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Oh, I dunno...that sounds like a lot of hullabaloo to me.
Questioning Medications
By: Dr. Suzanne LaCombe, September 2007.
Pharmaceuticals have unquestionably improved the mental health of countless people, and have made it easier for many to enter therapy. There's no doubt that medications have a place in psychotherapeutic treatment, at least at the present time.
I also believe however that the increasing medicalization of psychotherapy is at risk of diluting the impact of the therapeutic relationship and its potential for creating change.
Several things seem apparent:
- Clients do not have access to unbiased information about the risks and benefits of medications;
- Substantiation of the needs for meds is overstated and medications are being over-prescribed;
- Research on pharmaceuticals is problematic; and finally,
- The increasing "medicalization" of mental health problems is creating an artificial need for meds that could be better served in other ways.
In particular, I have seen pharmaceuticals promoted with the implication that there were no alternatives.
MyShrink promotes counseling as a practical and effective choice for folks who do not wish to take medications, or who hope to eventually dispense with their meds.
But please understand that the decision to go on (or off) your meds should ONLY be made in consultation with your physician or your health care practitioner. There are side effects for either decision and you should be aware of what to expect and what precautions you need to take.
Can't decide whether to go on medication?
It can't be easy. The decision to take medication treatment is a personal one. No one but you can fully appreciate what particular circumstance or internal distress motivates your decision to use, or not use medications.
While I acknowledge that MyShrink will not accept advertising dollars
from pharmaceutical companies, this policy was designed in part to
balance the over-emphasis on medications by many counseling websites
today.
If you are currently on medication or are planning to begin, please understand that it is not our intention to dissuade you or disparage your decision. You should never feel you have to apologize or explain your need for medication.
I have prepared a short list of links to sites and articles that offer alternative views from that promoted by the pharmaceutical industry. Included in this list are sites that help visitors understand the benefits as well as the side effects of medications. The opinions expressed on all sites are not necessarily those of MyShrink, however.
Dr. Suzanne LaCombe
September 2007.
Do Antidepressants Really Work?
You'll enjoy IronShrink's brief introduction on the question of antidepressant usage. Dr. Shawn Smith aka IronShrink has a flare for pointing out the obvious. (March 9, 2008)
From the Public Library of Science Journal news has reached us that prozac and other similar antidepressants are no more beneficial than a placebo. Why did this result make headlines when other equally compelling reports have not?
Well, apparently, drug companies have only been publishing 10% of their studies. It is now a legal obligation in the UK for them to do so. Therefore, this report includes data from drug companies. An interesting read.
The author, Darian Leader also points to a cozy relationship between CBT and medication research both of which appear to emphasize short-term symptom relief at the cost of a long term solution. (The Guardian, Feb. 27, 2008.)
Psychotherapy: A cost-effective choice over medications?
This article reviews some research on the cost-effectiveness of psychotherapy vs.drug treatment for depression. When you factor in all the costs (ie. side effects, relapse rates, and duration of relief), treating disorders exclusively with drugs is not economically justifiable. (APA Monitor, January, 2000)
Integrating psychotherapy and pharmacotherapy: Myths and the missing link (2006) PDF Form
This is a hard-hitting article on some common distortions in the way research results are reported by the pharmaceutical industry. Authors Jacqueline Sparks, Barry Duncan and Scott Miller review three major studies and expose the "evidenced-based" problems of drug research.
"We recommend that the medical model, as it gains ever more momentum in our field, be questioned for its assumptions, method, and implications. We call for recognition of the fact that psychiatric drug therapy is a profit-driven industry, built on questionable science."
Antidepressant Medications in Children and Adolescents
Looking for unbiased information on pharmaceuticals? Therapeutic Initiatives is a university-based organization that provides objective opinion on "evidence based" drug information to medical practitioners and pharmacists on "rational drug use" (they emphasize it is not "evidence biased" information). This is a revealing report on medication use in young people.
Apparently there are 8 million children in the USA on psychiatric drugs. Here's one of the ways that drug companies lure young people into getting their parents' consent.
For a chuckle, take this short quiz from the UK division of No Free Lunch and find out if you're an addict.
Authors Ray Moynihan (editor of British Medical Journal) and Alan Cassels (pharmaceutical policy researcher of the University of Victoria) expose pharmaceutical advertising tactics in this enlightening article published in The Nation (Oct. 17, 2005).
Dr. Breggin is a hero to many. For decades he has warned the public--and health professionals--of the potential side effects of drugs, electroshock therapy, psychosurgery and involuntary treatment.
Author of several books, he has also served as an expert witness in numerous lawsuits, which has given him access to the in-house research files of the largest pharmaceutical companies. Fortunately for us he has made his findings public.
Tooker Gromberg was an amazing man. I never knew him but his legacy lives on in the hearts of his supporters. This site showcases the "Depression Expression: raising questions about antidepressants", a PDF document filled with factual gems. For example, did you know that advertising prescription drugs is illegal in most countries in the world, except for the USA and New Zealand?
Worst Pills is operated by US-based Public Citizen, a non-profit consumer interest group. Their primary focus is on banning or re-labelling unsafe or ineffective drugs and encouraging greater transparency and accountability in the drug approval process.
Their searchable database of over 500 medications lists those that are known to have a high risk and/or insufficent research to back up their claims.
Drug vs.Talk Therapy for Depression
Consumer Report Survey Shows Antidepressants' Side Effects More Common Than Package Labels Indicate.
"...one appears to work faster, while the other may be more effective," says author Jeanie Lerche Davis, Sept. 7, 2004.
Talk Therapy Is Sometimes Best for Depression
WebMD: Drugs Aren't the Only Effective Treatment, Study Shows: April 4, 2005 -- "New research challenges the widely accepted idea that drugs are the only effective initial treatment for major depression." This news item was based on an article published in the Archives of General Psychiatry.
The Resignation of Dr. Loren Mosher
Dr. Mosher, another hero, boldly resigned from the American Psychiatric Association in protest for what he feels is his profession's collusion with the pharmaceutical industry.
A line from his resignation letter reads, "...there are no external validation criteria for psychiatric diagnoses. There is neither a blood test nor specific anatomic lesions for any major psychiatric disorder."
The Menacing Mathematics of Multiple Meds
Gary Craig is the developer of Emotional Freedom Techniques (EFT) a non-drug approach to anxiety and depression related problems. He wrote this article to highlight an important consideration when you're taking more than one medication.
EFT can be used for all sorts of problems and has relatively no side effects. Based on acupuncture, it involves tapping of pressure points to balance your energy. I've been using it for over a year and it is nothing short of amazing. It's simplicity is deceiving.
Training Daze - Why do doctors fixate on diagnosis, not treatment?
This article by Darshak Sanghavi examines an issue that is only recently coming to light. Too little attention is being paid by physicians on treatment. There are longstanding issues related to this pattern. And, a major source of treatment information tends to promote pharmaceuticals ahead of behaviour or lifestyle recommendations.
Blogs of Interest
Blogs are often posted anonymously and the accuracy of the information can't always be counted on. However, these blogs show promise.
Books for a Deeper Analysis
Selling Sickness
The Truth About Drug Companies
$200 billion are spend yearly by Americans on prescription drugs. In her work with the New England Journal of Medicine Dr. Marcia Angell watched close hand as the pharmaceutical industry "brazenly" raised prices for spurious reasons.
Caution!
After careful consideration and with the help of your physician and/or health care provider you have decided to come off your medication you are encouraged to do so under his or her supervision.
Withdrawal from many psychiatric drugs can result in serious emotional and physical reactions. In short, not only might there be problems starting a psychiatric drug treatment (i.e. side effects), but it can also be hazardous to stop taking them.
(For more information read: Many Suffer from Antidepressant Withdrawal)
From the BBC here's a transcript from a show on the potential withdrawal effects of Paxil: The secrets of seroxat (the name of paxil in Britain).
Conclusion: withdrawal from psychiatric drugs should be done ONLY under clinical supervision!
References:
Antidepressant Discontinuation Syndrome by Donald S. Robinson, MD
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