Psycho-Babble Medication Thread 29656

Shown: posts 1 to 14 of 14. This is the beginning of the thread.

 

Joseph Glenmullen, MD and Prozac Backlash...

Posted by Adam on April 11, 2000, at 18:55:35


I very much enjoy tuning in to Christopher Lydon's "The
Connection" on public radio. Last night I listened with
great interest (and discomfort) to Dr. Glenmullen pitch
his new book "Prozac Backlash", which I guess came out
just last month. I'd never heard of Dr. Glenmullen before
(he is a professor of psychiatry at Harvard Medical
School and also has a private practice), and wondered if
he is a relative newcomer to "popular psychiatry" or if he
has been preaching his message publically for some time.

The gist of the interview was essentially that Prozac (his
paradigm for the SSRIs), while useful for some severely
depressed patients, was probably not worth the potential
risks for "less serious" conditions, and that alternative
treatments were being underutilized as a result of Prozac's
pervasive presence in modern psychiatry and primary care.

Having been on two SSRIs myself, as well as venlafaxine, I
would be the last person to disagree with the assertion
that Prozac has been overhyped, its potential side-effects
minimized in the manufacturer's literature, and that over-
prescription, especially driven by the corner-cutting
endemic to today's American health care system (read: HMOs)
is exposing many to unnecessary hardships while ignoring
the usefulness of psychology. For me SSRIs were more or
less of no use therapeutically, caused cognative as well as
sexual deficiencies, and distressing weight gain. I'm all
for a methodical and realistic discussion of such issues.

Dr. Glenmullen claimed several times that his only intention
was to promote a fair assessment of the real costs and
benefits of SSRIs, and stressed that when appropriate, he
himself prescribed SSRIs to his patients. I felt there was
an obvious tension, though, between his stated intent and
the real message of the interview (and his book?): Prozac
has a host of potentially disfiguring and debilitating side-
effects, its potential for permanent harm is unknown and
underappreciated, its producer is engaged in a capaign of
disinformation about Prozac's adverse effects, and under only
the direst of circumstances should it be used. His favorite
example was the purported ability of Prozac to cause, in some
patients (real or even estimated numbers were never discussed)
side effects remeniscent of the major tranquilizers, complete
with parkinsonian tremors and tardive dyskinesia.

This did not strike me as a measured form of discourse. I
can't imagine anyone lacking an informed view of psychiatry
coming away with any other message than Prozac is only for
very sick people for whom the cost of such adversity is
outweighed by their pathology. I myself have known a number
of people for whom SSRIs (not a one actually takes Prozac)
has been of true benefit. I'm in a serious relationship with
one of them. None of these people suffered depression nearly
as debilitating as my own (I would argue that SSRIs are, for
many, not as effective for major depression as MAOIs and
TCAs) and yet the change SSRIs brought to their lives has
been enormous. Furthermore, they suffer few, if any serious
side-effects.

Whether such information was felt to be too implicit for
lengthy consideration, or was deliberately ignored, I do not
know. It certainly received short shrift in the context of
this interview, and I do not feel it was a judicious discussion
about SSRIs. I will have to read the book to make up my mind
about Dr. Glenmullen (a much-needed public critic or a Breggin-
in-sheep's-clothing?)

Are any of you familiar with his work? Do you feel he is a
beneficial presence or someone who is out to cash-in on the
zeitgeist of disenchantment with modern psychiatric
interventions (which Glenmullen himself claims is a cyclical
phenomenon with a 30-year turnaround), a la Peter Breggin, MD?

 

Re: Joseph Glenmullen, MD and Prozac Backlash...

Posted by Mark H. on April 11, 2000, at 20:33:24

In reply to Joseph Glenmullen, MD and Prozac Backlash..., posted by Adam on April 11, 2000, at 18:55:35

Adam, Thank you for your brilliant and beautifully written posting.

 

Re: Joseph Glenmullen, MD and Prozac Backlash...

Posted by Jim on April 11, 2000, at 20:35:21

In reply to Joseph Glenmullen, MD and Prozac Backlash..., posted by Adam on April 11, 2000, at 18:55:35

Adam-
Thanks for this post. Very much of interest to
me. I read it just after making my post below -
"6th Week of Zoloft" I'll be having a look at
Glenmullen's book.

 

Mark Jim

Posted by Adam on April 13, 2000, at 11:12:01

In reply to Re: Joseph Glenmullen, MD and Prozac Backlash..., posted by Mark H. on April 11, 2000, at 20:33:24


Gosh, you're welcome.

I suppose I should come clean with the fact that not too long ago I was given to some rather disparaging comments about the SSRIs, which I feel a bit badly about now. Especially in the case of my current girlfriend, I'm coming to appreciate their usefulness for others, even though they did me more harm than good.

I also listened to Dr. Glenmullen's interview over again, and I still feel, though I can appreciate where he's coming from, that the tone of the conversation was too alarmist. Especially in the case of the frequent discussion of extrapyramidal symptoms, more acknowledgemnt of the rarity and the questionable legitimacy of such reports was warranted.

Jim, I read your posts on Zoloft, which I also took once, and all I can say is if you fail another trial with an SSRI it might be best to look elswhere. Unfortunately, the side effects commonly caused by other classes of drugs can be just as distressing, and the cost of relief from depression is sometimes other problems. Only you can decide what is easier to tolerate.

My greatest fear about Dr. Glenmullen's book is that it will be a deterrent to those who can benefit from psychiatric care, and might turn some off to antidepressants in general, since they all can come with a number of adverse side effects. The backlash he describes may be magnified by the expectation, which I have mistakenly had in the past, that antidepressants are pain-free mood brighteners that can make you feel better than well. It's a response to the initial hype, which was misleading. I feel caution should be used to make sure the pendulum doesn't swing too far the other way.

 

Re: Adam Joseph Glenmullen, MD

Posted by Abby on April 14, 2000, at 22:41:05

In reply to Joseph Glenmullen, MD and Prozac Backlash..., posted by Adam on April 11, 2000, at 18:55:35

I heard this too and plan to post a reply. I want to make it coherent, though so I'm writing it offline in Word Perfect. Hopefully this will make it shorter rather than longer.
Just to let you know I was reading and thinking.

Abby

 

Re: Joseph Glenmullen, MD and Prozac Backlash...

Posted by Susan on April 17, 2000, at 15:39:04

In reply to Joseph Glenmullen, MD and Prozac Backlash..., posted by Adam on April 11, 2000, at 18:55:35

I have reviewed “Prozac Backlash.” Notwithstanding the existence of legitimate issues about the efficacy of those necessary evils, SSRIs, I am here to tell you that Glenmullen is unscientific and polemical to the point of dishonesty. Rhetorically, the book is one long rant against straw men: who the hell are these supposed “false prophets of Prozac and zealots of Zoloft?” Nobody I know. The book is larded with unbelievable anecdotes about supposed patients of Glenmullen who seem not so much depressed as they are mentally retarded. In place of SSRIs, Glenmullen advocates psychotherapy as “an existential encounter,” with plenty of conversation about your nasty bits, and Saint John’s Wort (!).

Glenmullen’s book is nonsense, but so what? Carloads of nonsensical books are published every year. What is most demoralizing about “Prozac Backlash” are the shameless, uncritical endorsements from Harvard faculty members and prominent psychiatrists printed on the book cover, which, frankly, motivated me to buy the book. I want my money back.

Here is a “Prozac Backlash” backlash:
http://www.medscape.com/MedscapeWire/2000/0400/medwire.0413.prozac.html

Here is Glenmullen’s website: http://www.glenmullen.com/prozacBacklash.html.

 

Re: Joseph Glenmullen, MD and Prozac Backlash...

Posted by Adam on April 20, 2000, at 15:33:51

In reply to Re: Joseph Glenmullen, MD and Prozac Backlash..., posted by Susan on April 17, 2000, at 15:39:04

Susan,

Thank you very much for your impressions and for the Medscape
link.

I suspected as much of the book from the interview I heard with
Glenmullen, but as I had not read it or heard otherwise about
it, I wanted to withold judgement.

That a physician from an institution as well known and respected
as Harvard University would choose to be an exponent of the
growing antipsychopharmacology movement is truly disturbing.
The power of the Harvard veneer (deserved or not) gives works
by professors at the University a perception among the public of
authority and legitimacy matched by few if any other credentials
short of a Nobel Prize.

It's good to know, however, that there may be vocal opposition
to Glenmullen's apparrently irresponsible claims. Especially
from those who Glenmullen cited. It is my hope some of them
publish something of their own in response, to clarify the real
messages of their own research.


> I have reviewed “Prozac Backlash.” Notwithstanding the existence of legitimate issues about the efficacy of those necessary evils, SSRIs, I am here to tell you that Glenmullen is unscientific and polemical to the point of dishonesty. Rhetorically, the book is one long rant against straw men: who the hell are these supposed “false prophets of Prozac and zealots of Zoloft?” Nobody I know. The book is larded with unbelievable anecdotes about supposed patients of Glenmullen who seem not so much depressed as they are mentally retarded. In place of SSRIs, Glenmullen advocates psychotherapy as “an existential encounter,” with plenty of conversation about your nasty bits, and Saint John’s Wort (!).
>
> Glenmullen’s book is nonsense, but so what? Carloads of nonsensical books are published every year. What is most demoralizing about “Prozac Backlash” are the shameless, uncritical endorsements from Harvard faculty members and prominent psychiatrists printed on the book cover, which, frankly, motivated me to buy the book. I want my money back.
>
> Here is a “Prozac Backlash” backlash:
> http://www.medscape.com/MedscapeWire/2000/0400/medwire.0413.prozac.html
>
> Here is Glenmullen’s website: http://www.glenmullen.com/prozacBacklash.html.

 

Re: Joseph Glenmullen, MD and Prozac Backlash...

Posted by on-the-wave on February 3, 2004, at 8:57:40

In reply to Joseph Glenmullen, MD and Prozac Backlash..., posted by Adam on April 11, 2000, at 18:55:35

"Furthermore, they suffer few, if any serious
side-effects."

"For me SSRIs were more or less of no use therapeutically, caused cognative as well as
sexual deficiencies, and distressing weight gain."

Were these "cognative and sexual deficiencies, and distressing weight gain" not serious
side-effects.

If these SSRI's had little benefit on you, were you even depressed, more likely in discord with the disproportionate public acknowledegement of your own personal self-opinion.

I suffered serious depression for about 20 years, took luvox and effexor. The effexor i took for 3 years. Much of what occured to me during those three years of effexor nearly destroyed my life, my marraige and my family.

I thank only jesus christ and an extremely astute psychologist who saved me and my family.

One of the most important statements macmullen makes is about the wearing off effects and the wash out during withdrawal.

Effexor is extremely effective, for about 2 - 6 months. whereafter one is faced with rapidly diminishing returns and a downward spiral of incresed dosage and increasingly severe backlashes.

This is all before the withdrawal, which is a demon all on it's own.

If macmullen has written this without personal experience of use of SSRI's and withdrawal, i find it absolutely amazing, and entirely accurate.

With respect to peer acceptance, my personal limited experience is that most p-docs do not know very much about SSRI's, their long term effects or even fully understand their short term effects. It is generally accepted that this area of pharmacology is not very well understood and when combined with the emotional and psychological quagmire of anxiety and depression, the result, purely from it's unpredictability, is dangerous to say the least.

 

Re:Backlash (What is the alternative?)

Posted by shadows721 on February 4, 2004, at 13:05:03

In reply to Joseph Glenmullen, MD and Prozac Backlash..., posted by Adam on April 11, 2000, at 18:55:35

I have read a book titled, "It maybe your medication." The book really didn't offer an alternative to taking medication. I have had years of therapy. I have been off and on medication. Everyone one around me agreed that I was more functional on medication. I tried diet, therapy, exercise, herbs, and vitamins to name a few things. I prayed till I couldn't anymore. No answers and no relief. I STILL suffer, but now I can get out of bed easier on more days with medication.

I haven't read the book you mentioned. What is the author recommending as the alternative to medication? I have complex PTSD. It has been found that a person is chemically different and the brain operates as though the individual is under attack all the time with this condition. So, what is someone like me to do? I can't will myself to not be under constant hypervigiliance. My problem is at the unconscious level.

I don't doubt these medications are serious and have long term consequences. There are well documented evidence of side effects. The author of the book I read really never stated an alternative. If he did, I would have surely tried it. I shake all the time. I have severe depression and anxiety. Everyday is a war with myself. I would love to do something other than take medications. I hate taking medications for something no one can see that I suffer. I think there really isn't an alternative for me and others right now. We really are the quinea pigs, but most of us feel we really don't have a more powerful alternative to medications at this point in time. I don't doubt there will be serious consequences for my taking medications to treat my mind later in life.

I am not knocking you or the book. I think there is a serious message here. Don't take these medications without being fully informed and don't take them to get rid of a problem that you can take care of yourself. But, for the rest of us with familiar history of suicide and depression, those with Ptsd, those with bipolar disease, those with schziophrenia, those with chronic major depression/anxiety, what else can we do than take medications for now? I wish I had an answer to that question. I really do.

 

Re:Backlash (What is the alternative?)

Posted by on-the-wave on February 4, 2004, at 14:17:23

In reply to Re:Backlash (What is the alternative?), posted by shadows721 on February 4, 2004, at 13:05:03

I never had ptsd, i had bpd.

Having got over my "condition", I can only say make sure you are happy that your psychologist/psychiatrist UNDERSTANDS YOU AND YOUR PROBLEM. My experience was that my first Pdoc wasted 2 years of my life and a fist full o dollars and helped me none.

My 3rd pdoc understood me and my problem and was able to guide me through the most difficult experience of my life.

I don't know about ptsd, but my depression anxiety was a subcontious decision. I had to conciously undo that decision. And just thinking about that time now, breaks me emotionally. It was the toughest thing i had ever done. I had to let go of every defense mechanism my mind had created and HAVE FAITH. Faith in the people around you and faith in your Pdoc. You cannot rely on yourself because that is the problem. You are defending yourself against a percieved threat that is no longer there. You have to retrain your mind to trust.

This may sound easy, but i felt i would die if i let go. I let go and i never died.

 

Re: Joseph Glenmullen, MD and Prozac Backlash... » on-the-wave

Posted by drjanni on February 4, 2004, at 15:59:20

In reply to Re: Joseph Glenmullen, MD and Prozac Backlash..., posted by on-the-wave on February 3, 2004, at 8:57:40

I've read the book (or at least as much as I could stomach). While the author made broad statements about SSRIs, basically labelling them as dangerous; he used examples that few of us (I think) would qualify as true depression. Examples included minor depression after a woman had broken up with her boyfriend.

His work doesn't measure up scientifically and seems to be more of a "jump on the band-wagon" situation.

 

To: on-the-wave

Posted by shadows721 on February 4, 2004, at 16:16:16

In reply to Re:Backlash (What is the alternative?), posted by on-the-wave on February 4, 2004, at 14:17:23

Thank you for your reply. I am very happy you have found a great pdoc and gotten the treatment for your condition. I have a pdoc now. I am very comfortable with her. This is a 1st for me. I usually have just anger with everyone I see. I never felt they were really trying to help me.

You brought up trust. That's a big issue with me. I never could trust anyone, nor did I even really trust myself. I wish that I could learn more how you got better. Perhaps, you can help me get some peace in this Hellish existence. Sounds like you are on the right path and have found peace. You also have done a lot of work on yourself.

Thanks again for your post on how you got better. You have been a hero in your own mind. You have gave up the battle and won. You didn't have to die to find relief either. That's awesome.

 

Re: double double quotes » shadows721

Posted by Dr. Bob on February 4, 2004, at 21:46:05

In reply to Re:Backlash (What is the alternative?), posted by shadows721 on February 4, 2004, at 13:05:03

> I have read a book titled, "It maybe your medication."

I'd just like to plug the double double quotes feature at this site:

http://www.dr-bob.org/babble/faq.html#amazon

The first time anyone refers to a book without using this option, I post this to try to make sure he or she at least knows about it. It's just an option, though, and doesn't *have* to be used. If people *choose* not to use it, I'd be interested why not, but I'd like that redirected to Psycho-Babble Administration:

http://www.dr-bob.org/babble/admin/20020918/msgs/7717.html

Thanks!

Bob

 

Re: please be civil » on-the-wave

Posted by Dr. Bob on February 4, 2004, at 21:49:56

In reply to Re: Joseph Glenmullen, MD and Prozac Backlash..., posted by on-the-wave on February 3, 2004, at 8:57:40

> If these SSRI's had little benefit on you, were you even depressed, more likely in discord with the disproportionate public acknowledegement of your own personal self-opinion.

Please don't jump to conclusions about others or post anything that could lead them to feel accused.

If you have any questions about this or comments about posting policies in general, or are interested in alternative ways to express yourself, please see the FAQ:

http://www.dr-bob.org/babble/faq.html#civil

or redirect a follow-up to Psycho-Babble Administration. Thanks,

Bob


This is the end of the thread.


Show another thread

URL of post in thread:


Psycho-Babble Medication | Extras | FAQ


[dr. bob] Dr. Bob is Robert Hsiung, MD, bob@dr-bob.org

Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.