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Another psychiatrist on the gravy train cries foul on pharma pulling out of psychiatry


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Dan Carlat just posted a great item on his blog about psychiatrist Stephen Stahl's recent posting about how pharma is receding from psychiatry. Stahl's post (linked below) is histrionic-drenched and just absurd. Feel free to post your opinion on either Carlat's piece (also linked below) or on Stahl's blog. I posted anonymously twice on carlat's blog, and once as "psych survivor" on the Stahl blog.

 

PS: Good on Nancy Wilson for posting Stahl's pharma payouts. Here are his stats:

 

The disclosure statement posted on the NEI website reflects that "Over the past 12 months (January – December 2008) Dr. Stahl has served as a Consultant to Arena, Azur, Bionevia, BristolMyers Squibb, Eli Lilly, Endo, Forest, Jazz, J & J, Labopharm, Lundbeck, Marinus, Neuronetics, Novartis, Noven, PamLabs, Pfizer, Pierre Fabre, Sanofi, Sepracor, Servier, Shire, SK Corporation, Solvay, Somaxon, Tetragenex and Vanda; he has served on speakers bureaus for Wyeth and Pfizer and has received grant support from Forest, J & J, Novartis, Organon, PamLabs, Pfizer, Sepracor, Shire, Takeda, Vanda and Wyeth."

Carlat link: http://carlatpsychiatry.blogspot.com/2011/08/has-stephen-stahl-gone-off-deep-end-you.html

Stahl link: http://go.neiglobal.com/Blog/tabid/83/EntryId/16/Are-future-psychiatric-treatments-doomed-Be-careful-what-you-ask-for-you-just-might-get-it.aspx

Been on SSRIs since 1998:

1998-2005: Paxil in varying doses

2005-present: Lexapro.

2006-early '08: Effexor AND Lexapro! Good thing I got off the Effexor rather quickly (within a year).

 

**PSYCHIATRY: TAKE YOUR CHEMICAL IMBALANCE AND CHOKE ON IT!

APA=FUBAR

FDA=SNAFU

NIMH=LMFAO

 

Currently tapering Lexapro ~10% every month:

 

STARTING: 15 mg

11/7/10: 13.5 mg

12/7/10: 12.2 mg

1/6/11: 10.9 mg

2/3/11: 9.8 mg

3/3/11: 8.8 mg

4/1/11: 7.8 mg

4/29/11: 7 mg

5/27/11: 6.4 mg

6/24/11: 5.7 mg

7/22/11: 5 mg

8/18/11: 4.5 mg

9/14/11: 4 mg

10/13/11: 3.6 mg

11/9/11: 3.2 mg

12/7/11: 2.6 mg

1/3/12: 2.1 mg

2/2/12: 1.8 mg

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Thanks for this alert.

 

Dr. Carlat's response was excellent in my opinion.

 

As an aside, I just posted a comment on his blog and addressed Dr. Allen's point that anti psychiatry folks engage in black and white thinking. I said I found it ironic since many psychiatrists keep their patients on meds come heck or high water. There is nothing else in their toolbox. If that isn't black and white thinking, I don't know what is.

 

I went on to say that I bet they have never heard of Emily Deans who posted a comment and who has studied dietary approaches that might help certain conditions.

 

Your comment was excellent in response to Dr. Allen. He just responded to what you said as an FYI.

 

It looks like your first comment was not posted.

 

CS

 

PS - How does Dr. Stahl live with himself? I know, a stupid question but I couldn't resist.

Drug cocktail 1995 - 2010
Started taper of Adderall, Wellbutrin XL, Remeron, and Doxepin in 2006
Finished taper on June 10, 2010

Temazepam on a PRN basis approximately twice a month - 2014 to 2016

Beginning in 2017 - Consumption increased to about two times per week

April 2017 - Increased to taking it full time for insomnia

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Thanks for posting this, cine. @survivingads tweeted all over this:

 

Ranting psychiatrist Stephen Stahl bemoans criticism, complains Wild West days of psychiatry "anything goes" are waning. http://su.pr/Ao2AQL

Dr. Stahl represents psychiatry establishment thinking.

 

Good work on the comments, guys.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Dr. Carlat's comment on the original article at http://go.neiglobal.com/Blog/tabid/83/EntryId/16/Are-future-psychiatric-treatments-doomed-Be-careful-what-you-ask-for-you-just-might-get-it.aspx is very interesting:

 

 

Hi Tom—I agree that it would be better to work together for the benefit of patients rather than squabbling about political issues.

 

Dr. Stahl and I actually agree on most important things. We believe that psychiatric meds are effective, that off-label use is important and valuable, that doctors should be able to decide what medications to use, regardless of whether they are formally “approved” for a particular indication. We believe that pharma should continue to fund psychopharm research and that academic psychiatrists should be able to accept money from drug companies to conduct this research. Most importantly, we agree that, in the end, what’s best for our patients trumps everything else.

 

We disagree on some points. Dr. Stahl believes that academics should be involved in marketing drugs and in accepting money from companies to education doctors about their drugs. I believe doctors should get out of the marketing business and stick to research and patient care.

 

Both Dr. Stahl and Dr. Tom Stossel (a prominent Harvard doctor who coined the term “pharma-scolds”) believe that the more contact between doctors and drug companies, the better educated we will be about effective treatments. They see essentially no downsides to such relationships, only upsides. It’s not an unreasonable point of view, but they are swimming against the tide of ethical opinion in medicine. Most doctors have had too many bad experiences with industry funded talks that gloss over side effects and encourage the use of overly expensive agents that have few if any benefits over existing drugs. We are beginning to realize that taking money from drug companies to push their drugs yields minimal benefits for the profession or patients, and is besmirching the reputations of otherwise great and ethical doctors who participate in such ad campaigns.

 

As far as disclosures, I’m happy to disclose anything you’d like. My main source of income is from Carlat Publishing, which publishes The Carlat Psychiatry Report and The Carlat Child Psychiatry Report.

 

Here is my personal income breakdown from 2010:

--Carlat Publishing (profits from sales of subscriptions to newsletters and from joint sponsorships to provide CME credit for other non-industry funded CME organizations): $190,000

--Private Practice (about 5 hours/week, I take all insurances except Medicaid): $25,000

--Royalties from various books (Unhinged, The Psychiatric Interview), and honoraria for occasional speeches: $20,000

 

As you probably know, standard disclosures (such as Dr. Stahl’s) do not include dollar amounts, and I think that’s too bad. I think it is important to know exactly how much money doctors are accepting from drug companies to give promotional talks, to do marketing consultation, and to participate in industry funded CME. When it comes to money, size matters--$100,000 from a company is intuitively more likely to lead to a biased presentation than $5000. I would be astonished if Dr. Stahl would reveal how much money he makes from each company to do what, but would be impressed if he does so.

 

You asked about what meds I use or refuse to use. I use just about every medication in the psychiatric pharmacopeia. I rarely use the newest antipsychotics unless there’s some truly compelling clinical reason. I did prescribe Latuda to one patient recently, but only because a former psychiatrist had started it in a different city and I continued it. Now she wants to taper off of it because it is causing insomnia.

 

I have never prescribed certain newer antidepressants, such as Pristiq or Oleptra. I have never prescribed Silenor because Doxepin works just fine.

 

I'm not anti-psychiatry and I am in complete in disagreement with Dr. Szasz's opinions that mental illness is a societal construct. Like you, however, I respect his intellect and his chutzpah for standing up and sharing opinions that are extremely unpopular with his colleagues.

 

What else? Interesting that you were at the Wyeth meeting and that you saw it more positively. I viewed it as a fairly blatant indoctrination into a way of tweaking information for promotional value--but I acknowledge that there was some good solid information at the meeting if you worked to separate the wheat from the chaff!

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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I posted this comment on Dr. Stahl's article http://go.neiglobal.com/Blog/tabid/83/EntryId/16/Are-future-psychiatric-treatments-doomed-Be-careful-what-you-ask-for-you-just-might-get-it.aspx

 

As Dr. Carlat pointed out, pharma has glossed over side effects and adverse events from psychiatric drugs for many years. This has led to prescribing practices based on inadequate risk-benefit assessments, and inadequate post-marketing reporting.

 

If you don't know what the risks are, how can you responsibly evaluate the risk-benefit profile for any individual patient?

 

This has led to vast overprescribing of, for example, newer antipsychotics, for conditions far removed from psychosis. Somehow someone has communicated to psychiatrists and primary care physicians alike that there is little downside to chronically prescribed psychiatric drugs. Who could that be?

 

Just, for example, in terms of diabetes risk, unnecessarily chronically prescribed antipsychotics AND antidepressants clearly add to a public health epidemic. Which would you rather have, occasional insomnia or diabetes? Moderate depression or diabetes? Especially when there are other treatment options for insomnia and moderate depression?

 

Let us also remember it's not just bad form to allow oneself to be influenced by pharma company misrepresentation of risks and benefits. It's not just a breach of a gentleman's agreement. It doesn't merely look bad ethically. It's not just an embarrassment. It's not just a shaking of doctorly egos.

 

Underestimate of risks for any individual patient results in patient harm, sometimes long-lasting. The reason there are so many pharma-scolds and antimedication patients is because, at the absurdly high rate of chronically prescribed psychiatric medications, there are a lot of dissatisfied customers out there, and they're not keeping quiet.

 

This is something medicine and psychiatry needs to come to grips with. Your activities are no longer being carried on in private in hushed sacrosanct environments. This is the age of information-sharing, and flaws in psychiatric practice are coming to light in very public ways. Time to man up and own your responsibilities to patients, and stop whining about the criticism. The days of the Wild West in psychiatry are over, and you are now accountable.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Great post, Alto.

 

I loved everything you said but I really liked the points you made below. I am so tired of hearing about those anti psychiatry folks with no responsibility whatsoever on their end as to why people are so angry.

 

CS

 

"Underestimate of risks for any individual patient results in patient harm, sometimes long-lasting. The reason there are so many pharma-scolds and antimedication patients is because, at the absurdly high rate of chronically prescribed psychiatric medications, there are a lot of dissatisfied customers out there, and they're not keeping quiet.

 

This is something medicine and psychiatry needs to come to grips with. Your activities are no longer being carried on in private in hushed sacrosanct environments. This is the age of information-sharing, and flaws in psychiatric practice are coming to light in very public ways. Time to man up and own your responsibilities to patients, and stop whining about the criticism. The days of the Wild West in psychiatry are over, and you are now accountable."

Drug cocktail 1995 - 2010
Started taper of Adderall, Wellbutrin XL, Remeron, and Doxepin in 2006
Finished taper on June 10, 2010

Temazepam on a PRN basis approximately twice a month - 2014 to 2016

Beginning in 2017 - Consumption increased to about two times per week

April 2017 - Increased to taking it full time for insomnia

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""Dr. Stahl and I actually agree on most important things. We believe that psychiatric meds are effective, that off-label use is important and valuable, that doctors should be able to decide what medications to use, regardless of whether they are formally “approved” for a particular indication. We believe that pharma should continue to fund psychopharm research and that academic psychiatrists should be able to accept money from drug companies to conduct this research. Most importantly, we agree that, in the end, what’s best for our patients trumps everything else.""

 

Perfect example of him talking out of both sides of his mouth.

 

How is this in the interest of patients since these situations create conflict of interest?

 

""As far as disclosures, I’m happy to disclose anything you’d like. My main source of income is from Carlat Publishing, which publishes The Carlat Psychiatry Report and The Carlat Child Psychiatry Report.""

 

I had no idea that most of the money he earns is from the newsletters. Hmm.

 

""As you probably know, standard disclosures (such as Dr. Stahl’s) do not include dollar amounts, and I think that’s too bad. I think it is important to know exactly how much money doctors are accepting from drug companies to give promotional talks, to do marketing consultation, and to participate in industry funded CME. When it comes to money, size matters--$100,000 from a company is intuitively more likely to lead to a biased presentation than $5000. I would be astonished if Dr. Stahl would reveal how much money he makes from each company to do what, but would be impressed if he does so.""

 

Fair point but in my opinion, once you start paying anything, you create a very slipper slope. And once you accept money from a drug company, your objectivity as a medical professional has lessened even when being paid a small amount of cash.

 

""You asked about what meds I use or refuse to use. I use just about every medication in the psychiatric pharmacopeia. I rarely use the newest antipsychotics unless there’s some truly compelling clinical reason. I did prescribe Latuda to one patient recently, but only because a former psychiatrist had started it in a different city and I continued it. Now she wants to taper off of it because it is causing insomnia.""

 

Does he rarely use the newest antipsychotics because he has few patients with schizophrenia? Just wondering.

 

CS

 

"

Drug cocktail 1995 - 2010
Started taper of Adderall, Wellbutrin XL, Remeron, and Doxepin in 2006
Finished taper on June 10, 2010

Temazepam on a PRN basis approximately twice a month - 2014 to 2016

Beginning in 2017 - Consumption increased to about two times per week

April 2017 - Increased to taking it full time for insomnia

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CS, psychiatrists seem to dabble with atypical antipsychotics for folks on ADs. My experience with poopout (also a slippery slope) included being offered abilify, risperdal, seroquel in attempts to "potentiate celexa" because switching was such an issue. Looking back, of course, I realize that it was to avoid the two week taper, whiched caused such disruption when I went through paxil poopout.

 

1989 - 1992 Parnate* 

1992-1998 Paxil - pooped out*, oxazapam, inderal

1998 - 2005 Celexa - pooped out* klonopin, oxazapam, inderal

*don't remember doses

2005 -2007   Cymbalta 60 mg oxazapam, inderal, klonopin

Started taper in 2007:

CT klonopin, oxazapam, inderal (beta blocker) - 2007

Cymbalta 60mg to 30mg 2007 -2010

July 2010 - March 2018 on hiatus due to worsening w/d symptoms, which abated and finally disappeared. Then I stalled for about 5 years because I didn't want to deal with W/D.

March 2018 - May 2018 switch from 30mg Cymbalta to 20mg Celexa 

19 mg Celexa October 7, 2018

18 mg Celexa November 5, 2018

17 mg Celexa  December 2, 2019

16 mg Celexa January 6, 2018 

15 mg Celexa March 7, 2019

14 mg Celexa April 24, 2019

13 mg Celexa June 28, 2019

12.8 mg Celexa November 10, 2019

12.4 Celexa August 31, 2020

12.2 Celexa December 28, 2020

12 mg Celexa March 2021

 

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Right, Baxter, and doesn't it seem bizarre to maintain a person on a drug that's no longer working? Doctors are doing this everywhere to avoid withdrawal. This is sick, sick, sick.

 

cs, Carlat could afford be been so high-and-mighty about other doctors' income sources because his is supposedly clean -- he trains other psychiatrists on, supposedly, the "right" way to use drugs.

 

I've always found him to be a tad sanctimonious.

 

I'd like to get my hands on one of his newsletters to see what this "right" way is.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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CS, psychiatrists seem to dabble with atypical antipsychotics for folks on ADs. My experience with poopout (also a slippery slope) included being offered abilify, risperdal, seroquel in attempts to "potentiate celexa" because switching was such an issue. Looking back, of course, I realize that it was to avoid the two week taper, whiched caused such disruption when I went through paxil poopout.

 

WTF?

 

CS

Drug cocktail 1995 - 2010
Started taper of Adderall, Wellbutrin XL, Remeron, and Doxepin in 2006
Finished taper on June 10, 2010

Temazepam on a PRN basis approximately twice a month - 2014 to 2016

Beginning in 2017 - Consumption increased to about two times per week

April 2017 - Increased to taking it full time for insomnia

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Steve Balt has somewhat of an expose of Stephen Stahl on his blog, Thought Broadcast http://thoughtbroadcast.com/2011/08/28/psychopharm-rd-cutbacks-ii-a-response-to-stahl/

 

I am proud to call Steve Balt, a fellow Californian, one of those decent psychiatrists!

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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More about Stephen Stahl (seriously, it was produced to introduce his lectures):

 

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Just found this rather amazing quote from Dr. Stahl about the dismal results of the medical model of psychiatry. Kudos to Dr. Carlat for digging it up. It's a great window into what those at the top of the psych hierarchy are thinking -- it's pretty much what I expected: they know the medical model has been a failure, but they'll do anything in their power to keep it going as they've gotten rich off it. I know I sound like a broken record, but this is EXACTLY what's happening with the economy and economic planners: they know our economy that's based on overextended credit and debt doesn't help 99% of Americans, but it sure has helped the top 1%, and that's all that matters. It really is all the same when you think about it.

 

It's awfully depressing, but the best thing any American can do now (on psych meds or not!) is to realize they've been duped and that in these terminally corrupt and cynical times, TPTB (whether in medicine, academia, politics, or economics) don't care one iota about you, no matter what their public policy is. Thus we need to learn as much as we can about these bastards: you need to know enough to know when to squeal when you're kicked.

 

Stahl's quote:

 

I was just in Cambridge in May, I don't know if I told you this at this meeting, but there were 60 people invited from 16 drug companies that went over, like, 8 or 9 different pharmacological mechanisms of add-on to schizophrenia to see if it would help cognition; ampakines, alpha-7 nicotinic, I don't know what all—5HT6, all these things...didn't work, didn't work, didn't work, didn't work, didn't work, didn't work, didn't work.

 

Basically, the pharmaceutical industry is going to basically trash this pretty soon. Most of the pharmaceutical industry is leaving the treatment of depression. You know that, right? All the big companies say the drugs work well enough, nobody's going to pay any more for them, so there's no new innovation going on probably in 9 out of 10 big companies now in depression.

 

Now they're saying the same thing for cognitive symptoms of schizophrenia. They've failed and failed and failed, so this gets pessimistic, and I don't want to be pessimistic, but I can't not tell you the truth. And so we need to keep things alive by making sure we do the best with the treatments that are out there, and continue to tell the pharmaceutical companies and the governments that these are important problems, there are unmet needs, there are huge sufferings, and it is worth doing the research to fix it.

Been on SSRIs since 1998:

1998-2005: Paxil in varying doses

2005-present: Lexapro.

2006-early '08: Effexor AND Lexapro! Good thing I got off the Effexor rather quickly (within a year).

 

**PSYCHIATRY: TAKE YOUR CHEMICAL IMBALANCE AND CHOKE ON IT!

APA=FUBAR

FDA=SNAFU

NIMH=LMFAO

 

Currently tapering Lexapro ~10% every month:

 

STARTING: 15 mg

11/7/10: 13.5 mg

12/7/10: 12.2 mg

1/6/11: 10.9 mg

2/3/11: 9.8 mg

3/3/11: 8.8 mg

4/1/11: 7.8 mg

4/29/11: 7 mg

5/27/11: 6.4 mg

6/24/11: 5.7 mg

7/22/11: 5 mg

8/18/11: 4.5 mg

9/14/11: 4 mg

10/13/11: 3.6 mg

11/9/11: 3.2 mg

12/7/11: 2.6 mg

1/3/12: 2.1 mg

2/2/12: 1.8 mg

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Interesting. He thinks he's doing the Deity's work.

 

cine, got a link for that?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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It's the Stahl blog link, Alto. Scroll down the comments a bit and you'll find Carlat's post with the quote in it.

Been on SSRIs since 1998:

1998-2005: Paxil in varying doses

2005-present: Lexapro.

2006-early '08: Effexor AND Lexapro! Good thing I got off the Effexor rather quickly (within a year).

 

**PSYCHIATRY: TAKE YOUR CHEMICAL IMBALANCE AND CHOKE ON IT!

APA=FUBAR

FDA=SNAFU

NIMH=LMFAO

 

Currently tapering Lexapro ~10% every month:

 

STARTING: 15 mg

11/7/10: 13.5 mg

12/7/10: 12.2 mg

1/6/11: 10.9 mg

2/3/11: 9.8 mg

3/3/11: 8.8 mg

4/1/11: 7.8 mg

4/29/11: 7 mg

5/27/11: 6.4 mg

6/24/11: 5.7 mg

7/22/11: 5 mg

8/18/11: 4.5 mg

9/14/11: 4 mg

10/13/11: 3.6 mg

11/9/11: 3.2 mg

12/7/11: 2.6 mg

1/3/12: 2.1 mg

2/2/12: 1.8 mg

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I posted this comment on Dr. Stahl's article http://go.neiglobal.com/Blog/tabid/83/EntryId/16/Are-future-psychiatric-treatments-doomed-Be-careful-what-you-ask-for-you-just-might-get-it.aspx

 

As Dr. Carlat pointed out, pharma has glossed over side effects and adverse events from psychiatric drugs for many years. This has led to prescribing practices based on inadequate risk-benefit assessments, and inadequate post-marketing reporting.

 

If you don't know what the risks are, how can you responsibly evaluate the risk-benefit profile for any individual patient?

 

This has led to vast overprescribing of, for example, newer antipsychotics, for conditions far removed from psychosis. Somehow someone has communicated to psychiatrists and primary care physicians alike that there is little downside to chronically prescribed psychiatric drugs. Who could that be?

 

Just, for example, in terms of diabetes risk, unnecessarily chronically prescribed antipsychotics AND antidepressants clearly add to a public health epidemic. Which would you rather have, occasional insomnia or diabetes? Moderate depression or diabetes? Especially when there are other treatment options for insomnia and moderate depression?

 

Let us also remember it's not just bad form to allow oneself to be influenced by pharma company misrepresentation of risks and benefits. It's not just a breach of a gentleman's agreement. It doesn't merely look bad ethically. It's not just an embarrassment. It's not just a shaking of doctorly egos.

 

Underestimate of risks for any individual patient results in patient harm, sometimes long-lasting. The reason there are so many pharma-scolds and antimedication patients is because, at the absurdly high rate of chronically prescribed psychiatric medications, there are a lot of dissatisfied customers out there, and they're not keeping quiet.

 

This is something medicine and psychiatry needs to come to grips with. Your activities are no longer being carried on in private in hushed sacrosanct environments. This is the age of information-sharing, and flaws in psychiatric practice are coming to light in very public ways. Time to man up and own your responsibilities to patients, and stop whining about the criticism. The days of the Wild West in psychiatry are over, and you are now accountable.

Alto, can I just say: YOU ROCK.

Started on Prozac and Xanax in 1992 for PTSD after an assault. One drug led to more, the usual story. Got sicker and sicker, but believed I needed the drugs for my "underlying disease". Long story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything. Amitryptiline, Prozac, bupropion, buspirone, flurazepam, diazepam, alprazolam, Paxil, citalopram, lamotrigine, gabapentin...probably more I've forgotten. 

Started multidrug taper in Feb 2010.  Doing a very slow microtaper, down to low doses now and feeling SO much better, getting my old personality and my brain back! Able to work full time, have a full social life, and cope with stress better than ever. Not perfect, but much better. After 23 lost years. Big Pharma has a lot to answer for. And "medicine for profit" is just not a great idea.

 

Feb 15 2010:  300 mg Neurontin  200 Lamictal   10 Celexa      0.65 Xanax   and 5 mg Ambien 

Feb 10 2014:   62 Lamictal    1.1 Celexa         0.135 Xanax    1.8 Valium

Feb 10 2015:   50 Lamictal      0.875 Celexa    0.11 Xanax      1.5 Valium

Feb 15 2016:   47.5 Lamictal   0.75 Celexa      0.0875 Xanax    1.42 Valium    

2/12/20             12                       0.045               0.007                   1 

May 2021            7                       0.01                  0.0037                1

Feb 2022            6                      0!!!                     0.00167               0.98                2.5 mg Ambien

Oct 2022       4.5 mg Lamictal    (off Celexa, off Xanax)   0.95 Valium    Ambien, 1/4 to 1/2 of a 5 mg tablet 

 

I'm not a doctor. Any advice I give is just my civilian opinion.

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Alto, can I just say: YOU ROCK

I very much second that opinion!

Been on SSRIs since 1998:

1998-2005: Paxil in varying doses

2005-present: Lexapro.

2006-early '08: Effexor AND Lexapro! Good thing I got off the Effexor rather quickly (within a year).

 

**PSYCHIATRY: TAKE YOUR CHEMICAL IMBALANCE AND CHOKE ON IT!

APA=FUBAR

FDA=SNAFU

NIMH=LMFAO

 

Currently tapering Lexapro ~10% every month:

 

STARTING: 15 mg

11/7/10: 13.5 mg

12/7/10: 12.2 mg

1/6/11: 10.9 mg

2/3/11: 9.8 mg

3/3/11: 8.8 mg

4/1/11: 7.8 mg

4/29/11: 7 mg

5/27/11: 6.4 mg

6/24/11: 5.7 mg

7/22/11: 5 mg

8/18/11: 4.5 mg

9/14/11: 4 mg

10/13/11: 3.6 mg

11/9/11: 3.2 mg

12/7/11: 2.6 mg

1/3/12: 2.1 mg

2/2/12: 1.8 mg

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Oh, gee, thanks! I put a lot of work into that stuff.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Yes, yes.

 

There's a part of his argument that is so separate and detached from patients. We are actually live humans (just like doc). I feel like I should remind doctors of this now and again. I wish I didn't feel like this was needed though.

 

In this case, his cries come across to me like those of a teen having fun playing a shoot-em video game. The boy's, like, he's the game's high scorer and toast of the other gamers and everybody loves to tell him how great he is at the game, and... suddenly... his parents walk into his room and unplug the game. The kid moans and cries 'cuz he's winning the game and everybody loves him and he's not hurting anyone! I WANNA KEEP PLAYING! Whaaaaaaa!

 

Of course, we -- the live human patients -- don't exist on some video screen. We do not 'scold' from some vague dislike of violence. Some lives will be destroyed in exchange that he can keep playing with his toys.

 

We use words like suffering, but the word suffering is a euphemism for us. We use 'suffering' because it's probably the best word choice, but it's meaning to us is profound. A death in the family causes suffering, unpleasant but universal and respected. Our 'suffering' is a peculiar suffering, an irregular one. But doctor's don't respond to that word. For a doctor the whole day consists of patients' suffering. Tell a doctor you're 'suffering' and watch him... nod, then... yawn.

 

I try not to make myself feel too burdened or unique, but the particulars of our condition make it unlike almost all over sufferings. I've quoted Mr. Parker before: "Some people if they don't know, you can't tell them..."

 

Our suffering is debilitating, needless and, after you boil the facts, it results from exploitation and manipulation by Drug companies and doctors and (to a degree) ourselves as well. All of the parties have been eager to believe simple stories of healing that, coincidentally, confer sums of money and prestige to the dispensers of these stories. The difference, and it's huge: The patients, desperate to believe, we got the suffering not the money and status.

 

So when it comes to our suffering, doctor, you don't understand. How insolent it must seem to you that we ask you to stop inflicting it.

 

Thank you, Alto, for your comment.

"Well my ship's been split to splinters and it's sinking fast
I'm drowning in the poison, got no future, got no past
But my heart is not weary, it's light and it's free
I've got nothing but affection for all those who sailed with me.

Everybody's moving, if they ain't already there
Everybody's got to move somewhere
Stick with me baby, stick with me anyhow
Things should start to get interesting right about now."

- Zimmerman

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