Mind Control, Big Pharma, FDA...

[Dustin]

Please discuss whether pharmaceutical drugs such as antidepressants and other medications, etc., have helped or rather caused more complications.

YouTube - Fox News Big Story with Doug Kennedy on Big Pharma's Lie

[Aedes]

I prescribe them, and if you're interested I can link you about a million randomized, placebo-controlled trials that were NOT conducted by pharmaceutical companies that show dramatic clinical benefit of many different classes of psychiatric medications, and particularly the SSRIs (like Prozac, Zoloft, Paxil, etc).

They're not perfect, and the biggest problem with them has been the paradoxical effects seen in children and adolescents (especially suicidality).

When I was a resident, I could not get depressed patients to take care of themselves, even come to routine office visits, let alone quit smoking, fix their diet, take their medications, until they were on antidepressants. So early on I began screening patients for depression, and treating them if they were depressed. And it made a dramatic difference in their ability to care for themselves and my ability to actually make any progress with them.

So I'm a huge believer, both because of the medical research and because of my own clinical experience prescribing them.

[Didymos Thomas]

The FDA has some very serious corruption issues, there is no doubt about that, and the pharmaceutical companies... I can't even stand to go into that.

However, I do have some thoughts about antidepressants. Aside from criticisms that apply to nearly the entire market of prescription drugs, my concern with antidepressants is not whether or not they are effective, but whether or not they are the most effective and least harmful 'treatment' available.

From what I understand, correct me as needed, antidepressants fix some chemical imbalance in the brain which causes depression. The idea being that the medicine will provide enough relief for the patient to develop a healthy lifestyle so that they can then stop taking the medication and no longer suffer from depression.

I can certainly imagine cases where this sort of medication will be the best therapy, but usually when we have some problem, we address the cause of the problem, and something must have caused the chemical imbalance in the first place.
My fear is that if we medicate to fix the imbalance, the patient will be no less susceptible to future imbalances having never learned how to prevent such an imbalance from occurring. Nor do I like the idea of people going through some terrible cycle of depression and medication with no end in sight.

[Edvin]

...but usually when we have some problem, we address the cause of the problem, and something must have caused the chemical imbalance in the first place.

A former colleague of mine in an institution I used to work at, a psychologist, had very little faith in actually getting to the core of the problems the patient was experiencing to solve them. He would prescribe antidepressants whenever he saw that it could help the patient help themselves. It would enable them to react, and confront their problems, that they prior to the medication had seen as futile, due to the depression.
This, rather than countless sessions of conventional therapy was in many cases much more efficient. And, as Aedes said, progress is often depending on it.

That said, I do see the point of questioning the prescribing of antidepressants. I'm certain there are cases in which a therapist, or a doctor, prescribes antidepressants and lets the patient go without even concidering that therapy could be a better sollution.

Very interesting topic btw. !

[Aedes]

Originally Posted by Didymos Thomas

From what I understand, correct me as needed, antidepressants fix some chemical imbalance in the brain which causes depression. The idea being that the medicine will provide enough relief for the patient to develop a healthy lifestyle so that they can then stop taking the medication and no longer suffer from depression.

Not really. First of all, the commonly used term 'chemical imbalance' is not a useful way of thinking about their mechanism of action. Antidepressents increase the amount of serotonin and (in some cases) norepinephrine in the synapses; antipsychotics increase the amount of dopamine; etc. It's not so much a chemical imbalance as it is a physiologic inability of the cells to secrete enough of the neurotransmitter in question. (or in the case of things like manic symptoms or anxiety it's a type of cellular overactivity).

Psychiatric medications do not eliminate the underlying disease. They're mainly symptomatic treatments. Cognitive-behavioral therapy, incidentally, also will increase the amount of serotonin and norepinephrine in the synapses of depressed people. So in other words this "chemical imbalance" can be treated and improve in non-pharmacologic ways.

But the disease is still there, and probably the best one can hope for is that the treatment will allow the person to get their lives in order (including quitting drugs if that's an issue) such that later on they'll have enough internal resources that they won't need antidepressants.

The combination of cognitive-behavioral therapy and medications is generally better than either alone. But they're both effective. And therapy is extremely expensive -- for people to have hour long sessions several times weekly for months or years is not affordable.

Fortunately the psych medications we have are (for the most part) very safe and very efficacious.

I can certainly imagine cases where this sort of medication will be the best therapy, but usually when we have some problem, we address the cause of the problem, and something must have caused the chemical imbalance in the first place.

It's biology. And there are some biologic things we cannot fix even if we find the root cause. And in the case of most psychiatric disorders, we have a very limited understanding of the basic biology. Furthermore, the diseases themselves are diagnosed syndromically, i.e. based on a collection of symptoms -- we can't make an etiologic (causal) diagnosis of even plain old depression, we can only diagnose it based on the pattern of symptoms and thought processes of the patient.

My fear is that if we medicate to fix the imbalance, the patient will be no less susceptible to future imbalances having never learned how to prevent such an imbalance from occurring. Nor do I like the idea of people going through some terrible cycle of depression and medication with no end in sight.

What's the alternative? Having untreated people who cannot work, who become dependent on drugs, who cannot take care of their families, and who attempt or commit suicide? You don't need to look very far -- there are PLENTY of people out there with untreated psychiatric illness.

Don't knock symptomatic treatment. There IS a huge societal and personal cost to symptomatic depression. These drugs lower that cost because they allow people to actually live their lives. If they need to take Paxil for the rest of their lives, so be it if it means they actually can live productively.

[Dustin]

I believe and have personally witnessed natural products more effective and a lot less harmful. But wait, how come there are so many studies proving drugs to be effective and not natural products? Its because you can't put a patent on a plant.

I've heard doctors say that vitamin c does not work. Pshaw! The flu season has been pretty bad in my area this year, and I am quite certain I haven't been sick because every time I started to feel a sickness coming on, I immediately got some vitamin c and took about 2000mg every four hours until symptoms were gone. I do it every year and it works very well.

But I do believe that most diseases, etc., can be linked to the condition of the mind. Doctors are even starting realizing this. The mind controls the body.

These statements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure or prevent any disease.

[Aedes]

Originally Posted by Dustin

I believe and have personally witnessed natural products more effective and a lot less harmful.

And I've seen people die from natural products. And without evidence as to their safety, efficacy, and proper use, it would be irresponsible for me as a physician to prescribe them.

But wait, how come there are so many studies proving drugs to be effective and not natural products? Its because you can't put a patent on a plant.

We can and we do. There are probably thousands of clinical trials using various herbal / botanical / natural remedies, and there are some that are head-to-head trials against conventional drugs. Incidentally, St. John's wort works by the same chemical mechanism as Prozac.

You're very indignant about this issue, which makes me wonder why you allow yourself to be so misinformed about it. If you're interested in learning about clinical trials of botanical therapies, then you don't need to look too hard to find them.

I've heard doctors say that vitamin c does not work. Pshaw! The flu season has been pretty bad in my area this year, and I am quite certain I haven't been sick because every time I started to feel a sickness coming on, I immediate got some vitamin c and took about 2000mg every four hours until symptoms were gone. I do it every year and it works very well.

Are you thus taking personal responsibility for people treating themselves with a therapy that you do not understand, have not studied, and have not read the literature about? Because you CAN be legally sued if someone follows your medical advice and has an adverse event. Tread lightly here, and don't assume you know more than you really do -- the last thing you want is for someone to follow your advice and have a complication.

Vitamin C for acute therapy for influenza has been debunked for YEARS. It has been nonsense ever since Linus Pauling was throwing it around a half century ago, and it's stuck just because he (the discoverer of vitamin C's physiologic activity and the winner of 2 Nobel Prizes) advertised it all over the place.

There is very weak and inconsistent evidence for its use in prevention of colds (not influenza), and it is specifically NOT supported by evidence for acute therapy. And for the occasional studies in which there has been a benefit shown, the median decrease in time of illness has been less than 10% (which is less than 12 hours, considering that most colds only last a few days).

It's quite brave of you to take 2000mg of vitamin C every 4 hours considering that toxicologists say that vitamin C toxicity can be seen at doses greater than 2000mg in a single 24 hour period. It so happens that I'm a board certified specialist in infectious diseases, which includes among other things influenza and viral diseases, and I've answered this very question about vitamin C for patients many times, and I keep up with the medical literature. I can give you references if you'd like.

Other nutrients like vitamin A, vitamin D, and zinc do have immunomodulatory roles, and vitamin A is extremely important in the management of certain infections in developing countries (especially measles). But that's a whole other kettle of fish.

But I do believe that most diseases, etc., can be linked to the condition of the mind. Doctors are even starting realizing this. The mind controls the body.

Please inform us specifically how the mind controls the body. For instance, I'd like to know why it is that people who are brain dead or severely neurologically / mentally impaired still have a functioning immune system, endocrine system, gastrointestinal system, genitourinary system, integumentary system, lymphatic system, and cardiovascular system.

[ogden]

I would like to share a personal experience with you. My mother attempted suicide several (3) times over a five year period in the seventies. I didn’t understand it then nor do I understand it now, I only know how debilitating manic depression is.

Her early treatment was valium and therapy. Over the following years the drugs got better and those prescribing the drugs got better. The doctors would monitor and tweak the type and amount of drugs so she could function. There wasn’t much therapy because it was so expensive but what little she had improved over the years and let her come to terms with her illness in an informed rational way.

Gradually her medication was reduced to almost nothing and she had twenty more years of good life (that I could share with her). She told me that in the early days she never thought she could be happy ever again, and towards the end she would think back to those dark days and smile to think how happy she was now.

So yes there is benefit from these drugs. Not to say that they are perfect or that the drug companies are immune to greed or corruption, but real people have experienced real results. I know!

Care for mental illness has come a long way from its horrific early treatment using asylums and frontal lobotomies, so I give thanks for where we are now and hope to progress further. I think we have an epidemic of mental illness that goes untreated. Look in the prison system and homeless population and you will find many cases of untreated mental illness.

[Aedes]

Yes -- if there is any huge, glaring problem in American mental health, it's lack of access to care. People who actually get mental health care and get needed therapies do better than people who don't. That should be enough of an answer to the problem raised in this thread.

[Michael Addison]

If you're looking for something to gripe about, Dustin, there's plenty of stuff relating to this topic that may give offense.

The market certainly does concern itself more with the medical matters where there's money to be made. I'm sure a contrast between research dollars spent on erectile dysfunction and malaria would be interesting.