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Ghaemi, 2008 Toward a Hippocratic psychopharmacology.


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Conclusions: Contemporary psychopharmacology is non-Hippocratic. A proposal for moving in the direction of a Hippocratic psychopharmacology is provided.

 

Can J Psychiatry. 2008 Mar;53(3):189-96.

Toward a Hippocratic psychopharmacology.

Ghaemi SN.

 

Source

 

Bipolar Disorder Research Program, Emory University, Atlanta, Georgia, USA. nghaemi@emory.edu

 

Abstract at http://www.ncbi.nlm.nih.gov/pubmed/18441665 If you have full text, please attach.

 

OBJECTIVE:

 

To provide a conceptual basis for psychopharmacology.

 

METHOD:

 

This review compares contemporary psychopharmacology practice with the Hippocratic tradition of medicine by examining the original Hippocratic corpus and modern interpretations (by William Osler and Oliver Wendell Holmes).

 

RESULTS:

 

The Hippocratic philosophy is that only some, not all, diseases should be treated and, even then, treatments should enhance the natural healing process, not serve as artificial cures. Hippocratic ethics follow from this philosophy of disease and treatment. Two rules for Hippocratic medicine are derived from the teachings of Osler (treat diseases, not symptoms) and Holmes (medications are guilty until proven innocent). The concept of a diagnostic hierarchy is also stated explicitly: Not all diseases are created equal. This idea helps to avoid mistaking symptoms for diseases and to avoid excessive diagnosis of comorbidities. Current psychopharmacology is aggressive and non-Hippocratic: symptom-based, rather than disease oriented; underemphasizing drug risks; and prone to turning symptoms into diagnoses. These views are applied to bipolar disorder.

 

CONCLUSIONS:

 

Contemporary psychopharmacology is non-Hippocratic. A proposal for moving in the direction of a Hippocratic psychopharmacology is provided.

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

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Who was it that said "above all, do no harm". Maybe psychiatric students don't have to attend that lecture. :angry:

I started withdrawing off remeron in August of 2009, with the help of a holistic physician.The reason for the withdrawal was a year or two of off and on nausea, deterioration in my thinking, and more depression. It took me a full year to work from 135 mg down to 45mg. At that point, more drops were causing more depression. Unfortuately, the nervousness that I was also feeling for the last year continued with the 45 mg. Thirty one days ago, I stopped the remeron. I am still feeling the nervousness every day and the last week, I am feeling what I think is depression but not sure. In bed in the morning, I'm already dreading another day feeling this way. I am intensely unsure of myself and find it very hard to do anything. I was a practicing veterinarian for 29 years until I found I could not practice anymore. First of all I couldn't think, or remember, and I had absolutely no confidence in anything I did. These were things I did with relative ease for twenty+ years. So, this feeling of no confidence has been during the time I was on the AD(the last 2 years) and today. I take no other medication other than my blood pressure meds. I tried supplements with my holistic dr. but they seemed to make the intense nervousness even more intense. Anyway, I truly feel stuck.

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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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