Posted by mindevolution on February 2, 2007, at 23:29:28
In reply to Re: Atypicals for anxiety?))mattye » mindevolution, posted by yxibow on February 2, 2007, at 20:32:52
> I hear way too many "trash your doctor" statements online here.
it is obviously a case by case basis, and I think prescribing APs, being the most toxic psychiatric drug available, as a front line treatment for anxiety is cause for alarm.
> This is another generalization, which apparently has gone unnoticed from your previous set of generalizations about neuroleptics in the first place.
I backed up my generalisations with valid arguments and links to research which is all anyone can do.
On the other hand I questioned you about some of the generalisations you made about the suicide risk for unmedicated people with schizophrenia, and you have not backed up any of your generalisations at all.
> This doesn't mean that I don't think that one shouldn't start with something less than a neuroleptic for anxiety disorders, but sometimes complex situations may warrant something more. I fully agree that both SSRIs and benzodiazepines have safer side effect profiles for the most part when used as directed.
glad to hear it!
> We don't know the relationship that a consumer has with their provider -- we can make suggestions, we can yell all sorts of opinions about medication, but the sanctity of a doctor-patient relationship is something that the unlicensed individual without a medical degree I don't think should be throwing the baby out with the bathwater.
> Not quite yet. Not without really knowing the person at hand and not with a casual find-another-provider so you can go shop for medications. Maybe there's a reason why the doctor is doing what he is doing. And maybe there isnt a good one.
I can see that point, however, from reading posts on this board it becomes very apparent that all too often people trust their doctors, who in return lead them towards highly risky and toxic medications without pointing out such risks to the patientl; meaning the patient is denied informed consent. the moment this happens, the relationship is over in my book. taking their business elsewhere is the only remedy a patient has in such a circumstance.
> Some people can't manage without any medications. The ideal situation of course would be to manage a situation with various types of therapy alone, but we know that depressive and anxiety disorders work best with a combination of both and here we're talking about someone with concomitant illnesses. It is always best to have the MED (minimum effective dose) of any medication and I think any rational psychiatrist/psychopharmacologist would agree so.
well sure, the meds carry the most risk, so the lowest risk alternative is non med treatments, then if these don't work by themselves, a combination of therapy + meds.
however, all too often docs recommend the most risky meds first, like an AP for anxiety, what was he thinking?! a good doctor in my view starts with the lowest risk meds, and then gradually tries progressively more risky alternatives, with the highest risk alternative being the last medication to be suggested, keeping the patient informed all the while. good doctors that operate like this are extremely rare in my experience. for anxiety, I can think of at least 10 different meds that could be tried ahead of an AP with significantly lower risk.
> It is my opinion that I feel a general sense of loathing all medications coming from your opinions which is your perogative, but there are people on here who have gone through dozens of trials to find the right mixture for their respective situations and I think that also needs to be respected.
I am not against medication in any way, however, due to the current drug approval process, even if one reads all the drug company research, I think we do not get the objective data we need to make truly objective informed decisions. How does a patient know when they go to a doctor that APs are extremely toxic and benzos are much safer and are approved for anxiety without coming to a board like this one? Are they supposed to blindly trust their doctor, or should they be given as much information as they need to make their decisions? How do they even know if they have a good doctor?
One idea of mine is to have a central register of drug toxicity, so that every medication is given a toxicity rating for its recommended dose range out of 1000 based on independent government (not drug company) sponsored trials. Patients and doctors can both refer to the register as one way of objectively identifying the relative risks of medication alternatives.
me
poster:mindevolution
thread:728141
URL: http://www.dr-bob.org/babble/20070201/msgs/729247.html