Posted by JLM on January 2, 2004, at 8:48:14
In reply to Re: risperdal for anxiety, posted by JacquieJ on January 2, 2004, at 8:10:40
> Risperdal can help some people with anxiety. And as far as off label uses, that is how MANY drugs get discovered for so many new uses (THANK GOD). My nephew had major problems with PTSD as well as anxiety after he came back from the Gulf War. The PC doc tried all kinds of antidepressant cocktails including xanax (highly addictive!) and none helped. He went to a Psych at the VA who fully informed him of what Risperdal's potential side effects were (weight gain, decreased libido, etc) but Stuart was willing to try ANYTHING short of suicide (which he had thoughts of). Risperdal added onto lexapro was the magic bullet. He has been on 1mg Risp and lexapro (celexa first and then switched) and he is a new person. I think we all need to be a little less accusing of drug companies these days...I agree that there are certainly abuses that take place-but I wouldn't want to go anywhere else in the WORLD for my health care. There is no "one drug fits all" in this world. I volunteer for NAMI and have seen time and time again patients who don't work on one agent and then are switched to another with great results. The brain is a mysterious thing and it is an art form to help heal it. Off label uses of drugs are miracles for many, so respectfully, I suggest unnecessarily alarming people into thinking their docs are intentionally harming them.
First, I'd like to say that its great that you had good outcome. I'm glad to hear that. I think in extreme cases its worth the risk of trying something novel. However, you are still left with the 2 problems pointed out in the article:
1. in the absence of any controlled trials, you can't say for certain what caused the improvment.
2. you really have no idea of what the potential adverse effects are when you give a drug to a population for which it wasn't studied.I am also puzzled about your statement that 'psychiatry is an art form'. Either its an art form, or its medicine based on sound science, with repeatabled and demonstrable results. Treating people with diabetes, heart disease, immune system dysfunction is not an art form. It's science based. As are nuclear physics, electrical engineering, anthropology, and mathematics.
So, I think the premise of the article stands, insofar as with off label precribing you can't be sure that the treatment effect is not placebo effect, and you are assuming a huge unknown risk.
As far as being less acussing of drug companies of these days, they have more congressional lobbyists
than any other industry, and more drugs have been withdrawn from the market in the last decade than have been withdrawn in previous decades. And those were drugs being used for approved indications. And there is a lot evidence out that there the drug companies knew about many of those adverse events and didn't disclose them.I guess MY point is that a lot of the off label prescribing that goes on is NOT for extreme cases like your nephew where the possible benefit outweighs the unknown risks. Docs are too cavalier about it. Its basically experimenting on patients without their consent.
poster:JLM
thread:109623
URL: http://www.dr-bob.org/babble/20031231/msgs/295673.html