Psychiatrists

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She was 28, a bit overweight but tired and nervous at the same time.

“I’d like 15mg. of Celexa. My other psychiatrist wouldn’t give it to me, so I left him. He said it was either 10mg. or 20 mg. and that’s it.”

Not the usual “chief complaint” for why someone comes to a psychiatrist — but what the heck? Read more on How To Get 15 mg. of Celexa…

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I am sometimes amazed at my patients. They amaze me when I ask about their therapists. I ask about what their therapists are doing for them. Very surprised, they often tell me things like “I’ve been seeing my therapist for years,” and “She is kind of like a friend I talk to every week.”

If you are a “therapy patient,” you (or your insurance) is paying an alleged therapist to make you better. Well, often patients tell me they are doing or have been doing “nothing, really” and this I believe. Read more on How To Tell If Your Therapist Knows What They Are Doing…

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Recently I convinced a patient to buy and use one of these:

She had to pay about 700 dollars cash for it.

I had her on a variety of antidepressants and anti-anxiety drugs, and she had survived untold numbers of similar drugs from the three or so psychiatrists she saw before me. She assured me none of them had been much help. Read more on The Fisher-Wallace Stimulator…

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The depth of psychiatry deals with the entrails — the innards.

The world of psychiatry of the deepest personal thoughts is a world of fantasies of murder and fantasies or death and they are deep, so very deep, that sometimes people don’t even know that they think about them. Read more on It Sounds Like A Joke But —…

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The easy part is the FDA congratulating itself for an initial effort in 2004 to diminish the use of antidepressants in children and adolescents by adding the black-box warning that such medication may increase suicidal ideation.

Equally easy is blaming physicians who treat children and adolescents for becoming “inured” to warnings. Read more on More Kids On Antidepressants…

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I recently started seeing a patient whose previous psychiatrist ran him through absolutely every antidepressant drug that his (expensive) genetic testing suggested he would respond to. He had no improvement with any of them.

I will admit to having been an enthusiastic supporter of genetic testing not long ago. The science was sound on paper. Read more on Bipolar Genetics…

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When push comes to shove, any psychiatrist can prescribe anything they damned well please.

Oh, there are a few particularities. Like needing to have a “triplicate’ pad if you are going to prescribe speed, or a “tamper proof” pad if you are going to prescribe something wildly addictive. But any licensed MD can just phone those in legally if you give your “magic numbers” like your DEA (Drug Enforcement Administration) number — even if not a psychiatrist. Read more on Antipsychotic Medication For Children With Autism…

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Gag me with a spoon.

Psychiatric diagnosis is never a controversy. It is always a mess.

Within the first week of my residency training, my respected preceptor in child psychiatry told me “You aren’t going to child psych very much, Estelle. There isn’t much evidence for most of what we do. The research is about 20 years behind adult psychiatry.” Read more on The Alleged Controversy About Childhood Bipolar Illness…

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No, psychiatry is not dead. I am called by folks who want to see a psychiatrist.

Not only does insurance pay for it but it pays my rent. Read more on The Alleged “Psychiatry is Dead” Movement…

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Should I be inclined to comment on the physical or mental health of a public figure, I would need to start with a humongous disclaimer.

I suppose it is common decency that would force me to say I had never met the patient and/or had never been their doctor and/or had never had any access to their medical or psychiatric record. Read more on Approach, Not Author…