Friday, September 11, 2009

Some Thoughts

Generally speaking, I am not against the proscribing of certain drugs for psychological symptoms. They have their place, and to a limited degree, they work for some people. That is about it.
My objections to the way drugs are proscribed to teenagers and children are numerous, however:

1) The safety of the newer anti-depressants in developing bodies over the long term is not
established
2) Many times the drugs are proscribed for reasons that have never been studied
3) Medications do not work better than therapy
4) Most proscribers have a very limited working knowledge of their patients goals,
subjective experience, or social world
5) Interactions with other drugs have not been studied. The all too frequent cocktail of anti-depressants, anti-psychotics, anti-anxiety meds, seizure medications, et al have no basis in empirical research
6) Interactions with street drugs have not been studied, this includes street drugs such as Ritalin, Seraquel, and Xanax. Nor have interactions with pot or birth control pills. Or alcohol.
7) Many doctors, and of course ALL the drug companies, have a vested interest in increasing the number of prescriptions filled.
8) The diagnosis of a mental health problem has never been demonstrated to have any bearing on the outcome of the treatment. The diagnoses themselves- such as Bi-Poloar Disorder, Schizo-affective Disorder, Attention Deficit Disorder- are not distinct from one another, often blur into one another, and are rarely agreed upon by clinicians.

Safety, integrity of diagnosis, and transparency. These are the big, big problems with prescribing psychiatric medications to young people. Certainly there are times where there is no choice but to insist on meds. But the dangers are very real and the process is so murky that we should be very careful.

And most psychiatrists are not.

(edit: inexplicable misspelling of "prescriptions" and "prescribing")

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