antidepressants

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I find a lot of things I like in the New York Times. This article resonated with me as few others. First, there is the purpose of the human profiled.  Changing medicine into data science?  God save us all.

Sometimes I feel the best thing I do for a patient is to be human.  Just to have the pretension (a pretension which I do not take lightly) of being one human being in a room with another human being, trying to make them feel better.  This does more, I think, to make most of my patients “better” than all of the pills I have spent years studying about. All those years studying normative use of medications on large populations of humans.  And they work enough to please the powers that be.

Read more on Human Beings Are Not Computers…

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Only 16% of all murder victims are members of the defendant’s family?

That’s according to the PDF file that pops open (or opens in your browser) when you click this link – and you must have the free Adobe Acrobat reader to see it. (Fortunately, it is included with most computers nowadays).

Actually, I am surprised to see the number is so small.

I am a little bit heartened to learn that only 20% are strangers.

This leaves 64 % that are friends and acquaintances. Read more on Your Family Really Can Kill You…

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I am an expert on this — Anti-overweight discrimination.

First, from my practice.  I remember a woman in her forties I saw in Oklahoma for a routine antidepressant renewal who told me that she had a cardiac condition and had been to her primary physician (this is back in the prehistoric days when I took insurance) and he had told me it was her own fault she was overweight and she was risking her life by doing nothing about it.

She was not suicidal.  She told me she would never see that doctor again.  And she was not going to take any heart medicine. Read more on Anti-Obesity Discrimination and Obesity Treatment…

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Do some people become doctors just to earn a lot of money?  Yes.

Sigmund FreudDo some of them find out that it’s not as lucrative as portrayed in the media (based upon stereotypes at least 40 years out of date)? Hell Yes!

Psychiatrists are not normally schizophrenic — however there are two types.  One is the media stereotype “Talk Therapy” doctor.  These are nearly extinct. They exist mainly in Woody Allen movies and old TV series.  In fact, most of those are psychologists — not psychiatrists (but who knows the difference and who cares?).

The other type is what you chiefly find today — Pill Pushers.  Insurance and

Read more on Where Have All the Psychiatrists Gone?…

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All right — I am married to a man I love and I dearly love my profession.  So how could a “boy she has it all” woman like me possibly get depressed?

Mine didn’t look exactly like the criteria laid out in the DSM-IV.  I mean, I am not going to sit around for two weeks feeling this way just so I can meet criteria.  But other than the two-week bit — I was depressed.  I did not want to do much of anything except cry.  I could not believe the negative thoughts creeping into my consciousness and I was having a hell of a time pushing them out.  I felt sleepy, listless, the whole nine yards.

I did not prescribe myself an antidepressant.  I do not think that anybody really believes at this point that a congenital lack of antidepressant has made anybody depressed — ever. Read more on Things to Consider Before Reaching for Antidepressants…

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California is known as “The Golden State” and some have called it “The Land of Milk and Honey.”

The Beverly Hillbillies noted that it was the home of “Swimming pools – Movie stars.”

That should be encouraging for people like my 27 year old, freckled, red-headed patient.   After all, he had a pool cleaning business. But he was nervous — really nervous.

He did not have full-blown panic attacks, though he certainly fit the criteria for generalized anxiety attacks. Sometimes he did get a “heart in the throat” kind of feeling; something which some people would have called a “truncated anxiety attack.” But he had a lot of them and they really didn’t cramp his style very much.

He did not sleep very well, confessed that concentration was poor, and had great difficulty trying to find any interest in collegiate academics. As a result, his grades suffered considerably. And while I could potentially chalk this up to him falling into a category of males who may be better equipped for trade school than an actual 4-year college (based on patience; not necessarily intelligence), I didn’t believe this to be his case at all.

This guy was anxious. Read more on Stuck On The Treatment Treadmill…

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“There’s no such thing as a free lunch” – but there are plenty of free samples when you go to your doctor’s office for a prescription.

Be wary of free samples.

What? Am I asking you to look a gift pill in the mouth? Drugs are expensive, even the co-pay for drugs can be expensive.  What’s wrong with getting a freebie?

First, the drug companies that make them do not give them out forever.  Usually, they give out samples on a newer drug as part of a launch – kinda like a “grand opening” at a store.  The prices are really great that first week and it gets you trained to go to that store.

Another reason drug companies discontinue free samples is that, very often, the insurance companies or government programs may not have them on the “formulary” (the list of available drugs) right away.  As soon as the relevant insurance (mediCal in California) starts paying for them, you can say “Bye-bye” to free samples. Read more on Free Samples Might Carry Heavy Cost — Health…

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Number 5 in the USA Today catalog of medical changes in the past 25 years is (imagine a drum roll playing – and CYMBAL CRASH!) — antidepressants are the most popular drugs. Read more on Antidepressants Are Popular — And Dangerous…

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The first known account of this plant, known by Latin (Carolus Linnaeus) nomenclature “Sceletum tortuosum allegedly dates back to Jan van Riebeeck, Dutch founder of South Africa. He appears, also, to have seen the first recorded comet that passed through that distant place, so we know he was educated enough to be a scientific dilettante at the very least. He has earned, rightfully, a lovely place in the history of South Africa. I am not knocking such status, mind you. I think few people would be clever or concerned enough to be scientific even at dilettante level in our day and age — thinking of even the cleverest of politicians. I am somewhat more concerned about what the South Africans seem to be excited about. Read more on African Drug Being Developed For Antidepressant…

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I could not believe it when the patient asked me about ketamine.  I had just seen an episode of “House, MD” on one of those cable super-stations the night before and it dealt with this weird drug.  I told my husband about my experiences with it during my surgical career. Then, the next day, this patient brought up the same rare drug. When I looked at him closer, it became believable.  He was old enough — in his sixties — that in the swinging sixties he had surely been one of those “knowledgeable” druggies who pride themselves on knowing all about everything that could give one a buzz.

House, MD

Hugh Laurie as TV's Dr. House

This type of person is a sort of lay-pharmacologist — someone who knows not only how each drug made someone feel, but sometimes even about class of drug and mechanism of action.  Of course, this type of expert would seldom know terribly much about what the FDA thought or felt about these drugs. “I heard it works pretty well and faster than anything on depression,” he said, “and I am kind of depressed and the standard antidepressants, the crap like Prozac and Zoloft aren’t worth taking and don’t do anything.  But they say that stuff works fast on depression.”

Yes, he knew his stuff so well that he may even have read some kind of FDA reports or something. Still, ketamine is not the kind of thing you can dish out in a county clinic in Noplace, California.  If you want something exotic, try a university psychiatry or pharmacology department, or call or email the National Institutes of Health.  I could offer the standard stuff, but not ketamine.  Not me, not there.

Read more on Cure Your depression? Take a Trip, Man!…

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