The drugs don't workFollow

I would make a Brain Candy joke but it would be lost on 95% of you.

Yes, I work on an interdisciplinary treatment team that consists of psychiatrists, psychologists, therapists, and peer advocates. I never said I was an expert on psychopharmacology, you're putting words in my mouth. What I am qualified to discuss however, is the difference between medication and therapy, and my observations of such. Different mental health diagnoses warrant different courses of treatment; and beyond that, treatment plans tend t be highly individualized: what works for client A may not work for client B, even if they have the same diagnosis. This is why treatment team staffings, consisting of the aforementioned positions, occur on a twice-weekly basis where I work.

For individuals with MDD, it's safe to progress with a treatment plan that consists of both medication and therapy. For MDD, where therapy comes in as the only course of treatment, is when a client is particularly resistant to medication (as in, they don't want to or don't think they need it). I usually do not make a judgment then and there whether a client "needs" medication or not- that is up to a psychiatrist. If I am seeing a client first, I refer them to a psychiatrist for an evaluation; and similarly, if a client sees the psychiatrist first, they will send a referral our way so that the client can receive therapy as well.

No, it's research I've actually read, mostly while I was in school, and also at some CBT refreshers at work. Hollon was the researcher (from Vanderbilt or UPenn, I forget which) in particular that I am speaking of...his findings were that CBT was more effective in a few months than over a year of medication, with the emphasis that the benefits of medication stops when the client discontinues taking it, whereas a client can continue utilizing the tools learned from CBT for a lifetime. What we can take from this is that CBT is a very viable alternative. Feel free to look it up if you like.

Is CBT as effective on those with MDD as it is on those with a simple acute episode of depression? In most cases, no. MDD is a chronic condition which usually warrants an interdisciplinary approach, whereas an episode usually warrants addressing the issue that caused it (whether it's an event or a pattern of behaviors).

What I am advocating is that doctors and clinicians strive to, instead of instantly medicating someone who meets the diagnostic criteria for a depressive episode- which is what frequently happens at doctor's offices and some clinics- is that they examine the situation at hand to ensure if it's a life stressor/acute episode versus a more chronic condition. As I said before, depression is not necessarily over- diagnosed as much as it's over-medicated. Really, that's all. Time for dinner.

Edit: Found a link for you.
http://www.naturalnews.com/007173.html


Edited, Feb 27th 2008 8:21pm by Alixana

Edited, Feb 27th 2008 8:26pm by Alixana

I have to say, based purely on my observations of our psych regulars, that the folks (mostly the women) that are brought into the unit for depression are really just isolated, unhappy, and trapped in abusive relationships with no way out. They get medicated, they get out, and inevitably when they come back they are taking their meds but nothing else changes. In two years, only two never came back, and those are the ones that not only entered individual therapy but family therapy as well in order to address their relationship issues.
In the meantime, the ones that constantly bounce back because they're trying to harm themselves and others do so because they run out of meds. A week on their meds, and they're back to being functional.

I can't say that I'm 100% for or against drugs--I treat most personal illness with sleep, a lime or tea, but certainly I appreciate Tylenol when Jr. spikes a fever, Motrin after my severe whiplash, the Synthroid that keeps my thyroid active and the Glucoban that keeps my father healthy. I think it's naive to say that medication doesn't help, but there are people and institutions that encourage abuse by failing to educate themselves about their prescriptions. No one knows better than you how your body will react and how to best read it.

As for my antidepressant, I don't have one. I get sad sometimes, and I let it happen, and it passes. Nothing will ever break me, but sometimes your only option to smooth the rock is by allowing the water to roll over it. I'm not scared of it.

Did someone say flipper babies?

Nexa

Since I met online several ME* patients from the UK, I've learn to question studies done in the UK so I went looking for the study to see what more I can learn.

The full study can be found at http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371%2Fjournal.pmed.0050045#toclink3

Medline article quote, states a fact that I known for years.




I have Major Depression Disorder and for 10 years been in treatment and on different medication for as well as talk therapy. I also had postpartum depression in 1984, which was treated with medication and day treatment for 16 months and short pout of depression in 1989 that I received talk therapy for.

I been in a day treatment program where I been going for treatment 7 of the last 10 years, but for one year the state felt I didn't need the program. I can go up to 3 days a week for a mixture of group and individual treatment sessions with my treatment team.

I wouldn't take medicines if I hadn't seen how much of a difference they can make for me. I long ago decided illegal drug use wasn't worth risk of losing custody of my children and dislike being tipsy, though I do enjoy a good beer or occasional glass of wine. So I'm one of the few people I know in day program who isn't co-dependent.

IF I have one big problem that treatment can't seem to help with, it's that I tend to talk far too much and forget to keep on subject. This is why I have a low post count. I hate finding myself making gbaji length posts. I will admit that I can be wrong and accept criticism of my faults.

rest of post is history of medication and and only mention to show evidence for my statement so far. I'm not an expert, but I do play one for those who let me take the floor instead of speaking up in group.

During the years I tried 3 different tricyclics, 3 SSRI's and one SNRI, as well as Xanax for panic disorder. Of all of the anti-depressants only imipramine (brand name: Tofranil) never worked at all. Amitriptyline and nortriptyline, both had side effects that my other doctors saw as a problem due to very dry eyes, so though they work I was taken off them by recommendation of my eye doctor.

OF the 3 SSRI's I taken;
* escitalopram (brand name: Lexapro) - taken less then 6 months then stop working
* fluoxetine (brand name: Prozac) - Work at higher doses, but stopped when diagnose with FMS, when I was put on Amitriptyline. I then went on Gabapentin since it was throught to help with stabilization of mood disorders as well as show to help with nerve pain.
* sertraline (brand name: Zoloft) - Did not work after 3 months for me.

SNRI - venlafaxine (brand name: Effexor) This has been the most effective of all anti-depressants and only when I show sign of Season Depression Disorder, did we go first to max dose and then add Prozac in a low dose.

For the last 5 plus years, I been taking the max dose of Effexor XR, though I had to start blood pressure medicine to deal with it's worst side effect. 10mg of Prozac. My Psychiatrist also prescribes my Gabapentin, though I only need it for the pain of my FMS. Effexor is also what my OB-GYN, says They would have given me for perimenopause, since I have family history of breast cancer. Only other medicine I take is for my cholesterol level and Ultram for pain. Problem is I tend to forget to take the cholesterol medicine with meals and prefer to use meditation for pain since it has no side effects, to deal with so may go several days without any pain medication.

Last time I had problem with panic attacks, I was given Xanax, but took only 2 out of the bottle of 30 with 1 refill. I find talk therapy less addictive and far safer.

Currently drug test are only done to rule out other health issues and test liver and kidney or drug levels. Other pysch drugs for various other mental illness will require other blood tests, but I know of no blood test for them. It's hope that as we better understand how the drugs work we will also find ways to determine which medicines will be effective for each individual.

Computer Games are my antidrug.