you know he just had a child, a biological child with a friend of his, right?

Clay Aiken recently had a son. I guess his "guys" are fine.

I have been criticized for discounting the adverse outcomes of psychotropic medications and for emphasizing their benefits.

Fair enough. But should there be a double standard in the opposite direction where people mock those who find benefit from the medications without adverse effects?

Where's the outrage here about that?

This "American Idol" thing is on Sony Channel here in Brazil.
Never saw it and I've just watched Clay's photo and don't know him.
He's the "pretty face - David Cassidy-Partridge Family" style and I don't like men like this. Even when I was a teenager I could not stand David Cassidy. If I had to choose between him and Charles Bronson guess who? LOL

But my dear Clay!
Are you joining Delta Burke's club and promoting Paxil! Does Delta Burke still claims she takes Effexor?
Cope with anxiety? Wrong drug pall!
Take a diazepam please!

Ana:

Benzodiazepines are helpful if they will be used on an as needed basis for less than six months and in low dosages. Otherwise, there is a significant risk of becoming dependent upon them, requiring higher and higher doses for a therapeutic effect.

With all their drawbacks, SSRI's and SNRI's are the way to go if he does have a legitimate anxiety disorder.

dguller,
there are lots of alternatives to meds for anxiety disorders....SSRI"s are the way to go if you choose not to look at therapeutic interventions that don't involve medication...

SSRI's are the way to go if you are a psychiatrist who only believes in the prescription pad.

and I'll have you know SSRI's make some people's anxiety EXPLODE!! Really out of control explode...what then dear Dr?

Learning coping behaviors will work for a lifetime...SSRI's rarely work for more than a few years.

Ana:

Just to clarify my response. I never meant to imply that evidence-based psychotherapy should not be part of the treatment plan for people with anxiety disorders. For some, like panic disorder, the best practice involves a combination of medications and cognitive-behavioral therapy.

I was just trying to clarify which medications would be best to use, benzo's or SSRI's/SNRI's.

Sorry about the confusion.

Dear dguller,
You're advising a person who:
- has been on therapy for 20 years;
- take Effexor Rivotril and Seroquel because of a misdiagnose and impossibility to quit due to withdrawal problems;

The experience of many, many, many psych drugs are under my skin.
Please! Don't lecture me on this.
SSRIs or SNRIs has already been proven...
No, no, no...
Here is your answer:

"dguller,
there are lots of alternatives to meds for anxiety disorders....SSRI"s are the way to go if you choose not to look at therapeutic interventions that don't involve medication...

SSRI's are the way to go if you are a psychiatrist who only believes in the prescription pad.

and I'll have you know SSRI's make some people's anxiety EXPLODE!! Really out of control explode...what then dear Dr?

Learning coping behaviors will work for a lifetime...SSRI's rarely work for more than a few years.

Posted by Gianna at September 25, 2008 10:57 AM"

Medicate on hypothesis has already destroyed many lives.
Mine included.
I've already seen many patients with major depression changing one SSRI to another and ended up on ECT.

But I'm fine! I was lucky if compared with people who has PSSD, cognitive impairments, hallucinations and many other problems after quitting some off these drugs.
I've just lost some years of my life coping with withdrawal and side effects that led me to stop working and finally bankruptcy.

Are you a psychiatrist?

You must have learned from your clinical experienced hearing your patients.

How many times will we have to repeat it over and over again?
How many times will we have to repeat it over and over again?
How many times will we have......................

"But should there be a double standard in the opposite direction where people mock those who find benefit from the medications without adverse effects?"

LOL

I've read it now.
Are you kidding me?
NO ADVERSE EFFECTS?

This is a joke.
TherapyFirst is making school.

Please, don't do it.
Play FAIR!
You're making a mockery of others people sufferings.
This is the last time I will address any comment to you dguller.
I don't feed trolls.

Ana:

I think I misunderstood you.

I thought that in response to Clay Aiken's use of Paxil, you were saying that people with anxiety disorders should use Diazepam instead. I just wanted to clarify that the latest guidelines said otherwise, and actually prefer SSRI's/SNRI's and cognitive-behavioral therapy, and that long-term use of benzodiazepines could lead to substance dependence (that can be far worse than SSRI discontinuation syndromes).

I'm not too sure how that mocks other people's suffering, but I would appreciate you sharing your thoughts.

Also, you claim to have quoted me in your post @1:28 pm, but quoted Gianna's post @10:57 am. You did not quote me at all. I'm not sure if you were aware of that.

Finally, no matter what you may believe, the fact is that most patients on antidepressents do not experience significant side effects. I ask my patients at every visit if they are experiencing any -- and I go through a list of symptoms -- and the vast majority either say they have none or they are minimal in nature.

I feel terrible that you are one of those who do, and I wish you nothing but the best in slowly weaning yourself off your medications if they are not helpful.

However, I would hope that you are not arguing that if a treatment causes significant distress in any proportion of patients, then that treatment should be discontinued immediately. Is that your argument?

Thank you for your time.

she was quoting me because she agreed with me dguller...

Gianna,
I've really quoted YOU because I agree with YOU.
I will not answer any comment that are just teasing.
For me it's useless to discuss with people who deny data that are already common knowledge and distort what I say by pretending not to understand what is written. This is unethical and a manipulative way of conducting a good discussion.
We will end up with a topic full of comments but with useless information.

"and a manipulative way of conducting a good discussion."
I meant: "a manipulative way of conducting NO good discussion."

Ana:

So now I'm teasing you? Why? Because I disagree with you and provide an alternative viewpoint?

I'm denying data? What data? The only data that's been presented to me are websites that contain anecdotal data about individuals who have had severe withdrawal effects and abnormal behaviour, and some books by Peter Beggin.

When I present evidence that comes from peer-reviewed journals, I get criticized because apparently everyone in research is a drug company shill and there is a grand conspiracy that is manipulating the medical public.

What I deny is that psychotropic medications cause severe side effects in the vast majority of people and that their therapeutic efficacy is just people being unable to tolerate withdrawal effects.

I distorted what you're saying? Other than misunderstanding when you said "your answer is", what else have I distorted?

You call me "manipulative", "unethical" and "useless"? You're certainly entitled to your opinion, and I suppose you are probably right for us to discontinue our discussion, because I do not respond to insults and you do not respond to arguments and reason.

I still wish you well on your journey to discontinue your medications, and I hope you have a long and fruitful life.

Honestly, aren't we kicking the closet door back in the face of a guy trying to come out?

(Not that we didn't already know he was gay, of course ...)

Dguller,

What is the list of symptoms that you go through with people on SSRIs & SNRIs?

Could you write us the list.

I am curious if you ask questions like these.

1. Are you currently shop lifting from your local grocery or retail store?

2. Have you written to all your friends and pointed out their faults and their failures?

3. Have you secretly started an affair with the corner gas station attendant [asked of a woman] or have you started an affair with the gas meter lady [asked of a man]?

4. Are you currently suing anyone?

5. Have you taken up gambling as a habit but don't tell anyone, especially your spouse?

6. Has your drinking of alcohol increased but you are trying to hide it from friends & relatives?

7. Were you prudent with finances before starting an SSRI or SNRI but now you have maxed out all your credit cards?

8. Do you have homicidal thoughts or nightmares in which you are commiting a homicide?

9. Do you have periods of amnesia or confusion where you don't know what you are doing?

10. Were you pretty thick skinned before starting an SSRI or SNRI but now feel a lot of "rejection sensitivity".

11. Do you think about running away from home?

12. Are you secretly planning to divorce your spouse?

13. Do you act so "goofy" at work that you are in danger of being fired?

14. Do you, who previously were quite restrained, now swear & cuss enough to make a sailor blush?

15. Do your friends say you are acting bizarrely?

These are the kinds of questions that should be asked because they are the ones most often reported to the Prozac Survivors Support Group during the 1990's.

Also, www.SSRIstories.com now has a list of over 2,600 criminal or suicidal acts perpetrated by people on SSRIs or SNRIs. These are acts that have been confirmed by media articles. Besides these 2,600+ cases, there are 52 Journal Articles. One of these shows in a research trial that unmedicated anxious people have 8 times higher levels of serotonin than the average person. Perhaps this is why the FDA put out the General Warning on March 22, 2004 regarding anxiety, panic attacks, hostility, etc.

Do you ask your patients on SSRIs & SNRIs if they are feeling hostile?

Just wondering because when I talked to these people in the 1990's through the Prozac Survivors Support Group, when they would tell me these revelations, I would say, "Did you tell your doctor". There answer was always "NO". They were too embarrased to tell their doctor, besides which they didn't realize it was the SSRI causing this behavior. Only in retrospect did they realize it.

So maybe you should ask these questions. Right?

Larry,
Yes, you're right. Thank you for reminding the hard process of coming out.

Rosie,
Congratulations on SSRIStories. You're doing a very important job.
On November, 2007 I've wrote to ssristories and asked about Brazilian data.
You answered me and I've put our e-mail exchange on my blog.
http://justana-justana.blogspot.com/2008/08/trying-to-raise-brazilian-data-on.html
Unfortunately things are the same.
Thank you for the hard job.

Clay Aiken is a star, once a person is a star, people can and do make fun of him/her. I don't know why, but thats how it is.
I believe Clay is attributing magical properties to a legal chemical molecule, rather than an illegal one such as cocaine.

and Dguller is delusional re:asking if people are having any problems on medications.
1 people are nervous and intimidated with their Dr.
2 If having symptoms, how can the patient attribute them to the medication VS MENTAL ILLNESS?
3 What symptoms are you refering to? Do you ask specific questions of a side effect?

Rosie:

No, I do not ask all those questions, but I do ask:

-- Have you or anyone noticed you acting out of character?
-- Have you been having headaches, muscle pains, dizziness, tremors or confusion?
-- Have you had any nausea, vomiting or diarrhea?
-- Have you had any electric shock-like sensations?
-- Have you had any restlessness, agitation or panic?
-- Have you noticed a change in suicidal or homicidal thinking?
-- Have you noticed anything else since we last met?

I also emphasize with my patients that we work in collaboration to get them well and that it is important for them to share information with me. I think that good rapport is absolutely essential to all aspects of medical care, but especially in psychiatry where people have negative stigmas about having mental illness.

Regarding the over 2,600 cases, I think that it would be very informative to have someone go through all those records and notice the people's psychological frame of mind before the medications, what other medications they were on, what dosages they were on, whether they were abusing street drugs and alcohol, what their family history was, what their age and sex were, what other medical conditions they had, how compliant they were with their medications (i.e. taking too little or too much), the timeline of their symptoms, any psychosocial stressors present, any history of trauma and abuse, and so on. I think that would be far more useful than vague anecdotes to differentiate those cases that genuinely can be blamed on the medications -- and there certainly are too many -- and those that had other factors involved.

Just as an example, I was cited the example of Jeff Reardon as someone who's life was ruined by antidepressants when he robbed a store. It turned out that he was suffering from major depression and was suicidal two years before starting the medications, and was also prescribed half a dozen other medications after a surgery, which led to a state of delirium. After getting ECT he recovered. All I was initially told was that he was on six psychotropic medications and became psychotic, but when the whole picture is included, the problem isn't antidepressants per se, but polypharmacy without adequate follow-up.

In other words, one must have all the information before making a knowledgeable conclusion. People here are justifiably outraged by the drug companies not disclosing all information. I am equally outraged by people who selectively present cases without including all the data, because it can persuade people that these medications have a higher rate of adverse effects than they actually do.

thank you for your time.

"In other words, one must have all the information before making a knowledgeable conclusion."

It's good to know that physicians still do anamnesis.
Thank YOU for the information dguller.

Ana:

I don't know any physician that adheres to Plato's theory of anamnesis (i.e. our souls are immortal and have innate knowledge of the Forms that we must struggle to remember in this world with the help of "midwives", such as Socrates).

Perhaps I am misunderstanding you again?

Why the sarcasm? I assume that you are not against including all possible information before making any tentative conclusions. Am I wrong? Should we only include data that we personally like and ignore the rest? Is such a selective procedure appropriate for knowledge acquisition?

Thank you for your time.

I'm neither being sarcastic or referring to Plato's.

"Medical history
From Wikipedia, the free encyclopedia
Jump to: navigation, search
For another possible meaning of this term see History of medicine.

The medical history or anamnesis[1][2] of a
patient is information gained by a physician or other healthcare professional by asking specific questions, either of the patient or of other people who know the person and can give suitable information (in this case, it is sometimes called heteroanamnesis), with the aim of obtaining information useful in formulating a diagnosis and providing medical care to the patient. The medically relevant complaints reported by the patient or others familiar with the patient are referred to as symptoms, in contrast with clinical signs, which are ascertained by direct examination on the part of medical personnel. Most health encounters will result in some form of history being taken. Medical histories vary in their depth and focus. For example an ambulance paramedic would typically limit their history to important details such as name, history of presenting complaint, allergies etc. In contrast, a psychiatric history is frequently lengthy and in depth as many details about the patients life are relevant to formulating a management plan for a psychiatric illness.

The information obtained in this way, together with clinical examination, enables the physician to form a diagnosis and treatment plan. If a diagnosis cannot be made then a provisional diagnosis may be formulated, and other possibilities (the differential diagnoses) may be added, by convention listed in order of likelihood. The treatment plan may then include further investigations with the purpose of clarifying the diagnosis."

http://en.wikipedia.org/wiki/Medical_history

"The reliability of the psychiatric anamnesis.
Eastwood MR, Ross HE.

Related Articles

* Structured psychiatric interview: psychiatric history and assessment of the mental state. [Br J Hosp Med. 1994]
* How psychiatric disorders are missed during medical consultations. [Lancet. 1987]
* [Anamnesis technic for integrated determination of mental and somatic findings for nonpsychiatrists] [Med Welt. 1972]
* [Procedure for the standardization of psychopathological findings] [Psychiatr Clin (Basel). 1972]
* Impact of a patient history interview on psychiatric diagnosis. [Arch Gen Psychiatry. 1971]
* » See all Related Articles...

http://www.ncbi.nlm.nih.gov/pubmed/4836158

There are many links explaining the meaning of anamnesis.
I'm amazed that a physician don't know this term.

Ana:

I truly didn't know that term, nor have I ever heard it used.

In my profession, we simply call it "history taking". There are enough fancy words to remember in medicine that I suppose I'm glad that we've simplified one thing. :)

Thanks for the historical sidenote. :)

Where's the love for depressed, gay, pop stars who wish to procreate? :)

Why is this man's private life a topic anyhow?