an adequate trial of olanzapine, and still has residual effects of his/her disorder, you shouldn't say to try risperidone, instead. You look to other modalities that can be used to augment the partial efficacy of the drug that person is already on. Switching meds is by far not the first step in modifying most medication regimens.
I am not saying that subjective experience is not important; it is extremely important, but this type of information should not be given the same level of import, as longterm, naturalistic studies, until they have been shown that subjective experience can be incorporated into the theory. This is done through more scientific research, where the "subjective opinion" can be integrated into what we know on whatever disorder we are taking about, or not; thus changing (improving?) our knowledge of the disorder.
I do believe that Sal has found a place to vicariously act out his dream of being his father (a physician). He goes too far sometimes (ie the "suicide"-IM me" post. Those who have the knowledge, must read Sal's posts, to make sure that "no harm is being done." You cannot ignore Sal's posts, as you ignore a troll. This does lead to the question of what type of answers is Sal capable of giving, that will, or may not, lead to harm. The incident which scared me most was when Sal told a person with schizophrenia to stop his risperidone cold turkey, and that there would be no problems (James called him on that on).
I don't mind Sal sharing his experiences, but prescribing is beyond his and my training, especially in this environment. Shelli, I was taking it as a personal affront to the 22 years I have been learning this stuff. If he thinks that posting abstracts and links gives him knowledge into psychopharmacology, he is just taking LSD.
Also Shelli, I did not reply to your post, as I thought that you were not asking for one. I was not ignoring you, honestly.
Take Care; both you and Elizabeth. You're information is given in the context of your learning; and I appreciate that and, to no lesser extent, I appreciate the answers that you two give, especially when I end up learning something that I don't know. We may end up at loggerheads at times, but hey, that's science.
Sincerely - Cam
poster:Cam W.
thread:67742
URL: http://www.dr-bob.org/babble/20010809/msgs/74864.html