Posted by JackD on December 7, 2000, at 1:54:55
In reply to Tricyclics.Are they overshadowed by SRI/SNRIs,etc?, posted by Jim on December 3, 2000, at 9:46:29
What seems to be happening in the psychiatric community is a gross commercialization that has very much (I believe) led to conventional methods being overlooked.
People see Paxil ads on TV and want to take Paxil, and only Paxil, for their Social Phobia or anxiety. Paxil shouldn't even be the top choice (In my opinion) for social phobia. People who are on it, who are being helped, could probably be doing even better on classic meds or less-popular alternative.
I remember when I first visited my p-doc, I asked him what to take for anxiety, especially social anxiety. "Paxil", he says. I asked him, "Why not Klonopin?" He then proceeded to tell me his list of meds from first-line to absolute last-resort. Benzos were last. Why? There track record for anxiety can't be beat! Parnate and Nardil weren't even mentioned.
Doctors argue that the first choices are the commonly marketed drugs because they have better side-effect profiles than traditional meds. Since when does a slight- moderate difference in side effects take precedence over efficacy!
Would anyone who's been really depressed, or really anxious, or psychotic, or schizophrenic, honestly rather be helped less than to deal with side effects?
Like St.James said, TCA's are the "gold standard" and are (very) often much more effective in severe cases of depression. I know tons of people on antidepressants, and you know what, not a single one of them is on TCA's. They just don't seem popular anymore. It's sad, because those people could be doing much better.
poster:JackD
thread:49842
URL: http://www.dr-bob.org/babble/20001130/msgs/50111.html