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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by emmanuel98 on August 9, 2011, at 18:48:03
I just read an article (can't remember where -- maybe psychcentral, maybe NYT health section) about a study that found 80% of AD prescriptions are written by non-psychiatrists and 72% of these include no MH diagnosis. This may be why AD success rates are so low compared to placebo. People go to their GP and say, I've been feeling kind of low and tired lately and the GP writes a scrip for an AD. Probably an SSRI. Or someone comes in and says they saw an ad for abilify on TV and have felt kind of sad lately, would like to try it, and the GP writes a scrip for abilify. AD's are the third most commonly prescribed drug in the US, according to this article. (Don't know what 1 and 2 are, but probably statins and anti-hypertensives)
Posted by Phillipa on August 9, 2011, at 19:34:17
In reply to prescribing AD's, posted by emmanuel98 on August 9, 2011, at 18:48:03
I read the same one must be psych central as don't read the Times. Must have been googling and found it or it came on nursing newsletter. I also forget the others. What do you think of this? A doc told me yesterday that they only last for a while and then back to zero. Urgent Care for my cat bite. My own cat sick. Phillipa
Posted by Phillipa on August 9, 2011, at 19:43:14
In reply to Re: prescribing AD's » emmanuel98, posted by Phillipa on August 9, 2011, at 19:34:17
Interesting googled most popular prescribed meds and all the hits had vicodin as number l including Forbes magazine and BP meds two and cholesterol 3. Saw no mention of ads how strange is that? Phillipa
Posted by jono_in_adelaide on August 9, 2011, at 19:55:02
In reply to Re: prescribing AD's, posted by Phillipa on August 9, 2011, at 19:43:14
Thats because vicodin is a single drug, AD scripts are spread across 10 or 15 drugs, individualy they arnt that high on the list, but amatised then they are quite high up there
Posted by sigismund on August 9, 2011, at 19:57:31
In reply to Re: prescribing AD's, posted by Phillipa on August 9, 2011, at 19:43:14
>Saw no mention of ads how strange is that?
Not strange at all, surely?
Posted by Phillipa on August 9, 2011, at 21:24:28
In reply to Re: prescribing AD's » Phillipa, posted by sigismund on August 9, 2011, at 19:57:31
Sigi I love you you are the greatest. Had to say that hope you don't mind PJ
Posted by jono_in_adelaide on August 9, 2011, at 21:47:54
In reply to Re: prescribing AD's » sigismund, posted by Phillipa on August 9, 2011, at 21:24:28
Exactly, doctors are now prescribing antidepressants the way they prescribed Valium in the 70's, Dexamyl in the 50's, and Iron tonics before that - when they are confronted by a pateint who doesnt feel 100% and wants some pills, but they cant find anything wrong.
Posted by Christ_empowered on August 9, 2011, at 22:29:06
In reply to Re: prescribing AD's, posted by jono_in_adelaide on August 9, 2011, at 21:47:54
I've had family doctors notice that I seemed a bit anxious and offer me an antidepressant, so this article doesn't surprise me at all. I will say, though, that many psychiatrists--particularly the younger ones--will diagnose some kind kind of anxiety or mood disorder and push antidepressant and antipsychotics quickly, too. I don't know that there's really that much of a difference in actual prescribing habits, but shrinks do see more difficult cases and they have diagnoses justify to their behavior.
Posted by Phillipa on August 10, 2011, at 19:35:54
In reply to Re: prescribing AD's, posted by jono_in_adelaide on August 9, 2011, at 21:47:54
When I was prescribed valium in 70's panic was so bad couldn't care for my children. It was a have to. Phillipa
Posted by jono_in_adelaide on August 11, 2011, at 1:16:35
In reply to Re: prescribing AD's » jono_in_adelaide, posted by Phillipa on August 10, 2011, at 19:35:54
Oh, Phillipa, of course there were people who genuinaly needed benzos back then, just as there people who genuianly need them now, but in the 70's a lot of GP's seemed to feel they were harmless happy pills, to be handed out to anybody who they didnt realy know what to do with....... sort of like the way they prescribed iron supplements in the old days, as a general tonic.
Benzos are valuable drugs and absolutly essential for some people (you and me inclided) but in the mid 70's the #1 drug in the world was Valium, and the # 3 drug was Librium..... about 1 person in 10 was taking a benzo on a near daily basis, so there is little doubt they were over prescribed.
Posted by Christ_empowered on August 11, 2011, at 18:24:02
In reply to Re: prescribing AD's, posted by jono_in_adelaide on August 11, 2011, at 1:16:35
Benzos are pretty versatile. Pain, muscle sprains, anxiety, agitation, mania..they even help psychosis. ADs...not so much. I'm kind of surprised that the SSRI drugs, in particular, continue to be so popular now that they're off-patent. I kind of assumed that once Big Pharma was no longer pushing them, they'd start to fall by the wayside. Guess not.
Posted by Phillipa on August 11, 2011, at 21:12:03
In reply to Re: prescribing AD's, posted by Christ_empowered on August 11, 2011, at 18:24:02
CE been gone cat in ER vet again no dx yet. Just back left him there cost $3000 and I do agree with you the SSRI's seem to have as many if not more withdrawal problems than benzos ever did. Phillipa
Posted by bleauberry on August 12, 2011, at 18:18:57
In reply to prescribing AD's, posted by emmanuel98 on August 9, 2011, at 18:48:03
I can understand non-psychiatrists writing psychiatric prescriptions because frankly the regular GPs I've had did better than the pdocs. Heck, the best happens to be a Nurse Practioner. So I've seen it happen and the 80% number seems ok with me. imo
The thing that bothers me is there are a handful of useful diagnostics that could be done, but not typically done. You know, the stuff I usually talk about....cortisol, metals, microbials, vitamins, minerals. Heck, a girl I know at work found out she was gluten intolerant through a lab test. After adjusting her diet to that, her depression and migraines vanished. Ya know? Just one example anyway.
In my own personal journeys I think the difference for me between the two groups were that the non-pdocs were more cooperative in working with me. The cost was considerably less than a pdoc visit. At least in my area anyway.
The non=pdocs I've had seemed more daring and aggressive, while pdocs seemed more rigid. I have had a couple of goods ones on both sides of the fence.
Whether they overprescribe or not, I don't know. Maybe. I can see that. It is nice I think that people have the option to choose. It isn't like that in other parts of the world. Well, until healthcare kicks in anyway, then there won't be much of a choice I don't think.
Posted by sigismund on August 12, 2011, at 19:01:39
In reply to Re: prescribing AD's, posted by bleauberry on August 12, 2011, at 18:18:57
We have health care and freedom of choice. You just have to pay for certain things yourself. It's not a big problem.
For example my integrative doc is pretty much not covered. Just a fraction of that is covered. But I am OK with it.
Posted by bleauberry on August 14, 2011, at 10:49:32
In reply to Re: prescribing AD's » bleauberry, posted by sigismund on August 12, 2011, at 19:01:39
> We have health care and freedom of choice. You just have to pay for certain things yourself. It's not a big problem.
Well, if you are talking about the USA, those things won't last for much longer. The fine print in the obamacare makes it pretty clear that a panel of shirts in washington will decide which med you get...not your doctor...and in fact what doctor you can see.
I sure hope we get a good election in 2012 so we can repeal that nasty piece of legislation and get a good one that makes sense to replace it. Heck, even the health care system the way it is right now is a hundred times better than what shirts in washington will do to it. Bascially in a nutshell....time and money will be rationed....and that trickles down to choice of doc and meds.
>
> For example my integrative doc is pretty much not covered. Just a fraction of that is covered. But I am OK with it.Yeah me too. I like them though for bouncing new ideas off of and trying things a regular MD won't, can't, or doesn't have any wisdom on. Heck, without the integrative approach, I would still be a non-diagnosed lyme patient and a non=diagnosed gluten intolerant patient and a non-diagnosed metal toxicity patient....more than 12 doctors never even thought of those things. Well worth the money!
Posted by gman22 on August 14, 2011, at 22:37:45
In reply to Re: prescribing AD's, posted by bleauberry on August 14, 2011, at 10:49:32
> > We have health care and freedom of choice. You just have to pay for certain things yourself. It's not a big problem.
>
> Well, if you are talking about the USA, those things won't last for much longer. The fine print in the obamacare makes it pretty clear that a panel of shirts in washington will decide which med you get...not your doctor...and in fact what doctor you can see.
>
> I sure hope we get a good election in 2012 so we can repeal that nasty piece of legislation and get a good one that makes sense to replace it. Heck, even the health care system the way it is right now is a hundred times better than what shirts in washington will do to it. Bascially in a nutshell....time and money will be rationed....and that trickles down to choice of doc and meds.
>
> >
> > For example my integrative doc is pretty much not covered. Just a fraction of that is covered. But I am OK with it.
>
> Yeah me too. I like them though for bouncing new ideas off of and trying things a regular MD won't, can't, or doesn't have any wisdom on. Heck, without the integrative approach, I would still be a non-diagnosed lyme patient and a non=diagnosed gluten intolerant patient and a non-diagnosed metal toxicity patient....more than 12 doctors never even thought of those things. Well worth the money!
>
>
you must be kidding bleauberry...no way you really believe that stuff
This is the end of the thread.
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