Primary care doctors as well as psychiatrists give out antidepressants more than other kinds of medicine.

At the time I started training in psychiatry, we memorized the antidepressant side effects for early chemical classes derived from antituberculosis drugs and became overjoyed when the SSRIs came out.  Actually something safe and effective and pretty “clean” of risks and side effects and interactions!  First Prozac, which was FDA approved a day I was getting off call and grabbing a few hours of shuteye to be awakened by the morning news proclaiming that the new “safe” antidepressant would be a “wonderful advancement for psychiatry.” Read more on …


I remember my respected psychopharmacology preceptor always had a pile of a bit out of date copies of the Wall Street Journal sitting around the house.  I asked him why — about the third time I saw them sitting around his living room. He explained to me then it was the thing you really had to read to know what was going on in the pharmaceutical industry.

I remember I rolled my eyes heaven ward.  I was too busy memorizing molecular structures and trying to understand potential mechanisms of drug-drug interactions. I still do a bunch of that sort of thing.  I do it more quickly than I did at that time, but I still do it.  Oh, I will find on line pretty much anything I can in “Newsfeeds” and such, but it is more to condemn than to follow these days, from what I know and can see. Basically, my problem is that they seem to keep making better sounding drugs.  But from what I read, I don’t usually see them as a clear CLINICAL improvement over what I have seen in the past. In other words, I don’t think they are making people “more better” in terms of having more efficacy or less side effects or such.  I just can’t find it in statistics in general, and sometimes even wonder if statistics are not a tad “Gerrymandered.”

Read more on How They Plan To Sell Even More Drugs Next…

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I was poking around, looking for what is brewing in psychopharmacology; a field I am no longer particularly proud I spent a lot of time studying and working in.  Strange, or maybe not so strange, that I’ve met both of the principals allegedly involved in this pharmacological ghostwriting scandal.

Ghost WriterI saw Dr. Schatzberg when he led various sessions at a large professional meeting on the coast.  My main memory of him is that he looked tired, maybe even a bit depressed.  I was told I had to write a lot of articles and do a lot of research projects, so maybe someday when I grew up I could do this kind of work.  I was told, often and a lot, that I had plenty enough neurons, so it would only take work, and a lot of it.  Dr. Nemeroff actually came to Kansas between visits to the coasts.  He was friends with my preceptor in psychopharmacology.  He came to speak at our grand rounds, where we were awe struck by the large amount of patients seen, as well as the large amount of numbers and lovely statistics.

Read more on Who Knows Who Writes This Stuff?…

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I enjoy having friends, like just about everyone does. But that’s not why I’m in this business. When a patient needs help, I will do my best for them every single time.  And if a few colleagues get bruised egos along the way, so be it.

She was a 53-year-old woman, but I don’t think she even would have liked to hear me to refer to her as a woman.  We’re talking about someone who was short and stout and wore the kind of cap one would expect to see on a newsboy during World War I.  She wore a very male looking zipper jacket, and told me she had the name of the other woman to whom she had dedicated her life tattooed on the back of her neck.

Regardless of all this, her face was red and she was crying. She told me she was chronically suicidal and never thought about anything else.  Despite being medicated, her depression seemed to have gotten worse. Read more on What is there to Treat?…


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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If there is one time to get scared, it is when  a drug company, a government agency, a popular magazine article or – heaven forbid – your doctor says a metabolite is “better” than the drug it came from.

A metabolite is the substance that is left after the body breaks down (metabolizes) a medication.
Everyone in this picture know that oxycontin — read “morphine” — has lots of addiction-type problems.  Synthesized by the Germans in 1914, it has been around for quite a while, although not terribly commercially exploited until the folks at Endo Pharmaceutical started pushing it. Read more on Pain Killers Can Be A Prescription For Disaster…

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“I wants me some of them-there antidepressant pills.”

He was a 47 year old good old boy of the sort I had treated in Oklahoma and other rural parts west –a real cowboy. He had herded animals and done the rodeo and all of that.

No, he had never seen a psychiatrist before, ever.  He had been out crying on the front porch, and it was a next door neighbor who had somehow convinced him that there were medications and he did not have to tell his whole life story to get pills. Well, maybe that would work with a general practitioner, but he was not only disappointed but also angry that it was plainly NOT going to work with me. Figuring he had been had, he broke down and told me the story.  I could understand at once why he had been reluctant to get into this, for we went through half a box of Kleenex while he gave me a plot that was worthy of a tear-jerky country song. Read more on A Cowboy’s Lesson — Antidepressants Won’t Work Well With Alcohol…


People may look at the complex before they look at the obvious — which is a faster answer and closer to the truth. I happened to be talking and I found three more yesterday. Women.  Young, intelligent, and attractive women, who did not have and did not want boyfriends. All three were part of the mental health treatment establishment.

Men losing interest

Men are losing interest in sex

The first time I discovered one of those was some years ago, a few cities ago, and she was a very clever and very talented psychiatric nurse.  She loved her profession, and took good care of people.  She loved nature and animals and plants.  I believe her to have been quite attractive.  She had been turning down dates because she would rather go to her gardening clubs or whatever.

She had also said, without tears or depression, that she expected she would always be alone, would move into the home for old nurses when she was old enough, and die there. She had been on Prozac for about three years. There were a few problems with this. First, nobody had ever talked to her about getting OFF Prozac.  They said she might as well stay on it, since life was that good.

Actually, I have looked at data for depressed folks of varying ages. Sure, there is a risk of side effects, but nobody seems to care.  I cannot remember, off the top of my head, seeing data about the recurrence of depression that suggested anybody needed to stay on antidepressants permanently.

Certainly, nobody under, say, 55 or so.  And she was plenty under.  I mean, there are things you can do to lessen the chance of recurrent depression — psychotherapy, even reading books. And there is the whole question of getting someone off SSRIs.  I have had patients who claim it is impossible.  I’ve had people come to me because the withdrawal effects were horrendous.  Yet I have taken people off easily and (reasonably) quickly with natural substance regimens. It’s not impossible – you just have to know how.

That eliminates many of my colleagues.  Or perhaps they keep their patients on prescription drugs to insure their return and a steady cash-flow.  Naw – doctors wouldn’t do THAT!

There is another problem.  There are drug side effects we know little about or may find hard to measure.  I remember from my days doing clinical trials that at one time, shortly before I left the business, someone adopted a “uniform” side effect reporting system. The trouble with that was trying to fill in the blanks for the questions on the form when the patient is saying things that do not fit in the blanks.

Every one of these mental health professional women had been put on Prozac when it came out, because of the safety and efficacy.  I remember, collecting data, one of the first people I gave Prozac to during clinical trials before that drug was on the market.  She told me that she “felt like a zombie” and that she missed having the full amplitude of emotional expression.  She missed crying at the movies, something she had genuinely enjoyed.  Said she had a feeling of euphoria afterwards — a feeling of euphoria she really enjoyed. Try fitting that one on a uniform side-effects reporting system.

The three women I met yesterday are unlikely to get off their Prozac. They stood in wide-eyed disbelief of my assertions.  Of course, they had just met me and know little about who I really am.  Besides, people seem to have trouble taking advice for which they aren’t paying.  I just reminded them as I remind patients that taking any medication is a choice, and reporting what is going on to a doctor is always a good idea.

If any of these intelligent and well-insured women had gone to a therapist, they could have ended up with some kind of verbally analytic procedure, which obviously would not help.  Or maybe they would be referred for some hormone supplementation, which has biologic risks of its own.  Big ones, like — cancer.

Worse yet, I’ve met two psychiatrists in my 30 years of practice who gave everybody electric shock treatment. Everybody! The first person in whom I suspected a real lack of sex interest had changed her life — the psychiatric nurse — did finally get off her Prozac. If she had any recurrent depression problems, I do not know about them.

She had a date within two weeks, and last I heard, was dating many interesting men, looking for a best boyfriend.

I am convinced that we are looking at a Prozac side effect that the system has made it impossible to measure.  We probably have at least a little of the same side effect with similar drugs in the same class – such as Paxil and Zoloft.  Maybe others, too.

The psychiatric nurse easily agreed her general quality of life had been diminished while she was on Prozac.  She was too undepressed to notice.  When she got off the drug, she suddenly noticed.

Getting a drug past the FDA takes some studies on how it gets into the body and the like.  Nobody ever seems very worried about getting off a psychiatric drug.  That’s been the focus of my private practice for at least the past five or six years.

For the individual, the effect is pretty evident even though I only have one clear cut example. What about the species?  Is this just one of several steps driving humans to …. extinction? People change as time passes.  What affected you in the past may have gone away – as many illnesses seem to do.

Spending your lifetime on a drug when you no longer need it is tragic.  Or having your quality of life changed because of the way a drug reacts in your body – instead of seeking alternatives to control your problems.

I think it is worthwhile for anybody on a psychotropic drug to ask how their life has changed since they have been on a prescription medicine. We researchers have been limited to collecting information on side effects that the FDA and/or drug companies “let” us.

So don’t look toward the government or the drug companies for help.

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He looked more like the romantic hero from the era of Lord Byron than a psychiatric patient – he wore his hair longer than today’s style and he obviously pumped iron.  Indeed, I found out that working out was an important part of his life.

He was 28, and he had just been released from a two day stay at hospital and his medication was standard fare — Zoloft (sertraline) antidepressant.

I had no clue why he had to be seen by me on an emergency basis. It turned out he had been admitted to the hospital because he was uncomfortable about his roommate’s anger.  He had been concerned he might get “attacked.” I had no way of telling whether the roommate had an actual history of this sort of behavior or if this was delusional.  But the roommate was not the patient before me. “Just give me klonopin,” Lord Byron said. “Everybody else does.” Read more on Fixing The Problem Is Much Better Than Taking Addictive Drugs…

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