Posted by Quintal on December 6, 2006, at 9:34:11
In reply to Re: Are benzos the only drugs that do anything? » Quintal, posted by yxibow on December 6, 2006, at 1:16:18
> Which I have said before -- but not because of the side effects so much -- protease inhibitors are a real sticky wicket to manage with concomitant depression. They would like to keep their DEA license which allows them to prescribe, pay their malpractice insurance in case someone overdoses on buprenorphine, and generally stay out of the limelight of license auditing of doctors who freely prescribe opiates which while they in the short term help those who have been through a number of medications, are not a part of generalized western psychopharmacological practice.
There was no suggestion on my part they would refuse to prescribe buprenorphine on grounds of side effects. It is the legal status and social stigma attached to opiates that I suspect would deter many pdocs from even thinking about prescribing them.
>Thus, this board serves a subset of the community who do not respond to one, but maybe need two or more medications to exist.
Well I've certainly responded to many treatments Jay. The problem has generally been lack of long term efficiency with most drugs besides benzos. It is a very common problem and not only to the people posting on this board. For example, I know of several people that live nearby who have had similar experiences to me. They don't post on websites because they have no access to computers and are not computer literate in any case. Most are middle aged or elderly and living alone.
They also have no access to the detailed information we discuss here and no interest in pursuing it. They're working alone in the dark and have no confidence to challenge their GP/pdoc and request alternative meds and treatments unlike most of the people here. In general they trust the medical profession to give them the best treatment and if the almighty Mr.pdoc says this drug works and they suspect it isn't helping them, then they tend to blame themselves - who are they to argue with medical science?
There's an old lady that lives a few doors down my street who has been on Prozac 20mg for about 10 years since her husband died. She admits it stopped working soon after she started taking it but is now afraid of talking to her GP about it after being chastised by a locum for requesting another medication. The locum made her feel guilty that she was taking medication at all and from that point she decided to try and make the best of whatever positive effects it still had.
She would no doubt be classified as a Prozac responder if her GP was required to produce a report on the efficiency of antidepressants in her patients (as I was bizarrely according to my medical notes, although I felt much worse for having taken it myself).
I think it is reasonable to assume there are many more people in a similar position all over the world who are being marked up as treatment responders simply because they are compliant and tell the GP/pdoc mostly what they want to hear.
>And also while we are on the subject of ranting that no drug on the market does anything, I have to say that, with no disrespect to individuals on this board, who have been through tireless trials of medications, we are a special population. This is why we are here. This is why people rant about medications because a number of them are treatment refractory.
I don't think we're ranting that no medication on the market works, rather that there are some very effective drugs even for people who are refractory to first line SSRIs, but access to them seems excessively restricted - as in the case of benzos and stimulants in the UK.
There are people posting on this board who are doing very well on their drug regimen, sometimes even on a single medication and have come to tell us the good news. I'm encouraged by their results, so I don't think were necessarily a subset of treatment resistant patients here on psychobabble.
Q
poster:Quintal
thread:710470
URL: http://www.dr-bob.org/babble/20061206/msgs/710830.html