Posted by alan on April 17, 2002, at 21:08:15
In reply to Re: Marketing Hype and Specificity of Drug Treatments » fachad, posted by Elizabeth on April 16, 2002, at 23:17:29
> I think in both of these cases, the fact that SSRIs aren't controlled substances has a lot to do with it. Even when there are some symptoms that might suggest that stimulants or benzos would be worth a try after SSRIs fail, most pdocs would probably prefer to prescribe anticonvulsants and antipsychotics.
> -elizabeth
______________________________________________Case in point...a discussion I had with one of my inlaws who is a GP. This what I learned.
Bottom line about ANY controlled substance (and unfortunately bzd's are not distinguished from narcotics, etc. most of the time with docs and pdocs alike who don't know any better or are just plain lazy):
1)Can't be bothered with the SLIGHT RISK of a patient going behind their back selling them, endangering their prescribing privileges.
2)Can't be bothered with the AMOUNT OF TIME of keeping track of managing a patient when they call in saying they "lost" or "accidentally flushed" their prescription and need more (keeping track of paperwork, records, etc.).
3)Can't be bothered with the SLIGHTEST AMOUNT OF RISK of being viewed by their peers as the one in town who had prescribed a drug to an "addict". Doctor comes before the patient (Ego).
"Send em to the local psych say non pdocs if nothing else works and bzd's might be needed" was what I heard.
What about the risk of withdrawl syndromes and high incidence of sexual side effects of the ssri's that docs - including many pdocs - deny are possible straight to their complaining patient's faces? That's what I read here just about more than any other subject - side effects of ssri's and their equivalents. But are you kidding? BZD'S? You can just forget about it! Even if they DO end up working better than something else for chronic anxiety.
What about the risk of TD or the euphemistically referred to "movement disorders" with antipsychotics - even in small doses?
Meanwhile, all of those unused free samples of the latest AD's are crying for a home in the freebie cabinet. The same freebies that work at BEST 50% of the time (who knows ultimately if as well as a bzd) when a bzd tried on equal footing has proven - and continues to look more and more as we learn about the side effects of ssri's - at least as safe as any ssri.
Lazy, egotistical, misinformed, or overworked docs are the culprit re: this discriminitory attitude towards bzd's looks like to me. And it's a problem that's rampant from what I read here and on other bboards.
How's that for getting of on a rant? Maybe even Dennis Miller would be envious.
Alan
poster:alan
thread:103076
URL: http://www.dr-bob.org/babble/20020416/msgs/103373.html