Posted by med_empowered on September 29, 2005, at 18:43:39
In reply to Re: but why prozac?, posted by linkadge on September 29, 2005, at 15:30:28
I think this is an interesting sign not only of how pill-happy shrinks have gotten in the US, but also of how out-of-step with their international colleagues US psychiatrists often are. If you look at other countries--particularly canada and European countries--the suicide rate is often lower than that of the United States; the overall violent crime rate is also lower...however, overall use of psychiatric medications is lower, and even in more sevre mental illnesses (schizophrenia, bipolar disorder, etc.) the number of medications given to an average patient is smaller, and the duration of treatment is often shorter (ex: based on pretty good data, a number of docs in Europe use very low-dose neuroleptic treatment for schizophrenia and/or opt for neuroleptic-free treatment in certain patients; this has been almost unheard of in the US since the 60s-70s). Sooo...I'm not surprised the panel reached this conclusion; it makes sense, based on the available data, to go for a "precautionary principle"-based approach (avoid widespread use of medication until its *proven* safe and effective, rather than spraying it around until problems pop up, which seems to happen a lot in the US) to the antidepressant issue. With Sain John's Wort...my guess is that since they're focusing on only recommending use of products **proven** safe and effective in kids, the lack of data on Saint John's Wort would lead them to recommend avoiding its use in young people, even if there isn't necessarily evidence to indicate it's problematic. Its a really conservative stance, but its also the safest. In addition, some docs think Saint John's wort operates in an SSRI-esque way; whether true or not, I guess the assumption is that a drug that acts like an SSRI in alleviating depression could also act like an SSRI in increasing suicidality. My own guess would be that until more research is done, people who have had problems with antidepressants in the past should probably steer clear of saint john's wort, unless they have a health care provider who can monitor for problems and address them early on.
poster:med_empowered
thread:560944
URL: http://www.dr-bob.org/babble/20050927/msgs/561067.html