prescription drugs


It does not matter what country they were from. The father got into the system when his 19 year old son went stark raving looney bonkers and started destroying the homestead. Luckily it was an apartment in an urban setting, or I don’t think anyone else would have known about it. There was one older child who had already flown the coop, one wife who had died because the strain of leaving the old country had been too much. I had a feeling she had also gotten raped or something, but that was father’s post-traumatic stress disorder if anything. I told him to come back for himself, but I never saw him again. He swore on a stack of bibles that his son did not use drugs.  He said nobody had ever explained to him what was wrong with his son. At least no way he could understand and explain back to me.

For an American the solution would have been a support group, like the Alliance for the Mentally Ill. They lived in a rural area, though, and I did not know if the local chapter had anybody who spoke his language.  There is no way the patient could have handled that – and probably not the father, either. Read more on You Can’t Pick And Choose Which Medicines You Want…

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Eli Lilly gets credit for being economically savvy and the first out of the chute.

Cymbalta (duloxetine) is a much awaited antidepressant that is supposed to be effective especially on the bodily aspects of depression.  Those pesky aches and pains that are associated with depression in one form or another.

They seem to have secured “back pain” as an indication for Cymbalta. Read more on Cymbalta For Back Pain…


97 million Americans with chronic pain and I got a 57 year old screamer in a wheelchair. Back pain, leg pain, pain in places she was not sure of. No, psychiatrists are not supposed to give out morphine.  Yes, I know I have a prescription pad.  But I keep it close to my heart, locked in my file cabinet, or in my purse, because I actually enjoy practicing medicine and do not enjoy the vision of my license certificate on wings on its way out the window. Even if I could have done it fearlessly, I would not have increased her pain medicine.  The more you give, the more they hurt, the more they need.  This is written in a lot of places but you only have to look at the patients who have been created into addicts, and there are plenty of them.

Alternative recommended approach nobody will listen to: A Bryn Mawr college student, apparently not loaded down with clinical cynicism or even clinical experience, came up with this one.

The way it is said is brilliant.  We all act as if we had a pool of attention, and the more of it we place on something that is not pain, the less pain we feel. Experiments cited go from virtual reality to guided imagery to music. Read more on Down With Pain…

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I thought this person should be fired from the county clinic, but most counties don’t let me do that sort of thing.  The state of California has a nice service, where I ask to see who else is prescribing this person the same abusable drugs that I am.  I try to work with people who abuse drugs, I really do.  In one sense, it is the purest of pharmacologies, in that things I usually think are parts of a physician-patient encounter, like conversation and logic, play little or no role. House said that patients lie.  House is a Vicodin (opiate) addict.  Some of my more intelligent substance abusers are House fans. The same way that “Cops” was the most watched TV show in prison, when I was a jailhouse doc.

This person, was getting weaned off amphetamines.  After a lot of  years, I am not very sure I believe in ADHD, or “Attention deficit disorder.”  We all have problems of differential maturity.  These are just people who learn to concentrate later.  They may have other skills like class clowning that are way ahead.  My book learning was ahead of my social skills for a lot of my life. Besides, most anybody brightens up when you give them amphetamines.  Not that the effect lasts very long, mind you.  Even kids who take Ritalin in a quest to do better on the Scholastic Aptitude Test seem to revert pretty quickly to their previous state of dullness. Read more on Getting Amphetamines In Other Places…


Well, I did not expect to have anything good to say about the FDA this soon.
We have written on QNEXA, one of those drugs compounded from previously known compounds that are devised, as far as I can tell, to make money fast by combining previously approved drugs.  And putting them towards a popular indication, like weight loss. Read more on More On Qnexa Rejection By FDA…

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He was a pale faced, somewhat overweight 50 year old with a tired demeanor.  He had a treatment resistant depression and I had asked his primary care physician to run some tests.  He complained of not just lower back pain, but pain in all his joints, and I wanted to rule out autoimmune illness; things like rheumatoid arthritis, or even lupus. I also told him to review his pain meds with the doctor.

He claimed 8 months of sobriety from what had once been a pretty heavy alcohol habit.  Who knows what is real or true?  He had told me he had a couple “little relapses,” not unexpected in that sort of problem.

“The doctor says I am an addict and I am going to die from my pain meds, because I take too much of them.  I told him if he would give me better ones or stronger ones, I would not have to take so much.  It is his fault.  I really hurt.” Read more on Death By Pain Pills…

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The FDA has declined to approve the weight-loss drug Qnexa, which I wrote about a couple of months ago.

Generally, diet drugs are more danger than help.  But my opinion on that matter is already on the record.

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She was 29 years old and so obese that she had to walk through the door to my office sideways.  She had put on most of the weight, she said, after she had
been date-raped.

She did not remember much about what happened.  She knew the guy who had been with her, and avoided him as best she could, although she still had thoughts of him, that intruded into either her nighttime dreams or her daytime thoughts.  And she had the characteristic “hyper-arousal.”  I have learned, the hard way, never to think of slamming the door or clapping my hands to test this one.  I only did that once or twice and always regretted it.  I just asked her if a sudden noise made her jump in the air, ever, and she nodded.  “How did you know?”  she asked. Read more on Roofies, Ruffies, or Mexican Valium: It Doesn’t Say “I Love You.”…


I was a staff psychiatrist at the Las Vegas VA, when the endocrinologist who was assigned from that august institution to take care of me told me that Meridia for weight loss would be a good idea.

Surprisingly, the first thing that came up on my search today was something from the Forbes magazine health editor. Duh, this is a business story.

When I declined Meridia, because of what he thought were “only a few”
reports of sudden death, I was packing on the weight steadily– due exclusively because of his treatment for me — which included taking a lot of insulin which obviously I did not need.  After all, I had a bit much blood sugar and he never noticed it was chasing my triglycerides, and/or never saw this, although it had been starting even then to become evident to me. Read more on Harmful Drugs Are Reported As Business News — Not Health Or Medical…


“I really don’t need medicine.  I am fine and I applied to the fire department and I will be a firefighter.”

This is a typical response from a man.  In our culture, we raise junior John Wayne types — tough and independent.

He was in the room with his mother, who was fighting back tears.  “I have tried everything to make him take medicine.  I can beg him, but he does not take it very often.” Read more on The Mother Who Learned To Trust…

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