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  1. #1
    ds_writr
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    Before you pop another PAXIL

    hi little young JUBbers who are prone-to-depression and medicating with prescription Paxil.


    WARNING!
    WASHINGTON (AP) -- The antidepressant Paxil may raise the risk of suicidal behavior in young adults, GlaxoSmithKline and the Food and Drug Administration warned Friday in a letter to doctors...


    http://www.cnn.com/2006/HEALTH/05/12....ap/index.html


    Generally, I rather loathe the pharmaceuticals industry. I mean, they have their place and the day they create a cancer prevention pill, I may be the first to take one...

    ...BUT the big business which is many meds (and its arising med-culture) is not so great.

    I'd hate to see any of you young hunky prone-to-depression JUBbers jumping off the roof due to some regretable side effect.

    You MAY have no side effects (and lets hope not). BUT you may want to discuss the drug if you're on it with your doctor.

    OY, you take a pill to stave off depression and its been shown to PERHAPS in SOME users make those same little studs feel worse - to the point of suicide.

    So, if you've been feeling weird on Paxil, its NOT just your imagination maybe.

  2. #2
    Oden_grey
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    Re: Before you pop another PAXIL

    I think this is just another way for the pharmaceutical industry to protect themselves from lawsuits while contributing to the detriment of society. They put every warning under the sun for their drugs in the hopes of stifling any punitive litigation. I took paxil and I never felt suicidal. What this cop-out is going to do is have people thinking its the medication alone when in actuality the kid him/herself just needed a more aggressive anti-depression treatment program.

    I guess now we just sit back, relax and let the psychological establishment rest on their laurels as kids off themselves, because in their view that consequence is not because of ineffective treatment regimens, but because "the medicine made them do it".

  3. #3
    ds_writr
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    Re: Before you pop another PAXIL

    ^ I think there still remains a difference between what is depression and what is suicidal.

    I mean, you may need one to enact the other but I would think its certainly possible to measure the effects of a drug within a person's system as it spikes depression to suicidal status.

    also, wouldn't you think a person on an ANTI-depressant shouldn't feel worse (let alone suicidal) while on that anti-depressant?

    It would only seem to follow reason that the medicine is either doing something (negative) or doing absolutely nothing (causing it to be a dangerous placebo, in effect).

    Either way, being on it (in this case, Paxil) could prove dangerous to those in this group being identified.

    Perhaps they need a more aggressive treatment. But wouldn't the pharmaceutical company LOVE that conclusion and simply recommend higher doseages or a "NEW & IMPROVED Better Formula Paxil!" ?

    Why would it risk losing so many profits in sales when all it wishes to do is cover its legal ass? After all, they wouldn't lose a legal case unless it could be proven the drug contributed to a few suicides (I would think).

  4. #4
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    Re: Before you pop another PAXIL

    I took Paxil for about 8 months about 5 years ago.

    Dreadful things, really.

    When I first started taking them, I felt no different, really.
    Then, one afternoon about a week into things, I was sitting
    on our lanai, looking out at some flowers in the garden when the
    oddest thing happened....

    It's hard to describe, but visually it looked like someone had
    'turned up the color' on the TV. All the colors of the flowers looked brighter and more vivid. (ala LSD) It was an enjoyable
    moment, but so unexpected it was a bit scary as well.

    But, that feeling didn't last.

    Eventually, all the 'old school' SSRI's (Paxil, Prozac, Zoloft) do the
    same thing. They erase you. Sure, you don't feel depressed, but you don't feel anything else, either. Even orgasms seem
    boring and like you're just passing time.

    I can't speak for the newer ones out there today, but I avoid all
    of them like the plague.

    Josh



  5. #5
    Porn Star bshane's Avatar
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    Re: Before you pop another PAXIL

    I was on it for social anxiety. It helped. However I was on it for 4 years and I really got to the point of not caring about anything, including myself. I gained nearly 60 pounds, I drank a lot more and I started getting in trouble at work for saying things to management I wouldn't have said before going on it and now after it. I can see very well how people on it can get suicidal since it removes any emotion and feelings a person has. Then when I finally did come off of it I felt like I was hung over after a night of drinking but it lasted for nearly two months. It was horrible. Don't take this unless you absolutely need to and don't take it longer then you absolutely have to. Don't count on your doctor telling you when to stop it. Mine never did. I finally asked if it was ok to stop it and he said, sure, that would actually be a good idea!!!! I bet if I never asked I would still be on it 2 years later.

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    Re: Before you pop another PAXIL

    I was reading somewhere that one reason why antidepressants can cause someone to become suicidal is a phenomon callled activation. Depression isn't just about feeling sad. It also saps your energy so you can't be bothered to do anything. Sometimes an antidepressant will cut through the lethargy before it lifts your mood so you get up off your ass and kill yourself. This seems to be a particular problem with younger patients.

  7. #7
    The_Pianist
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    Re: Before you pop another PAXIL

    Quote Originally Posted by Joshua_me
    Eventually, all the 'old school' SSRI's (Paxil, Prozac, Zoloft) do thesame thing. They erase you. Sure, you don't feel depressed, but you don't feel anything else, either. Even orgasms seem boring and like you're just passing time.

    I can't speak for the newer ones out there today, but I avoid all
    of them like the plague.
    Exactly. I was on Effexor back at the beginning of 2000 and I really disliked the 'flat' feeling I was experiencing, so slowly weaned myself off of it.

    So far I've managed though I've had some pretty damn black days. I am not keen on going back on ANYthing and when the ol' doculous has asked during bouts, I've always declined.

    For those for whom they work, well and good, but I have no desire to ever go back on one again.

    Depressed or not, at least I 'feel' more 'alive', odd though that may sound.

  8. #8
    T-Zero
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    Re: Before you pop another PAXIL

    Not only what some of the above have said, but it's important to keep in mind that these drugs are not supposed to be used as mood elevators. They're supposed to be prescribed for the clinically depressed which isn't a matter of just a psychological depression, but one that is either compounded or being caused by an actual chemical imbalance in brain chemistry. An imbalance in the ability to produce and regulate serotonin uptake. Brain chemistry is greatly different between developing youth and adults.

    Also, sort of in line with what bshane was saying. If you are considering being placed on this medication it's a good idea to get multiple opinions about what would be and work best for you. I had experience with both Prozac and Welbutrin. I had horrible side-effects from the Prozac similar again to what bshane was saying about getting in trouble at work for saying things to management I would never have said before going on it and now after it. (A kind of artificial euphoria or sense of well-being due to the "flattening" of some emotions, chronic insomnia, sexual side-effects.) I went to another physician and talked to them about it in a consultation with my new physician along with the head of the physician's staff and the conclusion was that Prozac should never have been prescribed for me in the first place. It simply was not the correct treatment for my problems and hence my experience with Welbutrin. (BTW: Had no side-effects from Welbutrin and it's known for not causing sexual side-effects such as the other drugs mentioned: Paxil, Prozac, Zoloft. Although there was a similar sense of flattened emotional affect.)

    While some people may require being on these for extended periods of time (according to my physician not more than 2 or 3 years max), if the problem is mainly a chemical imbalance as causality it should not require extended use for more than 6 months to 1 year as by that time with the assistance of the drug the brain should begin to correct it's initial chemical imbalance and resume healthy production and uptake on its own.

    ===========
    Note to ds-writr:
    Paxil, Prozac, Zoloft <<<< Part of the problem with these and which has lead up to the notices like you've posted is that in the clinical trials these drugs were never tested on children and youth still undergoing brain development and brain chemistry changes that don't stabelize until some time into the early 20s, yet physicians who are not psychiatrists or psychologist and knowing this and against the pre-cautions were indiscrimenately prescribing these things to people as young as 10 or 11. The initial court cases like with Prozac required the pharmaceutical companies to stress this more strongly rather than as a minor aside in their contra-indications.

  9. #9
    ds_writr
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    Re: Before you pop another PAXIL

    Quote Originally Posted by khushibagh
    I was reading somewhere that one reason why antidepressants can cause someone to become suicidal is a phenomon callled activation. Depression isn't just about feeling sad. It also saps your energy so you can't be bothered to do anything. Sometimes an antidepressant will cut through the lethargy before it lifts your mood so you get up off your ass and kill yourself. This seems to be a particular problem with younger patients.
    See? Now that's what I think about all these problems arising from an easy med-culture : the magnifience of the brain (the mind) are being made to look too simple or as though we've cracked the case on such complexities (which I simply do not believe we have).

    The way a drug works (besides "differently" from individual to individual) is sometimes not the way one might think it works. I mean, some pain reliever can reduce nerve swelling while another could potentially simply stimulate the penis to such a point as to cause a guy a boner (as a "distraction" from the pain in his shoulder).

    When dealing with the mind, well, I do believe that some drugs for some are VITAL AND VALUABLE. But this culture of everyone being on anti-depressents? In Santa Fe, I LITERALLY could name a DOZEN people on Zoloft (and like drugs). HOW everyone's come to be diagonosed and prescribed these things "suddenly" is a tad suspicious (IN MY OPINION).

    What I have noticed in my interactions with these people is that they all rather lack in passion suddenly. I mean, they seem perfectly intelligent and reasonable and can laugh at a joke. But there is such an even keel, well, it can be scary on some level.

    But isn't it a TAD coincidental that nine people on ONE block are all on Zoloft. I mean, maybe, but how can this one drug have the same effect on each of them?

    (Oy, I'm sticking to fresh-squeezed orange juice).

    Other drugs also have to "do" something first in order to supposedly get to the desired effect or result. Isn't that sometimes what makes many blood pressure meds difficult to live with? The wrong one or the wrong doseage can make a person drive into a crowd of school children BEFORE it actually truly helps one's B.P..

    Or Viagra. It can cause BLINDNESS in "some men"? Now, to ME, that would be a HUGE side effect.

    And even now, YEARS later, doctors are saying that the effects of the pain med, VIOXX may STILL develop heart valve problems in YEARS to come (even after being off the crap).

    To me, heart valve damage is a BAD, BAD "side effect" - to the point where I wouldn't even call it a "side effect". I mean, when one drinks Dran-O, is convulsive internal bleeding a mere "side effect"?

    I ASK YOU THAT!

  10. #10
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    Re: Before you pop another PAXIL

    Do NOT come off your SSRI without first speaking to your doctor
    .

    Ds_writr, I would suggest to you that if a medicine does not have a side effect, it is probably a placebo...that is why homeopathy and other such preoccupations of the chattering classes are so well tolerated (and utterly useless).

    Why don't "natural" remedies have side effects? Because there is no reporting body for them. I would prefer that side effects of drugs are reported to the authorities rather than just let free.

    With drugs, ALL side effects are reported and documented - no matter how rare they may be.

    Hell, paracetemol has a side effect profile as long as my arm - doesn't mean that EVERY person with a headache goes into full blown liver failure.

  11. #11
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    Re: Before you pop another PAXIL

    Prozac actually made me feel worse.

    I quit it cold turkey after six months, and haven't been near a doctor since.

    I still get depressed, as anyone who reads my posts will be able to tell you. But I'm one HELL of a lot better than I was five years ago, and I did it all by pulling myself up by my bootstraps. No chemicals needed.
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  12. #12
    JohannBessler
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    Re: Before you pop another PAXIL

    Most of you are throwing the baby out with the bathwater.

    Even aspirin has caused deaths (some people are deathly allergic). Tylenol has been shown to be fatal (or cause severe liver damage)when
    used with alcohol. Should we then remove them from the shelves?

    The truth is that, for the majority of people, SSRIs have shown to be an effective treatment for depression. Untreated patients are prone to suicide. What would you rather have? A tiny amount of patients on SSRIs with suicidal tendencies, or millions of untreated patients with suicidal tendencies?

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    Re: Before you pop another PAXIL

    I WANT TO GO OFF THIS FUCKING MEDICATION NOW!!!!

    BUT MY STUPD DOCTORS WON'T LET ME!!!!!

    I hate the side-effects.

  14. #14
    T-Zero
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    Re: Before you pop another PAXIL

    I'd have to agree Ben, that unless you are having serious side-effects to an SSRI that would warrant abruptly ceasing following the medication regime there are risks in abruptly stopping it. SSRI's however do have a cumulative affect in the body — which is why they don't work immediately and usually require one to four weeks for the individual to notice a difference— so the risk is more physical than psychological. The greatest potential danger from abrupt cessation of SSRI medications is that serotonin effects vasoconstriction, stimulation of the smooth muscles, and regulation of cyclic body processes. The greatest danger from abrupt cessation is from the vasoconstriction qualities of the drug which when stopped abrutply can cause rapid changes in blood pressure and potentional seizures or temors due to the smooth muscle stimulation.


    ross: If you are having major problems with side-effects inquire with your doctor about a) alternative SSRIs or medication and b) compatible drugs which can be taken along with the SSRI to counter-act the side-effects. Your physician may not want you to discontinue an SSRI entirely but he may be open to letting you try alternatives to the one you're on.

  15. #15
    ds_writr
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    Re: Before you pop another PAXIL

    Well, I do want to make it clear (I think I was but in case...)


    I'm not recommending that anyone do anything in relation to their medications or health OTHER THAN perhaps discuss new findings, warnings, etc with one's doctor.

    Things change. New findings are reported, one's body changes, the effects of a drug can be cumulative...its always good I would think to stay abreast of whats happening.

    Imagine some guy who only used a half a bottle of Vioxx and may still be using it today after a rough game of touch football?

    I have MY OWN PERSONAL attitudes about a med-culture and big pharmaceutical companies and a medical profession quick to write out prescriptions...but I'm NOT a doctor. And I would never "tell" anyone to either get on or off a drug.

    I just want all the little JUBbers to make the healthiest choices.

    And it must be stated that I didn't make this WARNING pertaining to Paxil's potential side effect IN SOME young patients.

    Goodness gracious no. The manufacturor itself is warning the medical community.

    I'm just telling little JUBbers.

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    Re: Before you pop another PAXIL

    I totally agree with you ds_writr about people needing to be fully informed of their medications and the potential side effects.

    Medico-ethically it is essential that consent to treatment is fully informed. I don't dispute that information like this should be shared.

    I would say that it should be read with a cautious eye and the caveats of warning people not to stop their SSRIs immediately should be heeded.

    IF YOU ARE CONCERNED ABOUT THE SIDE EFFECTS OF ANY OF YOUR MEDICATIONS - SPEAK TO YOUR OWN DOCTOR. He or she will be able to discuss the alternatives with you.

  17. #17
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    Re: Before you pop another PAXIL

    ^ Yeah, I definitely should have mentioned that.^

    DO NOT do the cold turkey thing, *especially* with Paxil.

    It's only recently that some Dr.'s are warning their guinea pigs
    (us) about this. Years ago when I was on them, no one mentioned
    a word about what could happen. So, one fateful Friday afternoon
    I was so fed up with the things that I flushed the rest of them down the toilet. (BIG mistake)

    By Monday morning I felt as if I was losing my mind. No sleep, no
    appetite, and hallucinations from hell. I 'heard' loud crashes coming
    from behind me, only to turn and find nothing there. It seemed like
    I could see lightning bolts all over the place, many of which felt like
    they were inside my brain.

    Serious shit, people.

    I ended up in the ER where they pumped me full of some Benzo just
    to help take the edge off.

    All this from a 'harmless and safe' anti-depressant, dispensed by
    the good Dr. and picked up at Walgreens.

    Learn from what happened to me, and ween slowly off the things with the help from whomever prescribed them to you.

    Josh



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    Re: Before you pop another PAXIL

    Quote Originally Posted by BenF46
    IF YOU ARE CONCERNED ABOUT THE SIDE EFFECTS OF ANY OF YOUR MEDICATIONS - SPEAK TO YOUR OWN DOCTOR. He or she will be able to discuss the alternatives with you.
    you would think.....

    I've asked my doctor for any alternative, and he says that I have to be on paxil (which i think is complete bullshit).

  19. #19
    cozmik
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    Re: Before you pop another PAXIL

    This has been something with all anti depressants that has been a concern for a few years now, actually. If you're on an anti-depressant of any kind, though, you can't just stop taking them. That will really cause major imbalances. You need to go to your doctor first so he can advise you as to the best way of bringing yourself off.

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  21. #21
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    Re: Before you pop another PAXIL

    Quote Originally Posted by ross_1986
    you would think.....

    I've asked my doctor for any alternative, and he says that I have to be on paxil (which i think is complete bullshit).
    And this is the sort of thing that lead to my complete and utter mistrust of the medical profession.
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  22. #22
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    Re: Before you pop another PAXIL

    Quote Originally Posted by ross_1986
    you would think.....

    I've asked my doctor for any alternative, and he says that I have to be on paxil (which i think is complete bullshit).
    Remember, your doctor is not there to hurt you - he obviously believes that in his professional opinion, Paxil is the most effacious drug for you.

    Why not ask if you can have a psychiatry referral, or a second opinion?

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    Re: Before you pop another PAXIL

    Quote Originally Posted by winterknight
    And this is the sort of thing that lead to my complete and utter mistrust of the medical profession.

    Exactly.

    Everytime, I ask him about it, he changes the subject, and just tries to get my appointment overwith. It's a complete joke, and I feel like i'm going around in circles.

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    Re: Before you pop another PAXIL

    Quote Originally Posted by BenF46
    Remember, your doctor is not there to hurt you - he obviously believes that in his professional opinion, Paxil is the most effacious drug for you.

    Why not ask if you can have a psychiatry referral, or a second opinion?
    I did, and guess what the psychiatricst told me WITHOUT even letting me have a sessions so I can talk about my problems....

    "You're probably gonna have to be on paxil for the rest of your life".

  25. #25
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    Re: Before you pop another PAXIL

    Quote Originally Posted by winterknight
    And this is the sort of thing that lead to my complete and utter mistrust of the medical profession.
    Look.

    We are not there thinking, how can we make the depressives even worse?

    Doctors are there to help you. We WANT to help you.

    I'm sorry that your own particular doctor-patient relationship fell on stony ground, but DON'T judge all doctors as a bunch of evil, experimental scientists out to get you.

  26. #26
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    Re: Before you pop another PAXIL

    I'm sorry, Ben. I didn't mean any offence to you personally.

    But it's a little bit hard to believe in tenet non nocire when *every* contact you've had with a doctor since you were twelve - at three surgeries and two hospitals - has left you feeling worse than you were when you went in.

    The antidepressant fiasco was just the final straw.
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  27. #27
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    Re: Before you pop another PAXIL

    I didn't take any personal offense whatsoever.

    I was just hoping to redress the balance so that you would seek out professional help through the appropriate channels for your own sake.

    I can empathise with your conundrum, but all you need to do is find the right doctor for your own needs.

    Good luck.

  28. #28
    ds_writr
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    Re: Before you pop another PAXIL

    (ahem)


    hi again everybody (many of you not feeling too good ),

    One has to have faith in one's doctor or else even the finest among them won't be effective (unless perhaps you're strapped to bed).

    I PERSONALLY think that if you can, you must be honest with self and ask: "Do I have this mistrust, lack of communication, and arising resentment with everyone? or all doctors? or just honestly, specifically, with certain specific doctors?"

    I mean, it can be hard, but one doesn't want to chase the ball all over the field if one doesn't "like" any doctor one has had.

    THAT SAID (whew!)

    I do think think that if possible, one should shop around for a doctor if one is uncomfortable with or cannot communicate with or feels marginalized by one's current doctor.

    BUT, one must also decide if its a personality conflict or a need to have better or more communication with one's doctor OR if its indeed we don't want to hear what someone might be telling us.

    That's why I think that knowledge is power to a great degree. If one hears the same thing from THREE different doctors, then one can determine if its the NEWS or the APPROACH which is causing one to mistrust or dislike one's doctor.

    I have a good doctor NOW. He's an excellent physician but is also the right "fit" for me emotionally and intellectually. He knows I know certain things and he's great at knowing he needs to be honest & detailed with me.

    I am NOT a "go get this filled and take it and I'll see you in six months" sort of a patient.

    And he works from a university research/teaching hospital so there is some sense that he has a different set of eyes watching him (versus what happens in some of these physician vanity clinics or hospitals where they are majority investor).

    ^ BUT THAT'S ANOTHER TOPIC FOR ANOTHER DAY

    I am fortunate in that (KNOCK WOODIES ) I don't have any current medical problems (its the frsh-squeezed orange juice, I tell ya!). And I've never been diagnosed as being clinically-depressed or bi-polar (but then, I never keep the appointment) < JUST KIDDING!

    A physician-patient relationship is as personal as it gets. SADLY, with malpractice insurers, doctors are quite literally AFRAID to say too much or to jump from treatment to treatment. And with regular medical insurers LOOKING on over their shoulders at everything being done, the doctor is afraid to change course too quickly or too often. They, too, after all, have to work (HOPEFULLY) by a certain standard and code of ethics.

    Its usually a good thing to have a doctor not too quick to try or change stuff.

    Of course, on the other hand, you don't want a medical hack who gets prescription kick backs and doesn't remember your first name and pressed his erection against your leg while telling you about some new boat he's thinking about buying.

    And NO ONE needs a doctor who is not responsive to one's needs.

    If possible, seek the opinion/s of another doctor or two.

    You may find one who is responsive or a better fit. Or you may get some perspective on your current doctor. "Hey, old man Doc Geyman ain't so dumb, after all. AND he jerks me off when checking for hernias!"

  29. #29
    JohannBessler
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    Re: Before you pop another PAXIL

    Dr Writer: (et. al.)

    THat's a well-thought out response; a good doctor is essential for success with SSRIs.

    Perhaps a personal note is in order here. I have an uncle who was diagnosed with Major Depressive Disorder without Melancholia. He was put on about 12 medicines--no joke!--before he found a medication that would work for him. One of the medications--I have forgotten which, but I think it might be Efflexor--actually made him feel worse. The medication he's on now--Wellbutrin (a non-SSRI) is working for him, and has worked for a couple of years now. He says he no longer has suicidal thoughts.

    This anecdote says it all, folks. Never give up on just one medicine. You might lose your life. Remember, psychiatric medicine is very much in its infancy; SSRIs have only been used since 1988. Is it really fair--or prudent--to give up after just one medicine?

    Except in the case of transient episodes of Depression, it's not curable through effort of will alone.

  30. #30
    T-Zero
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    Re: Before you pop another PAXIL

    Quote Originally Posted by JohanLarson
    The medication he's on now--Wellbutrin (a non-SSRI) is working for him,
    Thanks for pointing that out. When I mentioned my experience with Prozac and Wellbutrin I didn't make that distinction. When I mentioned they concluded Prozac should never have been prescribed for me it was indeed because Welburtin is unrelated to the selective serotonin uptake inhibitors which had a different effect on my brain chemistry and the effect of the serotonin uptake inhibition was actually interfering with treatment and causing imbalances where there were none before.

    Something else I'd like to mention, is that pay attention when on these drugs the cautions about not taking certain drugs, foods, or recreational drugs — even smoking pot (I know, I know, grumble grumble) — but they truly can interact with these medications in some very unpleasnat ways or exacerbate a depression.



  31. #31
    ds_writr
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    Re: Before you pop another PAXIL

    on a natural, wholistic, non-clinical level: maybe I don't have any of these problems because I eat so many bananas and turkey.

    and I avoid saccharine and most artificial sweeteners as they say they can contribute to feelings of depression (as it screws with one's serotonin levels).

  32. #32
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    Re: Before you pop another PAXIL

    Quote Originally Posted by ds_writr
    I avoid saccharine and most artificial sweeteners as they say they can contribute to feelings of depression (as it screws with one's serotonin levels).
    Really ??? You're kidding.

    That's the first I've heard of that one. Gads, considering I
    drink between 8 and 10 cans of diet soda a day, you have my
    complete attention. <nervously eyes can of Diet Mountain Dew by keyboard>

    Yikes.

    Josh



  33. #33
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    Re: Before you pop another PAXIL

    Quote Originally Posted by Joshua_me
    Really ??? You're kidding.

    That's the first I've heard of that one. Gads, considering I
    drink between 8 and 10 cans of diet soda a day, you have my
    complete attention. <nervously eyes can of Diet Mountain Dew by keyboard>

    Yikes.

    Josh
    Well, they are chemicals. And as chemicals, they have their effects on the brain's chemistry.

    Aspartame was an early sugar substitute to come under fire. But recently they are finding that besides cancer risks, saccharine (the Sweet & Lo stuff) is also making rats act all down in lab tests.

    I would think that if one IS NOT having such reaction, its no biggy (god knows how much saccharine one would need to ingest in order to make one curse the day). But its something to consider -especially if someone's chemistry is already off and trying to get into balance maybe.

    ANOTHER THING TO DISCUSS WITH ONE'S DOCTOR.



    Of course, if one is DIABETIC, I'd imagine its a better alternative than switching to sugar sodas and sugared candies.

    OY, isn't it ironic how so much in life is all about FINDING BALANCE? I mean, from brain chemistry to dietary needs to relationships to world power to our checkbooks - its all always about finding balance.




    that's my guru-ian comment for the day

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    Re: Before you pop another PAXIL

    Quote Originally Posted by ds_writr
    Well, they are chemicals. And as chemicals, they have their effects on the brain's chemistry.

    OY, isn't it ironic how so much in life is all about FINDING BALANCE?

    Well, it's true, though....

    Myself, I'm a type II diabetic, so it's a constant 'balancing act'
    to make sure my sugar is not too high, not too low, each and
    every day.

    By the time I hit the big 4-0, I'm sure I'll have to go on some sort
    of medication, but for now I can control it with the ol' 'diet and
    exercise' thing.

    But, I think everyone has to find their own 'balance' with things.

    What's right for one person is not right for another.

    For example, red meat is supposed to be so bad for you, (every bite of steak...one step closer to death ! ) But for me, I feel
    at my best after eating a big ol' honking steak...go figure.

    Whoops, I've gone and hijacked this thread, haven't I ?

    As you were...

    Josh



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    Re: Before you pop another PAXIL

    As a physician myself, I feel obligated to weigh in on this discussion.

    I have personally prescribed boatloads of Paxil over the years I have been in practice. This is not, alas, because I am receiving kickbacks from SmithKline Beecham. I happen to think that for many patients Paxil happens to be the best choice. For other patients, I choose other drugs or even no drugs at all. The factors which go into this decision are extremely complex. It is entirely possible that I am doing a horrible job and have spent my career inflicting enormous damage on mankind. But I would not do what I do if I really believed that. I believe Paxil has saved many, many lives and has given comfort and normalcy to many more. Is it perfect? Of course not! Has it harmed some people? Probably. But I cannot offer you a magic pill to cure whatever ails you. We are far to ignorant for such fantasy. But there are many times when I believe that that is what my patients expect of me.

    We live in a culture where the expectations of the medical profession are, I fear, grossly unrealistic. We in medicine operate in a field that is remarkable more for the profundity of its ignorance than for the depth of its understanding. You spend a third of your life sleeping, yet we have no idea what function sleep serves, or why you dream. We don't understand why a woman can harbor a baby within her uterus for nine months time and again without rejecting the fetus, but if we tried to transplant a kidney into the same women, she would reject it as foreign tissue. We don't understand why diabetes and depression are so common, as both are clearly evolutionary impossibilities. We have much to learn.

    But ignorance is relative to the times in which we live. There are today, in fact, very few diseases in which nothing whatsoever can be done to alleviate the course or the symptoms. But almost never can I offer you a simple resolution to your complaints. Life just isn't that simple.

    Those of you who are dissatisfied with therapies you have been rendered so far need to appreciate that your relationship with your physician is a dynamic one. Communication in both directions is important. Yes, I know, we never have enough time with you. That is another regrettable aspect of modern healthcare. But try to make your doctor understand whatever concerns you may have, and try to get him to explain why he feels the way he does about your treatment. There is a lot more going on there than you may appreciate.

    But don't stop your Paxil, or necessarily avoid taking it or any other drug for fear of some media report.

  36. #36
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    Re: Before you pop another PAXIL

    I have always come down firmly on the If You Need Help Get It side of the equation... and if that help means pills, then pills are what you should take. But pills aren't all of the answer, they have to be taken in conjunction with ongoing therapy and medical attention, as well as personal and family attention. Those teens who committed suicide on Paxil might very easily have just been given the Paxil and ignored by their parents and doctors... "here, take these and leave me alone."

    I resisted going the medical route for my depression until it advanced into type-2 bipolar disorder, by which time I would gladly have given up both nuts and my right foot to stop feeling as horrible as I was feeling. All I got for side-effect from my Prozac was some extra fat and a bit of gas; I just started taking Depakote as well, I'm waiting to see what that does to me. Whatever it is, I bet it's better than how I felt before.

    And looking above, I see that a lot of people have had bad experiences with antidepressants; and I think there are a lot of doctors out there who have become just a bit jaded and don't pay sufficient attention to their patients' needs. And yeah, a lot of these antidepressants will do a number on your body. When my friend went off the Paxil he'd been taking for four years, he broke out in liver spots! A twenty-five year old kid walking around with great brown splotches all over him. Of course, he went cold-turkey against his doctor's advice because he wanted to just get it out of his system; he was tired of feeling flat and asexual.

    However, there is just as much fault with the patients. One of the things I learned in my bipolar group therapy is that many bipolar people don't even think they're bipolar because they enjoy being manic... the extra energy, the extra sex-drive, the extra creativity. So they treat their bipolar disorder as if it were straight depression. And since they're not sharing all of their symptoms with their doctors, the doctors don't know any better. When my friend went off his Paxil, he didn't stop his bimonthly therapy sessions, he checked in with his doctor frequently during the withdrawal period, and he took decisive action towards maintaining his mental equilibrium and physical health during the process.

    There's also this perception on the part of both physicians and patients that being depressive or anxious or bipolar isn't really that big of a deal. We learn to cope with various of our symptoms, and those symptoms become part of our personalities. And so when we're sitting down with the doctor going over our symptoms, we will frequently gloss over various symptoms or ignore them altogether. And so the doctor only gets partial information, and he or she prescribes on that partial information.

    When I decided to go the medical route, I did a lot of research, I went to classes, I went to group, and I talked to my psychiatrist every three weeks to see how I was doing on my medication, had any side-effects surfaced, had any ill-effects taken place. I only get three refills on any of my meds, so I have to meet with the shrink face-to-face to discuss my treatment at least twice a year. My HMO does that sort of thing to make sure we make the most of our time with the doctors (prevention is way more cost-effective than reparation), but the attention to detail is something that anyone can bring to the party.

    If I had gotten a doctor that just gave me a pill and sent me on my way, I would have changed doctors. And I would have kept changing doctors as long as it took until I found one who was interested in working with me, interested in discussing various treatments with me. I was lucky, the psychiatrist I drew out of the hat was the right one (when we started discussing medications, she gave me a sheet of twelve different treatment options to discuss with her and choose for myself), but there are twenty or so other shrinks I could have gone to if that one didn't work out... and that was just in my HMO, I could just as easily have gone out of my HMO if it was important (and I think my mental health is important).

    The research is really important. When I was telling my father about why I'd started limiting myself to three cups of coffee a day, he wondered why he had never heard about caffeine and refined sugar and chemical sweeteners being cited as contributors to disorders like bipolar and depression... he's been under treatment for bipolar disorder for more than ten years, but this was news to him! Yet when I looked up the websites suggested by my therapy group leader, that was one of the first things I learned!

    Daddy didn't know about it because he'd never asked. And he still drinks three or four Diet Pepsis every day even knowing that, because he doesn't really care enough about his mental health to make sacrifices in his comforts and addictions to help himself.

    It's incredibly important for the patient to take an active part in his or her therapy, not just taking the doctor's word for anything, not just taking your friends' word for it, not just making it up as you go along. The information is all out there, you just have to dig it up; the help is out there, you just have to ask for it.

    * Question the Dominant Paradigm *

  37. #37
    T-Zero
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    Re: Before you pop another PAXIL

    Quote Originally Posted by Centurion
    As a physician myself, I feel obligated to weigh in on this discussion.
    Hi Centurian.

    I'm glad you have weighed in on this discussion. This affords me the opportunity to pose some questions I've had for quite some time now and which has become a growing concern of mine after having worked professionally in the past within the field of psychiatric social work and mental health counseling in close relationship with psychiatrists and clinical psychologists. (These are concerns also reflected in the opinions of RM above.)

    (Caveate: I mention in the past, because it's been a little over a decade since I was actively employed in those areas after having switched into another professional area. )

    I ask these questions with all due respect, and I do mean respect for physicians.

    What has occured within the medical profession that has caused such a radical shift where patients presenting to practitioners of general and internal medicine with symptoms of mental illness such as social anxiety disorders, clinical depression, and mild to heavy suicidal ideology have become qualified to begin making psychiatric and psychological diagnosis and prescribing medical regimes as the sole measure of treatment? (Keeping in mind how many mental illnesses share over-lapping symptoms and can be easily misdiagnosed even by psychiatrists and psychologists without thorough psychological examination and patient intake histories.)

    Yes, these medication regimes address the organic components of the illness and make the symptoms more bearable but doesn't this fail to also address and provide the other half of treating the actual illness by providing the necessary qualified psychiatric or psychological counseling which should be done conjunctively to effect a cure or adequately address the illness itself and its symptoms?

    I don't know of many physicians who when presented with such patients who does anything other than a brief medical intake interview, prescribe the medication regime, treat the organic component in a way which makes the symptoms more bearable but who also provides the requisite psychological examination and provides the psychiatric or psychological counseling. And often times doesn't even make a referral for that part of the diagnosis or treatment of the mental illness. This is something we used to ask our patients — if they had been referred to us and very few had been. They'd simply been provided medication, found their problems persisting and then sought our additional help. Is this just an anomaly of my personal professional exposure?

    Note: Even with my own very personal experience after leaving the field of mental health, I've only had one physician who suggested such a referral and that was only after having switched physicians for having been misprescribed the Prozac as I earlier related and was switched to Welbutrin. (Fortunately I was only under treatment for less than a year.)

    Are these mental illnesses (especially when heavy suicidal ideology is present) just simply viewed now by physicians and pharmaceutical companies as being purely organic in nature and thus singularly treatable by medication?

    I don't know how physicians view this, but just from what is projected in the relatively recent and increasing development of pharmaceutical companies advertising their wares commercialy to potential patients in the media, or sometimes direct mail marketing, this certainly seems to be the projected attitude: "Your illness is purely organic, take this pill and all will be well."

    Naturally, I recognize that in these advertisements they are emphasizing the organic aspects and the need to see a physician in order to get people to seek help without inferring to what is too often considered a stigma if it's suggested one seek psychiatric or psychological help, as well as to alleviate feelings of failure or guilt on the part of the patient also too frequently associated with mental illness as being "purely" psychological which we do know is false with many mental illnesses. But it does seem like on the physician side there would be this emphasis with the patient for a more thorough psychological exam and dual treatment modality rather than simply a brief medical intake and then prescribe chemical treatment.

  38. #38
    ds_writr
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    Re: Before you pop another PAXIL

    ^ I agree with you as I, too, "notice" what appears to be a phenomenon of prescription and little in furthering mental health counseling.

    Perhaps some of it has to do with a med-culture. And maybe some of it is that much in the arena of mental health has been diminished (monies) - and just when it seems EVERYONE needs them.

    I know its anecdotal but its INTERESTING that I know of about a dozen people on Zoloft, for instance. But only one seems to go to a psychiatrist on a regular basis.

    And all were people who seemed to go from, well, let's just say, "non-diagonosed" status to prescriptions. And yet only ONE seems to go to regular mental health "counseling" (of the talking kind) ?

    Knowing so many people - artists, photographers, city bureaucratics - I know they all expressed "anxiety" disorders (which led to their prescriptions) and anxiety disorder, as I understand it, is connected or related to "depression" (a manifestation of it?).

    I would know that if some GP or internist said I "seemed" like I might be suffering a depression and he wrote out a prescription for an anti-depressent, I would not be able to go on them unless or until I did some form of a couch routine.

    Its not to say he'd be wrong. But I do understand the point about at least cross-referencing the "illness". Its bio-chemistry but perhaps also something other which causes or triggers such effects (in some people).

    I mean, I'm a very listening-sort of a person in life and people tell me things. For that reason, I have a lot of friends, I think. And even being a NON-professional, I will sometimes listen to them and THINK (I only listen), "Maybe some of it, too, is the fact you live alone, have a lot of pressure at work, financial strain, tension due to the world crises...your dog died..." And yet none of them are doing more than filling prescriptions.

    Maybe that's the magic pill syndrom which Centurion said. Maybe there is some theory that its all only bio-chemistry and can be "adjusted" that way.


    Here's my take on this (if its not a prescription industry or culture): You know how those persons who wish to undergo sexual reassignment surgery must go through both physical bio-chem altering hormone therapy AND mental health counseling (both, together) in order to get approval for the surgeries (in the USA)?

    Maybe, anyone on prescriptions for "mental health" reasons or on "psychiatric drugs" must simultaneously be undergoing both mental and physical care prior to a prescription either being filled (or RE-filled).

    One thing I do also WONDER about is the reality that one med may work on one person while another person needs to try things in order to find the right one (and in the right doseages).

    But if a relatively healthy person suffering from a MILD form of these illnesses could get into balance in a year's time, but hops around from med to med (as some do) , they can find themselves on meds for YEARS (try this for 3 mos...try that for 6 mos..)

    Also, if a person suffers from anxiety disorder, even IF a prescription isn't technically addictive physically, wouldn't the THOUGHT of coming off the prescription, well, you know, in a person with ANXIETY DISORDER, cause that person some ANXIETY?

    That's why I would think it ought to be mandatory that someone on such meds be receiving counseling for the non-bio chem reasons, impact, effects on one's life - you know, BEYOND the meds.


    To me, its a bit like any other illness. A doctor may put some guy on insulin but a good one finds the causal root of his diabetes.

  39. #39
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    Re: Before you pop another PAXIL

    The National Institute for Clinical Excellence (NICE), in their latest guidelines, strongly suggest that all patients put on anti-depressants for depression or social anxiety, receive cognitive behavioural therapy from a clinical psychologist too.

    Quite how they will acheive this ambitious aim with the current cutbacks in mental health resources by Comrade Hewitt is beyond me!

  40. #40
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    Re: Before you pop another PAXIL

    Quote Originally Posted by ds_writr
    To me, its a bit like any other illness. A doctor may put some guy on insulin but a good one finds the causal root of his diabetes.
    Even if you do manage to find the cause of someone's diabetes, it would be a purely academic exercise as it wouldn't alter the management of it.

    In that nature, it is different to depression and other mental problems.

  41. #41
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    Re: Before you pop another PAXIL

    I think putting you on something that you hate is bad enough... I was on depacot (sp) and I felt like a patient in my own house...

    I had friends who were on that, I am sure they as like you hate the side-effects, no one would like to have side-effectf or a medication...

    I think it is very much so bullshit

  42. #42
    JohannBessler
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    Re: Before you pop another PAXIL

    Quote Originally Posted by BenF46

    In that nature, it is different to depression and other mental problems.
    I don't think I agree. As I have heard,"The brain is an organ--just like the heart, liver, or pancreas--and it gets physically ill, too."

    If medication is given to a brain for a lack of seratonin (or dopamine or norepinephrine), and to a pancreas for a lack of insulin, isn't it exactly the same thing?

  43. #43
    JohannBessler
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    Re: Before you pop another PAXIL

    Quote Originally Posted by T-Zero
    ... even smoking pot (I know, I know, grumble grumble) — but they truly can interact with these medications in some very unpleasnat ways or exacerbate a depression.
    I couldn't agree with you more.

    This issue is something the pro-marijuana people just won't discuss, however.

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    Re: Before you pop another PAXIL

    I understnad the need to be on paxil and everything. Because depression can get really bad, really quick, and me my parents and my doctor all agreed that I should be on it.

    But I also think that now that I've been on it for 2 years, I should try ti see if I can make it without the meds, because I feel like I've hit a dead end. I want to move forward, but the paxil just makes me feel weird. I've been feeling like a different person ever since I've been on it.

    (I apologize for the totally self-importance post, lol)

  45. #45
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    Re: Before you pop another PAXIL

    Quote Originally Posted by TechPepsi
    I think putting you on something that you hate is bad enough... I was on depacot (sp) and I felt like a patient in my own house...

    Ben....If you're out there, could you give us a brief rundown on
    Depacote ?

    My shrink wanted to put me on them years ago, but it just seemed
    like the wrong thing to do, to me.

    It seemed like too much of a 'big time' drug to take, if that makes
    any sense.

    Josh



  46. #46
    T-Zero
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    Re: Before you pop another PAXIL

    Quote Originally Posted by JohanLarson
    I don't think I agree. As I have heard,"The brain is an organ--just like the heart, liver, or pancreas--and it gets physically ill, too."

    If medication is given to a brain for a lack of seratonin (or dopamine or norepinephrine), and to a pancreas for a lack of insulin, isn't it exactly the same thing?
    In mental illness, as has been pointedly underscored, mental illnesses are a combination of organic and psychological interactions (except perhaps in some very rare instances.) They're not purely organic, nor purely psychological but the two interacting together. Tthe desired outcome of treatment is not just simply a manageable level of maintenance (as with diabetis) but actual recovery and recouperation that usually requires a dual treatment modality of medication and counseling.

    The only time the long-term goal is to achieve a desired manageable level of maintenance with regard to mental illnesses rather than recovery is with those illnesses toward the far chronic and extreme end of the spectrum of mental illnesses such as chronic schizoid disorders (for example) or full-blown chronic psychoses rather than transient acute episodes of psychotic breaks (for example), or when it's known that going off one's meds will definately cause a relapse as with, for example, bi-polar illnesses which require stronger medications such as Lithium.

    At least from the perspective of mental health workers. Which is why I was interested in getting Centaurian's response. The purely medical perspective may view this entirely differently.

  47. #47
    XPTP29A
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    Re: Before you pop another PAXIL

    I took Effexor XR for 3 years and after its effectiveness dwindled my psychiatrist and I decided to wean me off it. I was on some high doses (~700 mg) but I gradually lessened the doses over two months.

    The thing I worried about the most was that my head and neck would shake uncontrollably at night while I was on it. Also, when I forgot to take it I would get some really bad headaches and dizzy spells.

    I've been on four different medicines for clinical depression and none of them worked that well. What has worked is cognitive-behavioral therapy. Although I did the CBT while on the medicine, it has been more effective without the medicine, but that's just me. CBT and anti-depressants are typically a good combination, though.

  48. #48
    T-Zero
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    Re: Before you pop another PAXIL

    Quote Originally Posted by JohanLarson
    I couldn't agree with you more.

    This issue is something the pro-marijuana people just won't discuss, however.
    Actually that's a bit of a straw man argument. Since you should not drink alcohol when on these meds either for the same reasons.

    It has nothing to do with healthy people doing things in moderation and for whom exhibit no ill effects or exacerbated problems.

    Not that I'm trying to make any kind of point pro or con with regard to what is legalized or criminalized or alluding to any recreational drugs other than marijuana.

    That would be a complex topic on a whole other level.

  49. #49
    JohannBessler
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    Re: Before you pop another PAXIL

    Tzero, maybe the meds theory and the psych theories are both right. Psychopharmacology is still in its infancy.

    Perhaps in some patients, the causes are primarily organic, in some, the causes are psychological, and in a third group, it's a combination of both.

    For example, we know that schizophrenia is primarily organic; all the therapy in the world won't help these patients. Depression might be different, though. What do you think?

    But the originator of this thread threw the baby out with the bathwater; essentially, he said,"They're all bad." I think that's an imprudent approach, to put it mildly!!

  50. #50
    ds_writr
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    Re: Before you pop another PAXIL

    my reference to the diabetes was more about how a good doctor would want to not only treat the ailment but also figure out its origins or variety.

    I certainly think that the brain and mind is more complex on many levels than is the pancreas. What they share is that they're both major organs which can fall out of whack or balance and cause us severe problems. And they can both be medically treated.

    of course, you can't talk to your pancreas very well and in that, the two would considerably different beasts.

    what I meant to say about a doctor treating the chemical or physical side of mental disorders, imbalances or illness, is that, like it or not, the brain is doing more than bubbling juices.

    I suppose I'm an advocate for doing all one can do. and I don't know if all meds is any better or any more effective than is all talk (psychotherapy- alone forever).

    I would just think that since many people are getting these "diagnoses" (and prescriptions) from regular generalized medicine physicians - although they are doctors, the mind is not necessarily their specialty (by any stretch).

    Other than a finite prescription doseage for some mild anti-anxiety sedative, like Atavin (is that the one? like the MOST PRESCRIBED med on the planet) after the death or someone or particularly obvious times of stress, I'd think a G.P. or internist should always refer the patient to a specialist (in these cases, a psychiatrist).

    Sadly, I fear that specialty, although a medical doctor, still carries with it some stigma (everyone wants to be able to say they saw the DOCTOR and got a prescription rather than say they saw a PSYCHIATRIST and he put them on psychiatric drugs).

    I do believe that social stigma or discomfort still exists.

    So they'll get the drugs but from the WRONG specialist (in my opinion).

    If one goes to a G.P. and you have a weird EKG, he immediately sends you to a cardiologist.

    If you got to the ER and they find a LUMP in a scan, they send you off to an ONCOLOGIST.

    But when the AVERAGE person is feeling depressed, anxious? And he gets on Zoloft, Paxil, etc through some family practicioner?

    I dunno.

    Ya know what I mean?

    I think there there should be some requirement that someone prescribed such drugs seek the care of a certified specialist.

    I thought the POINT of a psychiatrist was that he is both medical doctor and an expert in the BRAIN and workings of the mind (you know, in theory).

    Or if its all just BIO-CHEMICAL, send everyone to a neurologist and see what he can do.

    If I discovered I had a mental illness, I'd be in VIENNA having everyone probing my brain. I would not be shuttling between my doctor at the mall and Walgreens.


    But that's just ME.

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