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The New Therapeutics: Ten Commandments by British doctor-blogger


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http://blogs.bmj.com/bmj/2012/01/03/richard-lehmans-journal-review-3-january-2012/ If doctors followed these 10 commandments, they would prescribe psychiatric drugs much less frequently.

 

This was reprinted on the BMJ site from Dr. Richard Lehman's Journal Watch summary for Oxford University's Centre for Evidence-Based Medicine http://www.cebm.net/index.aspx?o=2339

 

The New Therapeutics: Ten Commandments

 

  • Thou shalt treat according to level of risk rather than level of risk factor.
  • Thou shalt exercise caution when adding drugs to existing polypharmacy.
  • Thou shalt consider benefits of drugs as proven only by hard endpoint studies.
  • Thou shalt not bow down to surrogate endpoints, for these are but graven images.
  • Thou shalt not worship Treatment Targets, for these are but the creations of Committees.
  • Thou shalt apply a pinch of salt to Relative Risk Reductions, regardless of P values, for the population of their provenance may bear little relationship to thy daily clientele.
  • Thou shalt honour the Numbers Needed to Treat, for therein rest the clues to patient-relevant information and to treatment costs.
  • Thou shalt not see detailmen, nor covet an Educational Symposium in a luxury setting.
  • Thou shalt share decisions on treatment options with the patient in the light of estimates of the individual’s likely risks and benefits.
  • Honour the elderly patient, for although this is where the greatest levels of risk reside, so do the greatest hazards of many treatments.

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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If doctors took the Hippocratic Oath seriously, they would prescribe psychotropic drugs much less frequently. They would prescribe other scary drugs like Lipitor, Fosamax, and Vioxx a lot less frequently. If they comprehended Paul of Tarsus' words that "the love of money is the root of all evil", they would be prescribing a lot less of everything, and possibly going into different career fields like investment banking or the Mafia.

 

I was reading a book titled Broken by Karin Slaughter, just finishing it up last night, which was all about several murders and other nasty patient reactions that occurred during a "clinical trial". First off, I was horrified at how clinical trials are conducted. They're basically run by private practice physicians who have to recruit victims, er, patients for the trials and the doctors stand to make quite a bit of money by doing so. In this case, the doctor had registered several people twice and given them twice the dosage of the drug in question, an antidepressant. (Big surprise.) There are apparently quite a few ways to tamper with clinical trials and I wouldn't be surprised to find that the participating doctors can get a lot of heat from drug companies to skew the results.

 

The second shocker was a statement by one of the main characters, a woman doctor named Sara Linton, who said that ONE IN TEN PEOPLE in the USA are now on an antidepressant, although few of those are actually getting any benefit. Are we turning into a nation of zombies??? This makes me think of that drug, Soma, which I believe was in George Orwell's 1984.

 

The book was fiction, but most of the better detective-mystery type writers research their subject and include accurate factual matter, such as the above, and I tend to believe it's true.

Psychotropic drug history: Pristiq 50 mg. (mid-September 2010 through February 2011), Remeron (mid-September 2010 through January 2011), Lexapro 10 mg. (mid-February 2011 through mid-December 2011), Lorazepam (Ativan) 1 mg. as needed mid-September 2010 through early March 2012

"Never attribute to malice that which is adequately explained by stupidity." -Hanlon's Razor


Introduction: http://survivingantidepressants.org/index.php?/topic/1588-introducing-jemima/

 

Success Story: http://survivingantidepressants.org/index.php?/topic/6263-success-jemima-survives-lexapro-and-dr-dickhead-too/

Please note that I am not a medical professional and my advice is based on personal experience, reading, and anecdotal information posted by other sufferers.

 

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The statistic is now 11% of the US population over the age of 12. Another 3 million people are on antipsychotics.

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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The statistic is now 11% of the US population over the age of 12. Another 3 million people are on antipsychotics.

 

I think I'm going to throw up.

Psychotropic drug history: Pristiq 50 mg. (mid-September 2010 through February 2011), Remeron (mid-September 2010 through January 2011), Lexapro 10 mg. (mid-February 2011 through mid-December 2011), Lorazepam (Ativan) 1 mg. as needed mid-September 2010 through early March 2012

"Never attribute to malice that which is adequately explained by stupidity." -Hanlon's Razor


Introduction: http://survivingantidepressants.org/index.php?/topic/1588-introducing-jemima/

 

Success Story: http://survivingantidepressants.org/index.php?/topic/6263-success-jemima-survives-lexapro-and-dr-dickhead-too/

Please note that I am not a medical professional and my advice is based on personal experience, reading, and anecdotal information posted by other sufferers.

 

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The system is so broken I have a tough time imagining how it can be repaired and kept free of fraud and bias

I don't know what the going rate is for patient enrollment these days but I knew private practice docs getting $40k per patient for a few week trial •just a little incentive to show that the drug worked

Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc).

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If the public only knew how sloppily clinical trials are run -- the clinicians treating patients have little or no oversight. They basically do and report what they want. Who knows if the patients they recruit actually meet the criteria? They have enough incentive to drag bums in off the street, and often do.

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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