Posted by Racer on May 28, 2004, at 8:39:42
In reply to What is wrong with the pdocs?, posted by Ann Marie T. on May 28, 2004, at 8:11:55
I think there are a number of factors at work here. For one thing, the clinical trials are so short, that withdrawal effects after long term treatment probably wouldn't show up. It's only after years of clinical use that doctors really start to learn about things like withdrawal, and they've got to make a big effort to keep up or they won't find out about that sort of thing.
Also, doctors in general -- including veterinarians, I've talked to mine about this -- have to protect themselves emotionally from their patients. This is true of the psychiatrists as well as the oncologists and cariologists. It's not only the death of their patient they need to insulate themselves from, although that's bad enough, but the effects of the treatment on a patient. In the case of psychopharmacologists, think of how difficult it must be for them to prescribe drugs to their patients, knowing that the same drugs that may improve the one aspect of their lives will also devastate the life the drugs make possible? A pdoc prescribing a drug that will improve depression has to face the fact that that same drug also puts the patient at much higher risk of obesity with all its attentdant health problems, reduced productivity if it's one of the more sedating drugs, long term gastrointestinal problems, and a wicked withdrawal when the medication is stopped. What's that line from the Hippocratic Oath? "First, do no harm?" These doctors are prescribing drugs they know will cause discomfort to their patients, but these drugs are all they have to work with. If all you have is a claw hammer, everything starts to look like a three penny nail.
Personally, I think a lot of the problem is those doctors who resolve this for themselves by distancing themselves so much that they can't offer true compassion anymore. These are the drugs they have, so these drugs are good enough and the patient is being unreasonable to complain about, say, anorgasmia when at least the patient wants to have sex again. They'll tell patients, "Just put up with the shaking hands and jerking arms from the medication" without stopping to think of how they would feel losing control of their own bodies that way. On the one hand, they have to stifle their empathy in order to function and survive. On the other hand, though, it means that they do a real disservice to their patients, who are likely to be most vulnerable to begin with.
I'm sorry you're having withdrawal troubles. I hope the discomfort eases soon for you.
poster:Racer
thread:351421
URL: http://www.dr-bob.org/babble/20040527/msgs/351429.html