Droogs...

[denny]

From a friend's journal, thought it might interest some:

"DR JOANNA MONCRIEFF believes that psychiatric drugs are overused, often ineffective and is critical of the idea that they correct chemical imbalances in the brain. She talks about how drug companies can influence scientific data and the contested issue of mental illness and what it means. Joanna Moncrieff is taking part in the debate From Bad to Worse: the Worst Ideas on the Mind on 18 July at King's College London. Tickets can be booked online or by calling the Royal Institution on 020 7409 2992."

http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10%2E1371%2Fjournal%2Epmed%2E0030240


(couldn't resist the urge to use my shiny new icon for this post - original image courtesy of avalon_bliss's party-making powerz and libellum's pic-taking skillz)

Comments

[azekeil.livejournal.com]

Separated at birth? Here's one of synthclarion's:

[dennyd.livejournal.com]

Yes, I did think of that when I saw it :)

[dpash.livejournal.com]

I was reading something the other day about how SSRIs are being used for everything from depression to panic disorder to eating disorders and OCD. I don't know enough to decide if this is the mental equivelent of anti-biotics or not. *fears a drug resistance strain of super depression*

I know my girlfriend was prescribed several different anti-depressants for her panic disorder and OCD.

[dennyd.livejournal.com]

An ex-gf went to see her doctor about having trouble sleeping, back when the states had just banned Prozac. Guess what she got offered to help her sleep better? I guess it must have been cheap wholesale that month.

[bluecassandra.livejournal.com]

Could have been worse, i get lots of people who go to their gp saying nytol doesnt work that promptly get offered Valium.

GP's only have about 6 weeks training in mental stuff, and many of them hate it, so it's not really suprising that they try and prescribe whatefer they hear the most about, in exactly tha same way that you don't get the best advice about which of the zillion methods of birth control would be the best for you from the GP.

[reddragdiva]

Various SSRIs at various doses do in fact work on each of these things. It helps to keep in mind that "SSRI" describes an effect; the actual chemicals are vastly different.

A strain of super-depression will not evolve because depression is not caused by an infectious agent; antibiotics act against bacteria, which are an infectious agent susceptible to evolution. Possibly they will lead to otherwise-depression-prone people reproducing when they wouldn't, but that would be a much slower effect.

[dpash.livejournal.com]

A strain of super-depression will not evolve because depression is not caused by an infectious agent; antibiotics act against bacteria, which are an infectious agent susceptible to evolution. Possibly they will lead to otherwise-depression-prone people reproducing when they wouldn't, but that would be a much slower effect.

Can I introduce you to irony?

[reddragdiva]

My apologies for not detecting irony in what appeared to be quite plausible stupidity.

[dpash.livejournal.com]

I was aiming for non-plausible stupidity. :)

[reddragdiva]

You have been lucky enough not to encounter sufficient stupid. I prefer to err on the side of taking things seriously in SSRI discussion because there's so much FUD and rubbish talked about them. (They're neither Satan nor panacea, and need care and thought like any other dangerous medicine.)

[dpash.livejournal.com]

The Internet: Where the stupid people are :)

[bluecassandra.livejournal.com]

There is some evidence in favour of using SSRI's in OCD and ED's (specifically fluoxetine/prozac), and bear in mind that those two have alot in common. Also, these can be comorbid with depression. Of course, both take a long time and can be very expensive to treat (min 20 sessions of CBT for OCD), so there is a vested interest in trying to find a pill to stop them :)

[dpash.livejournal.com]

My understanding is that we could be waiting 12 months for CBT sessions, so yes I can understand why they might want to find a pharmaceutical solution to the problem.

[bluecassandra.livejournal.com]

Ha, yes. This is likely to get worse because despite saying they want to provide more CBT, they have just cut the training places for the people who most often provide it - clinical psychologists.

Mind you, I've seen some OT's do it. Really badly. The way they teach us not to.

[reddragdiva]

Tra la la!

Moncrieff touted by Scientology.

From here: 'Moncrieff, a lecturer at the University College London and co-chair of the Critical Psychiatry Network, describes depression as a condition that "should be dealt with without drugs, because it's something people need to learn to deal with themselves."' She's from a group that questions the existence of depression at all, hence her attacks on SSRIs. See also here.

So I would take what she says with at least a few pinches of salt ...

[kaet.livejournal.com]

As I understand it, though she's supported by scientologists and I don't think that's really her fault or negates her argument. I'm not sure that questioning the effectiveness of anti-depressants is necessarily a damning indicment, either. I hope that such things aren't dogma, either.

I'm sure she has an extreme position, but I certainly think that she has points which are worth people considering. When I was having problems with depression, I found SSRIs helped, but the "chemical imbalance" thing meant that people that were causing much of the trouble carried on acting in exacly the same way and they had no problems with that, because depression was entirely a barin-physical problem of the sufferer, not of any of the bastards getting you down.

[reddragdiva]

It sounds like they'd have been a problem either way and the most cheering thing to do would be to drop a piano on them from the top of a tall building.

There isn't a clear separation of mind and brain. A useful way of thinking of psychiatric drugs is as a crutch, splint or prosthesis. You can use the SSRI to help your brain work a bit so you can fix whatever's causing the depression; if nothing in particular is actually identifiable that's dragging you down, you can keep using them and be much more functional than you would be without them. They're medicine, not candy or panacea. Use with caution, knowledge and forethought. Etc. Etc.

[dennyd.livejournal.com]

A useful way of thinking of psychiatric drugs is as a crutch, splint or prosthesis.

That's an interesting approach. Following that up, there would seem to be a much more pronounced tendency amongst people prescribed SSRIs to keep using them for long periods (compared to people issued with crutches for broken legs, who tend to get off them within a few weeks or months). Do you think this is because the drugs support something which requires longer to heal, or because they make people think the problem is 'fixed' and doesn't require further attention as long as the pills keep coming, or because [ insert insightful alternative here ] ?

[hythloday.livejournal.com]

I think that at least a part of it is that there isn't a "cripple" stigma attached to anyone using SSRIs. Possibly that's another way of stating your second suggestion?

[reddragdiva]

"I think that at least a part of it is that there isn't a "cripple" stigma attached to anyone using SSRIs."

I think there is, or something worse than "cripple." But also that it's not externally visible.

[hythloday.livejournal.com]

Yes, hence my (careful) use of the word stigma, "a mark".

[reddragdiva]

True :-)

[reddragdiva]

Takes longer to heal and counselling help is not so easy to get from the NHS, I'd say. Also, the pills can work on an otherwise passive patient; actually fixing the problems requires an active patient, which doesn't fit in well with (a) a passive patient medical model (b) people used to being consumers and acting like it. Just off the top of my head.

[kaet.livejournal.com]

In some ways the separation of the mind and the brain to the extent that anything else does, in that they are distinguished by people from each other and their context. I think in general it's more than nasty individuals. Some people might find something like, I dunno, not being able to afford a house leads to problems that in some people leads to depression (I tried to choose one that isn't one of my own triggers, so sorry if the example is a bit weird and stupid). In situations like that is it appropriate to say "thse people have something wrong with them, they need a splint, crutch, etc", or do you say we shouldn't hurt these people, we need a level playing field, like an access issue. Why should people who (say) buy-to-let and force up prices not be medicated with psychiatric drugs to be less greedy?

[dennyd.livejournal.com]

Why should people who (say) buy-to-let and force up prices not be medicated with psychiatric drugs to be less greedy?

*glee* I'm going to forward that to my dad :)

[kaet.livejournal.com]

In some ways the separation of the mind and the brain to the extent that anything else does,


Okay, verb gone walkies. Put an "exists" or an "is" in there, :). Thx.

[bluecassandra.livejournal.com]

"A useful way of thinking of psychiatric drugs is as a crutch, splint or prosthesis"
Oddly enough I describe them to clients in just such a waym, which massively helps to remove the stigma.
Recently though I've been finding them less than helpful; the sedative style effects seems to be making various clients a little disconnected from feelings and occasionally thoughts, which isn't productive for any of the three major models for counselling.

What you can't see about this psychiatrists stance on here that I found quite interesting is that she isn't someone who goes, bah to antidepressants lets give everyone CBT, she's actually interested in the socio political world that gives rise to increasing rates of depression, which seems pretty radical for a psychiatrist.