Posted by yxibow on February 17, 2007, at 2:55:34
In reply to Re: Sleep Ridiculous, posted by willyee on February 17, 2007, at 1:19:36
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> > That's because Xyrem (GHB) is dangerous and was only brought back for a specific disorder. Your doctor can get their license yanked.
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> Not true,xyrem was recently given the go ahead for OFF LABEL use,so its up to the docters discression to use it for something as common as clinical insomnia which it is being used for,even though as u stated its FDA approval is initialy for narcolepsy.
Any drug can theoretically be used off-label in the US. That doesn't mean that it will be used off-label, as there have not been peer-reviewed studies that sufficiently place it in the realm of antidepressant use that psychiatrists would feel comfortable enough to use it because others are already doing so and they collaborate.I'm not saying that it should or shouldn't be examined, but it is not as harmless as previously thought. That's why its C-III, which is written on tamper proof pads or triplicates depending on your state.
This psychiatrist promoted Xyrem for off-label use and the publicity got him in rather major troublehttp://www.nytimes.com/2006/07/22/business/22drugdoc.html?ex=1171861200&en=aa8915409cf87521&ei=5070
That is what I'm talking about why some psychiatrists are conservative about the off-label use of medication. To make an example, my psychiatrist is not a GP or a back doctor. However, he has the go-ahead from my GP to prescribe Robaxin because the two have collaborated and I have signed a consent form for inter-communication and it is easier to renew the medications in one spot. But even with the drug, there were P450 interactions that might not have been picked up by someone not knowledgable in Serotonin Syndrome. Robaxin is an old agent and was never tested against P450. So we reduced the dose a bit.
I don't think you would want your psychiatrist say, prescribing antibiotics. They've been through medical school, but it is out of their realm of practice. An exception might be if you were on Clozaril or Remeron and developed agranulocytosis and a confirmed infection. Then he or she might prescribe preventative care with or without collaboration with your GP. Most likely would refer you to the ER in fact.
The same can be said that I don't think most GPs should be prescribing major pscyhoactive substances, especially neuroleptics, etc., because they don't have the training to recognize signs of EPS and TD, unless they have taken CE credits.
Sometimes in a small town it is necessary for a GP to prescribe a psychoactive substance such as, oh, Prozac, say. But I'd feel more comfortable if the individual took CE credits on how the P450 interactive system works.-- tidings.
poster:yxibow
thread:733048
URL: http://www.dr-bob.org/babble/20070213/msgs/733529.html