Posted by Geaux Tigers! on December 9, 2012, at 18:47:11
In reply to What combination of psychiatric drugs has worked?, posted by Geaux Tigers! on December 9, 2012, at 18:46:32
A lot of PDOCs rely on polypharmacy, including myself the rationale behind this is that we are medicinally trying to solve their psychological problems instead of using therapy. If the patient were to utilize therapy, mind development, etc. then our role as drug providers should lessen with time and ideally approach zero. In a perfect world, these psychiatric drugs would only be prescribed on a temporary basis; however, we know that this isnt the case. The majority of psychiatric drugs are toxic in some way and cause addiction and withdrawal behavior. The patient must decide if the trade-off between mental alleviation with psychiatric drugs is worth the addiction and, for the most part, neurotoxicity a PDOC will write *something*. Philosophically and scientifically, there are a lot of different and very reasonable arguments that attack the field as a whole, and I definitely understand the rationale.
As a psychiatrist (or in my case, PMH-APRN), you should strive to prescribe the fewest amount of drugs possible needed to alleviate symptoms, and there are always excess meds yes, I prescribe excess in a lot of cases. If a patient comes back and claims they are more depressed, even with ADs prescribed, you have to decide between whether he is simply going through a bad time (everyone, no matter what drug you can conjure up, will suffer depression as a part of being a mammal, imo), or has actually suffers TRD. Clinically, I presume TRD and may write yet an unnecessary script that might be one which he may be on for years and years. Its definitely different from traditional medical fields in a lot of ways.
Psychiatrists kill themselves, etc. (I abuse drugs) I sometimes wonder, like the critics, if the medications are really worth it versus therapy and self-discovery, and most of all-- the extent of the scientific knowledge that allows us to properly prescribe medicine. There is always research coming out saying this and that, e.g. oh the only reason this AD works is because of BDNF, etc.
Another amazing thing, you can almost look at the world as a computer, its amazing that we are only ourselves, one unit, doing one particular role with different schemas. I think ones schema is the key to unlocking mental problems. As I said with the medications, it is easy to do affinities of neurotransmitters, etc. but it is difficult what processes they are inhibiting in worlds most complex computer the human brain.
poster:Geaux Tigers!
thread:1032714
URL: http://www.dr-bob.org/babble/20121130/msgs/1032716.html