tag:blogger.com,1999:blog-26666124.post8585699529272529651..comments2024-03-18T03:28:36.581-04:00Comments on Shrink Rap: This Medicine Might Kill You, But....Unknownnoreply@blogger.comBlogger36125tag:blogger.com,1999:blog-26666124.post-16018880130386519332011-11-23T18:33:07.210-05:002011-11-23T18:33:07.210-05:00I also wish the issue of adverse effects were sepa...I also wish the issue of adverse effects were separated from the question of extreme antipsychiatry.<br /><br />An issue addressed by neither the original post nor by comments: when patient considers possible adverse effects, perhaps in light of prior experience, and says, no more. No more drugs. I said that and experienced a fair amount of abuse in response. One psychiatrist laughed in response. Another announced that I must have a PTSD. It was this lack of respect, together with permanent damage (tinnitus from Wellbutrin, about which psychiatrists are in general ignorant) that caused me to run from psychiatry in toto. <br /><br />And no, I never saw an informed consent form. Never.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-73762495976778443392011-09-18T10:44:43.358-04:002011-09-18T10:44:43.358-04:00I respect a doctor more if she/he takes the time a...I respect a doctor more if she/he takes the time and shows enough respect for me to warn me about the side effects.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-6472194778526407982011-01-30T15:15:27.691-05:002011-01-30T15:15:27.691-05:00That's the whole point, Moviedoc, there was no...That's the whole point, Moviedoc, there was no informed consent. I don't think it's unreasonable to expect that when someone is prescribed a 5 drug combo that there's data out there on the benefits/risks of that combo or that patients are at least informed that there have not been clinical trials to study the risks/benefits. I wish I had known this prior to taking the coctails as my expectations would have been much lower, and I would have known what I was getting into. The concerns others raised about the drugs I was on was after I was already pretty drugged, and that's a little late at that point. <br /><br />It's true many people are willing to gamble when they're suffering, but that's not a universal truth and shouldn't be assumed. People who have no other options routinely turn down clinical trials because the data isn't there and they determine it's not worth it. Others choose to try it and thank goodness or we would never have any drugs approved. In those cases, however, people understand what they're getting into. I had a relative who was offered a clinical trial and I saw the informed consent document - it was quite long and he and everyone else understood the gamble. The physician also clearly discussed the risks/benefits. That's the way it should be. I wish my physician had done the same.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-62432443878118023942011-01-30T13:55:59.707-05:002011-01-30T13:55:59.707-05:00Nothing will lessen the need for informed consent,...Nothing will lessen the need for informed consent, but lack of good data will lessen its accuracy. When you're really suffering, you're quite willing to gamble. (I'm sitting here with a pinched nerve in my neck wondering if it's time to consider surgery or a steroid injection.) Who wouldn't be upset at a bad outcome, but if you made the choice with adequate information, don't blame the doctor. If only we could predict who will have which adverse effect.moviedochttps://www.blogger.com/profile/03617061594621924756noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-9678355116196904872011-01-30T13:48:24.088-05:002011-01-30T13:48:24.088-05:00Ok, I can appreciate that there is no funding to p...Ok, I can appreciate that there is no funding to pay for studying these drug cocktails (although considering some of the goofy studies people get grants for it looks like someone could come up with the money), but does that lessen the need for informed consent? Maybe, if more people realized it was such a gamble they would be a little less upset when it didn't work or they got worse or ended up with some weird side effect. <br /><br />The pharmacist was right to be concerned. He wasn't the only one. My primary care physician, ER doc, and family also expressed similar concerns. I should have paid attention to that, although I was pretty blitzed on all the stuff I was on, so I didn't at the time. <br /><br />I'm not opposed to trying out different things to see if it helps, as long as patients realize what a gamble it is.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-68307514314416972582011-01-29T15:59:49.542-05:002011-01-29T15:59:49.542-05:00Anon: There were no clinical trials of the combina...Anon: There were no clinical trials of the combination because there was no money to pay for them. If you have to choose between paying attention to a pharmacist and paying attention to a psychiatrist, believe me, pay attention to the psychiatrist.moviedochttps://www.blogger.com/profile/03617061594621924756noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-37619902850913966662011-01-29T15:52:34.996-05:002011-01-29T15:52:34.996-05:00I would like for there to be informed consent requ...I would like for there to be informed consent required for some of the off label prescribing. I was on some cocktails that I now understand there was no data on regarding efficacy, risks, etc, and probably the data is still not there. With chemotherapy, my understanding is that if they start mixing even approved drugs together they will often do a clinical trial to study the risks/benefits of using them in conjuction with each other. I wonder why there were no clinical trials to study the cocktails the psychiatrist put me on?<br /><br />I probably didn't question nearly as much as I should have in the beginning and would ask more questions today. Live and learn. A good rule of thumb, if the pharmacist hands you your bag of meds and says, "Good luck," that's probably a clue you should pay attention to.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-4716485392680866522011-01-27T16:38:57.171-05:002011-01-27T16:38:57.171-05:00I'm hopeful that docs are getting better about...I'm hopeful that docs are getting better about warning patients of withdrawals from SSRI. Years ago, i remember seeing it in two friends, who had no idea where their sudden dizziness and "electric shock" sensations were coming from (I recognized it from experience and asked as gently as i could, "Are you on any medicine?") My last two docs did warn me of this, which i take as a good sign.<br /><br />AA: "The issue for me is not informed consent but doctors blowing you off when you report side effects making you out to be an idiot."<br /><br />That reminds me of when i was inpatient, and the shrink had decided i was both bipolar and a liar for refusing to admit to having ever experienced mania (because i haven't). Anyway, my first day on Lamictal, i had some trouble talking and tried to explain it to the doctor (which was difficult, because i couldn't talk right!), and he gave me a Look and flatly said, "Lamictal doesn't cause that." That was not reassuring, because the reason i was scared was that it <i>wasn't</i> on the list of side effects, and therefore i had no idea what was happening or how long it would last. The impression i got was that he either didn't care or, likely, thought i was faking. Luckily whatever it was, it went away by the next day.<br /><br />For the record, i have had shrinks who are wonderful at recognizing the whole risk-benefit thing, particularly how meds affected my ability to do my job (rather than being like, "Just be happy you <i>can</i> work!" which, don't get me wrong, i am!).<br /><br />Sarebear: I agree with you that just a little empathy can help a lot in these situations, and i think it can aid effective communication. For example, if the doc just blows me off, i might wonder if maybe i just didn't explain it right, so maybe there really <i>is</i> some serious issue going on or something the doctor can do, but they just don't understand the situation due to my bad explanation.Snoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-28440258107601126072011-01-26T23:48:15.473-05:002011-01-26T23:48:15.473-05:00This comment has been removed by the author.Sarebearhttps://www.blogger.com/profile/09208596053319110470noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-18301795483697213682011-01-26T21:36:28.706-05:002011-01-26T21:36:28.706-05:00Gone off the meds to shed the pounds they helped m...Gone off the meds to shed the pounds they helped me put on. Not caring much about the repercussions, if any. To the person who mentioned sexual side effects. Not one doc ever brough this up but I am getting a divorce now because i cannot show my man how pleasure he gives me--none at all since the meds. He wants a responsive woman. Not a medicated zombie. Cool beans.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-45713621599683345092011-01-25T21:06:28.359-05:002011-01-25T21:06:28.359-05:00Hyperlexian Aspie, now I'm wondering if someon...Hyperlexian Aspie, now I'm wondering if someone can have a side effect and not know it, because for so many years it's been THEM, then things look up with ONE, and then you start the heavy meds and NOTHING. Is the NOTHING me, or the meds? I'm used to living this way so I'm resigned to it, but wish I knew what a normal life in that regard felt like. I'll never know if it's me or the meds, and with my history, the doc would never believe me anyway, so there's really no hope, if the meds ARE affecting things. Let's hope they aren't. I dunno which would be better, actually. This is how I have to live so it's just how I have to live.Sarebearhttps://www.blogger.com/profile/09208596053319110470noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-65993663447238790242011-01-25T13:41:07.105-05:002011-01-25T13:41:07.105-05:00i completely understand that people will care more...i completely understand that people will care more about weight gain than the possibility of death when trying a new medicine. if you look at the rates of weight gain as compared to the rates of death, it is quite clear which side effect is more likely.<br /><br />also, the concerns are regarding the <i>quality</i> of a patient's life. a person's quality of life can be greatly reduced by certain side effects (weight gain, or how about anorgasmia?), and that is much more of a valid concern than some slim chance that a person could die. <br /><br />anorgasmia is the side effect i happen to be, errrr, intimately familiar with. it is difficult to even convince a psychiatrist that it is happening beause i am female (and therefore sexual side effects must be blamed on my gender and not on my medicines). but after trying many medicines and suffering the same side effect, i eventually had to choose whether mood stability is worth losing something that profoundly affects my quality of life.<br /><br />i don't expect that psychiatrists will run down a long list of side effects as i believe that patients should be responsible enough to read their own inserts and do some of their own research (please note that i also live in a less-litigious nation than the US), but i DO expect that my concerns will be taken seriously. quality of life is *very* important.manchester fat acceptance https://www.blogger.com/profile/11207482764987668705noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-11824029679838657962011-01-25T07:53:50.480-05:002011-01-25T07:53:50.480-05:00Okay, so I'm somebody who kind of overreacted ...Okay, so I'm somebody who kind of overreacted when I found out about a aide effect. I mean, I never would have consented to take the drug if I had known that it could cause irregular periods. I took Geodon for 6 months and started to think I had hit menopause 5-10 years early. Only then does the doc tell me that the Geodon could cause that. I was at the very end of my fertility and still considering whether or not to try to get pregnant--so the information mattered to me. Different roles the patients and the psychiatrists play--doctor trying to avoid weight gain by offering up a weight-neutral med, and patient just trying to live life while still having some control over her own bleeping body. I say that patients should Google their meds and go to every website they find.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-49752329228270340302011-01-24T23:21:31.198-05:002011-01-24T23:21:31.198-05:00The weight loss effect of Metformin only lasts abo...The weight loss effect of Metformin only lasts about 2-4 weeks...the same amount of time it takes for the horrible diarrhea to go away. I wonder if there's a correlation (not really wondering)? That said, had I been put on Metformin when I was on Risperdol, perhaps I would not be a type II diabetic now! For me the weight gain was minor, but the high blood sugar went unnoticed (pre-black box warning)<br />...Metformin certainly would have helped with THAT issue!Battle Wearyhttps://www.blogger.com/profile/01503957693970441332noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-34504042056777185922011-01-24T17:51:24.594-05:002011-01-24T17:51:24.594-05:00Anon: of course their are other treatments if you ...Anon: of course their are other treatments if you can't take meds. Psycotherapy of course, but also ECT, transcranial magnetic stimulation, vagus nerve stimulation, deep brain stimulation. And with meds less is usually more: There's too much tendency to keep adding meds which usually leads to more adverse effects and confusion over what's doing what.moviedochttps://www.blogger.com/profile/03617061594621924756noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-61649483349393095732011-01-24T05:09:17.936-05:002011-01-24T05:09:17.936-05:00Sarebear, even though I don't have bipolar dis...Sarebear, even though I don't have bipolar disorder, I joined a yahoo groups list for people with with BP who cope without meds. I did it while I was tapering off of my psych med cocktail in the hopes I could pick up some useful tips. I haven't really visited there much for other reasons but you might find it helpful.<br /><br />http://health.groups.yahoo.com/group/ALT-therapies4bipolar/<br /><br />By the way, I am not suggesting you go off meds but perhaps, joining this group could give you some ideas to your problems you hadn't thought of.<br /><br />Dinah, I hear what you're saying. All I can say is what a heck of a choice, to barely exist on meds vs. decompensating.<br /><br />Here is a question for you and other psychiatrists who visit this blog. What about patients who simply can't take meds for various reasons? Then what? <br /><br />Is that the only thing in your tool box? Medicating for side effects often leads to a huge med cocktail to the point where you don't know what med is doing what.<br /><br />And just so people are clear, this isn't about being anti-meds vs. pro-meds. If meds work, great. But for people that they don't, people need to be given other options.<br /><br />Unfortunately, in this day of 15 minute visits, I realize that psychiatrists are in a tough position as they don't exactly have time to research what they might be.<br /><br />But it is obvious that the current method is greatly flawed.<br /><br />AAAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-47281750112444670412011-01-24T03:51:42.052-05:002011-01-24T03:51:42.052-05:00What about the potential negative effects of psych...What about the potential negative effects of psychotherapy? Its easy to rattle off a few common side-effects of medication, but no-one mentions potentially harmful effects of psychotherapy.<br />Re side effects of medication: My psychiatrist told me that because of my personality I notice the side-effects more than most, and refused to believe the symptoms were real.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-4572286478932073472011-01-24T01:58:46.480-05:002011-01-24T01:58:46.480-05:00Since people brought up cancer, several cancer sur...Since people brought up cancer, several cancer survivors who wanted to be more involved in their treatment teamed up with some health professionals to form the Society of Participatory Medicine which you can read about at e-patients.net. I'm trying to expand the base to include more people in mental health so am helping to organizing a special issue of the Journal of Participatory Medicine--the announcement is at http://sites.google.com/site/mentalhealthcfpMarcelahttps://www.blogger.com/profile/15063798529442596178noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-45292702973211335452011-01-23T21:00:16.826-05:002011-01-23T21:00:16.826-05:00Metformin has its own raft of side effects as well...Metformin has its own raft of side effects as well. I've taken it before but not for diabetes nor for the reasons mentioned here. I endured the side effects because after some time they eased up; had they not, it would have been awful.<br /><br />Regardless, I guess if there's no option but a raft of drugs to choose from that all seemingly have one particular side effect of concern to the patient, rather than sort of blow me off, it would have been nice if she'd said, "While I understand your concern about that particular possible side effect, it doesn't happen to everyone, and leaving your mania untreated right now would be of even greater concern to me. We need to get the mania under control, and unfortunately the medications to do that often have unwanted side effects like this."<br /><br />Something like that, maybe shorter since I'm not very brief right now, but something like it would leave me feeling like my concern had been acknowledged, and that I was a part of the process a little bit and not just dismissed or blown off. I guess I just wanted to feel heard (which tends to be one of my core issues, not feeling heard.)<br /><br />Can I live with her not having said the above? Sure. All the other problems we're having set aside, it wouldn't have helped the relationship any to feel blown off or unheard, but it wouldn't have hurt it by a ton either, as many doctors would have done the same.<br /><br />I see your point, Dinah, about being frustrated from the psychiatrist's point of view on this issue. What I suggest to be said above is just one possible way to help make both doc and patient more satisfied with the interaction.Sarebearhttps://www.blogger.com/profile/09208596053319110470noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-42650314900774879692011-01-23T20:23:18.203-05:002011-01-23T20:23:18.203-05:00http://www.montrealgazette.com/technology/Antidepr...http://www.montrealgazette.com/technology/Antidepressants+found+fish/4148501/story.html<br />These poor fish were never told about the side effects but you won't hear them complain.<br /><br />Re: metformin. It is an option.If it was a great option then everyone would get a script for that along with their other meds.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-92163033685486893552011-01-23T19:27:06.792-05:002011-01-23T19:27:06.792-05:00Dinah, apparently a lot of psychiatrists prescribe...Dinah, apparently a lot of psychiatrists prescribe Metformin, a diabetes drug, to counteract wt gain from psych drugs. I don't feel comfortable doing this, but would tell a patient to discuss with their PCP.moviedochttps://www.blogger.com/profile/03617061594621924756noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-24078931650301661362011-01-23T17:38:40.241-05:002011-01-23T17:38:40.241-05:00It's not a matter of minimizing the issue of ...It's not a matter of minimizing the issue of weight gain, or any other side effect for that matter---it's just that it's hard to know who will gain weight before a pill is tried.<br /><br />Sometimes it's frustrating for a doc as well, and what may be seen as being cavalier, uncaring, or dismissive is simply the psychiatrist's helplessness. A patient's been on a zillion meds, maybe been in the hospital, maybe for long periods of time or repeatedly, and life is unlivable with the symptoms of the illness. So they take a medicine and finally something helps. What a huge relief. But the patient gains weight or loses interest in sex or feels tired all the time and stopping the medication isn't really an option (hmmm, last time you were sick it took 2 years to get you better....last time you were sick you got arrested....nothing else has worked this well). And there's nothing to say. I'm sorry this medicine makes you feel lousy and if there was a better medicine that worked for you and didn't do this I would want you on that. But I didn't make the meds, I just prescribe them from a limited and imperfect menu, and these days insurance companies want to limit that menu even more---Dinahhttps://www.blogger.com/profile/09227988351623862689noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-39248976020714687912011-01-23T17:17:19.889-05:002011-01-23T17:17:19.889-05:00The psychiatrist I am seeing (can't call her &...The psychiatrist I am seeing (can't call her "my" anymore as there's trust issues and no I can't leave, or if I did it would be to no care at all; a sharp, on the ball on meds and cruel in other areas doc is better than no care at all) dismissed sort of my concerns about weight gain a few months ago when I asked about these mood stabilizers she was considering for me. She said, "ALL of them cause weight gain." Then she proceeded to figure out which one to put me on, just ignoring my concerns as irrelevant since there's seemingly nothing to be done. It's a matter of weighing the pros and cons, no pun intended, because my mania WILL return if we lower or remove the medication; recently lowering the Risperdal from 1.5mg back down to 1mg definitely proved that to me when certain symptoms of mania came flooding back like wild horses I was trying to control. So she sees it as, either the patient ruins her life, or we put her on meds despite the weight gain issue (if she even thinks about the weight issue, anyway.) So put in those terms, it is more difficult. Especially since the manic behavior that is, well, it feels like I'm being compelled, but I know I'm responsible for my actions, I'm just saying it's strong urges to do some reckless, awful stuff, this manic behavior WOULD wreck my life, as well as, after I did it, I"d likely feel suicidal (not that she knows that last.) So when compared to the potential consequences of not medicating me, the weight gain seems minor, even at my weight, because I could ruin several people's lives and likely become quite suicidal, if I do what the mania leads me to.<br /><br />Yeah, I know I have a brain and can choose not to do stuff. It's like fighting wild horses though with everything I've got, and sometimes, everything I've got doesn't seem like enough . . . <br /><br />I give it everything though. Mania sucks.Sarebearhttps://www.blogger.com/profile/09208596053319110470noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-51038808985737669262011-01-23T16:15:18.311-05:002011-01-23T16:15:18.311-05:00My psychiatrist never once discussed side effects ...My psychiatrist never once discussed side effects of any of the drugs he prescribed unless I specifically brought it up. And, once I did bring it up I couldn't get him to give me a straight answer. It was very frustrating because I wanted to know the risks and I guess he had already decided what was best and felt that I should just do as he said without questioning. I was there for his opinion and for information. But, I wasn't there for him to make the decisions for me.<br /><br />WHen I asked about the risk of memory loss with ECT he went into a rant about scientologists and antipsychiatry groups which told me nothing about the risks which is what I had asked about in the first place. So, I was left to try and sort out the risks on my own without his help. I would have preferred his help in that, but I didn't get it because he just wanted to talk on and on about the antipsychiatry crowd. <br /><br />Weight gain should not be minimized and especially when a patient has made it clear that they aren't willing to accept those risks. My psychiatrist died from heart disease and was morbidly obese. Not sure if the obesity led to the physician's death, but it probably didn't help things. It's not a minor issue.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-88757419663352803812011-01-23T15:09:45.945-05:002011-01-23T15:09:45.945-05:00Moviedoc, you shaved. Xtranormal should be used to...Moviedoc, you shaved. Xtranormal should be used to talk about the Federal Reserve, not drugs unless you are referring to the drugs the folks at the Fed are on, and i am guessing it is not Gabapentin. Crap drug in my opinion anyway.<br />Why do you think patients want to watch vids of their doc rather than wade thru FDA papers? I want the papers, not my doc's interpretation of it and especially not the edited for general audiences version.Anonymousnoreply@blogger.com