Posted by zeugma on May 16, 2004, at 17:42:12
In reply to Re: Adrafinil - Is it dangerous ?!, posted by iansf on May 16, 2004, at 13:50:19
> > > In order to get Adderall or Dexedrine, is a diagnosis of social phobia enough, or do you need your pdoc to diagnose you as ADD? I understand there are no hard and fast rules, but my primary doc thinks of Adderall in about the same class as speed, and wouldn't prescribe it to save her life.
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> More to the point, I suspect your doctor would't prescribe Adderall to save YOUR life. That's certainly been my experience. They wouldn't think of prescribing something that could help but has risks, but they don't balk at all at condemning someone to a constricted and unfulfilling life that leaves them lonely and struggling to survive financially. That's somehow OK. That I've often contemplated suicide because of my frustrations is apparently not a concern. "Big deal, you end up dead. At least you won't be addicted to anything when you die. Isn't that better?"
>Well, we live in a litigation culture, and it's all about covering your own a**. I have an extremely low opinion of SSRI's, and I believe their great popularity relative to drugs that work better (TCA's and MAOI's) is that they are not lethal in overdose. Ironically, this doesn't mean that fewer people kill themselves on SSRI's: it just means that the doctor can't be blamed, because he/she didn't prescribe something that could be used to commit the act.
Similarly with scheduled drugs, benzos and stimulants. The FDA thinks nothing of doctors who prescribe tons of SSRI's, even though there DOES seem to be a correlation between impulsive acts committed early in SSRI therapy (due to a peculiar kind of disinhibition) and suicide. Maybe these drugs will be scheduled soon, already I think that prozac is the only drug in this class approved for childhood depressions because of its relative lack of discontinuation syndrome. My pdoc had to be prodded by his colleague, who knew me well, and knew that I had literally tried every other option to manage an anxiety that was threatening my livelihood, to prescribe a benzo. I have gone through terrible frustration due to run-of-the-mill pdocs who thought SSRI's were magic pills, and more enlightened specialists who were familiar with older drugs such as TCA's (which are the only things that ever alleviated my depressions) but who balked at benzos because my anxiety was 'psychological' (I am quoting what he said: as if my depression, ADD, et al. weren't 'psychological' too!). Benzos and stims IMO are LESS risky than many newer treatments, but because they are scheduled, pdocs dislike prescribing them because they might be held accountable at some point, either for 'addicting' someone, or for making an 'inappropriate' number of scripts for controlled substances. I am ranting, b/c I'm not feeling especially good at the moment, but I wanted to respond to your post because I have been there myself more than once and it is infuriating.
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poster:zeugma
thread:347165
URL: http://www.dr-bob.org/babble/20040515/msgs/347497.html