The Scary Truth Essay, Research Paper
The Scary Truth
A young woman walks into a psychiatrist s office. She is a few minutes early so she proceeds to sit down in the waiting room. The doctor s secretary calls the woman into the doctor s office. The woman sits down and the doctor begins to ask the woman about her problem. She tells the doctor that her father just recently passed away and she is experiencing difficult time dealing with the problem. The doctor patiently listens as she proceeds to talk. The woman tells the doctor that she is feeling emotionally depressed. With that, the doctor suggests that he prescribe a prescription medication to her. He informs her that this medication may help her feeling of depression. She agrees to take the medication and the session is over. The woman walks out of the doctor s office with a prescription slip in her hand and a feeling of relief. This is a prime example of how physicians are dealing with chronic depression today. People now rely on a pill as a form of relief for depression. Twenty years ago this was not the case. There were no pills to administer. People had to rely on the support of others. People would go to the psychiatrist and the doctors would specifically talk to the patients and try to understand the patient s problem as best he/she could. Today we are now using pills as well.
In the United States today, antidepressants are over prescribed to poorly diagnosed patients. People who often feel depressed turn to doctors who can prescribe medication. Sometimes with this professional help, psychiatrists prescribe antidepressants ; medication prescribed to patients in hope to prevent the feeling of depression. Patients have the right to make their decisions about their drug usage. Patients are not educating themselves enough on their usage of antidepressants and young children who are not fully medically educated are being prescribed antidepressants as well. Doctors rely on just a small amount of family history to determine the distribution of antidepressants. If the drugs are over prescribed wrongly, the drugs may react adversely and can affect the patient s life in way that makes them feel worse than when initially diagnosed. The paper by Priest et al (p 858) sheds light on patients’ reluctance to take antidepressants. A doorstep survey of more than 2000 people found that only one in six thought people suffering from depression should be offered antidepressants. The large majority considered them addictive. Most thought that depression was caused by adverse life events, and nine out of 10 thought that counseling should be offered. One example that may be taken into consideration by psychiatrists would be the idea of support systems. Support systems may create a decrease on the problem of over diagnosing antidepressants. The problem is though, the fact that there is obviously not enough support provided.
A well-known friend of mine was experiencing what she thought was depression which was mainly influenced by her parents recent divorce. She willingly decided to go see a psychiatrist. She informed the psychiatrist that she was very unhappy lately and that she was having trouble sleeping. The psychiatrist wrote a prescription for 30mg of Zoloft along with a mood stabilizer called Depakote daily for her depression, a stimulate such as Adderol or Ritalin and was also prescribed, and she was instructed to take a very strong sleeping pill at night. She went home and immediately started to take her newly prescribed medication. Immediately she was feeling overly happy . She said, I cannot try to even think of something unhappy or sad, when I start to, I immediately think of something funny or happy. She said that after a while (approximately two weeks later) she was feeling odd and abnormal. She also said that she was having more problems sleeping. So, willingly she decided to stop taking the medication that had been prescribed to her two weeks earlier. She switched psychiatrists. After informing her newly chosen doctor what her previous doctor had done, he informed her that she was prescribed too high of a dosage and to many medications were being prescribed once. Her new psychiatrist also said that this was very dangerous and unhealthy to be taking such strong medications with such large dosages. This is a prime example of antidepressants being administered in too large dosages than needed. As stated in the Journal of American College Health, “The number of antidepressants prescribed in 1997 was two and a half times greater than in 1990, rising from 1240 to 3050 defined daily doses per 100,000 population, that is, from usage by one in 80 people to one in 30. The rising rate of prescription of antidepressants suggests a recurrence of the barbiturate epidemic of the 1960s and 1970s (Morris 1999). The medication that is being prescribed may relate to the opinion of some that doctors are prescribing these antidepressants because of the idea that doctors are lazy and are not giving the ethical treatment that a patient deserves.
Another problem with the over administration of antidepressants would be the fact that antidepressants are administered to easily. Drugs, which are referred to as antidepressants, such as Zoloft, Prozac, Paxil, Celexa and Welbutrin are easily administered to the patients. These drugs are known as Tricyclic antidepressants. Although the actual effect of these drugs on patients with a lack of need for them is still relatively unknown the psychiatrists are still administering these drugs to their patients. Even in patients who are clearly depressed , the specific and individual benefits and/or effects can vary from person to person. It is obvious that these drugs still need to be researched more and are not ready for the mass usage and mass consumerism that occurs today. Research so far justifies antidepressants only for major depression, a diagnosis requiring the presence of low mood or loss of interest and pleasure that has continued for most of the day for at least two weeks (Kendrick 3).
An acquaintance of mine decided to go to her psychiatrist and deliberately lie to the doctor so she could be able to take the antidepressant and use it to her own physical benefit knowing that she was in no need of antidepressants. The psychiatrist asked her what her symptoms were and she told the doctor that she was experiencing major depression and she was not wanting to communicate with anyone, which was a lie. Nevertheless, the doctor believed her and prescribed a large dosage of antidepressants to her. She went home from the psychiatrist s office with her new medication in the palm of her hand knowing that there was no medical usage of it. This is a prime example of antidepressants being administered way too easily.
Most psychiatrists who have the ability to administer antidepressants to their patients also use another method to determine if he/she is in need of antidepressants. This method would be the idea of the doctors researching the patient s family history to see in the patient s relatives had taken any medication in the past. With this information the doctor now could determine if the patient needs that certain type of medication. For example if I walk into the psychiatrists office and told the doctor that I was feeling depressed he or she would ultimately ask me if there was any records in my family of depression. If I said that my mother was chronically depressed and took Zoloft for all of her life, the likelihood of he or she prescribing me Zoloft would be very high. Psychiatrists now are learning the genetic relations of their patients by asking their patients questions about their relatives, mostly their immediate family. Questions that are asked are as follows: Have your mother or father have any experience with depression? Have they had any experience with antidepressants? If so, what type of antidepressants was he/she taking? These questions are very familiar to patients who are seeing psychiatrists that are considering prescribing medication to them. For example in Geriatrics it states, History taking should always investigate the possibility of a family history of depression. This can help guide initial drug selection since an agent that was effective in a genetic relative is likely to benefit the current patient; likewise, a drug that was ineffective in a genetic relative is less likely to benefit the patient in question (Christianson 6).
The Prescribed antidepressants are effective for treating depression when they are administered the right dosage. Therefore physicians must expend some effort in becoming familiar with the current depression treatment choices to facilitating the needs of the patient. The criteria that should be considered and examined by the physician in antidepressant selection is prescribing the right dosage to the patient, familiarizing the patient with the side effects of the drug, researching the patients family history on depression and researching the patients family history on the usage of antidepressants. These are all factors that the physician has to take into consideration before the antidepressant is administered. A study of more then 2000 people found that only one in six thought people suffering from depression should be offered antidepressants (Priest et al 858).
Another problem with the administration of antidepressants is the fact that the patients are sometimes not fully aware of all the side effects that may come with these drugs. Some psychiatrists are prescribing these drugs to patients without warning them of the side affects that can occur when they stop the medication. When these individuals, who did not necessarily need to be on the drug on a long-term basis, try to stop taking these drugs because they are feeling better, up to 80 percent may start experiencing some withdrawal effects, such as sadness and dizziness. Fearing a return to the condition that put them on the drug to begin with, they continue taking the pill (ABC News). ABC News interviewed Dr. Joseph Glenmullen, a clinical instructor in psychiatry at Harvard Medical School, and author of Prozac Backlash: Overcoming the Dangers of Prozac, Zoloft, and Other Antidepressants with Safe, Effective Alternatives. He said,
Now what we ve learned is that some of the later introductions into this class of antidepressants, like Paxil, Luvox, and other antidepressants wash out very quickly, so if you stop them very abruptly, what happens is the brain has made adaptations to living with the antidepressant 24 hours a day, seven days a week, 52 weeks a year, and when you stop the antidepressant, the brain essentially has to dismantle the adaptations it has made and go back to living without the antidepressant. It is like throwing the brain into reverse, and you can have very dramatic withdrawal symptoms that make patients feel held hostage to the antidepressant, because it can take months to get off of it.
This Doctor mentioned above has a clear understanding of the risks involved with the taking of antidepressants. The problem is that patients are often not told all of the risks involved and the side effects.
A bigger problem that is happening is the concern that children are being prescribed antidepressants. Not only are the physicians over prescribing antidepressants to adults they are prescribing the same drugs to children who are much too young to make medical decisions for themselves. Dr Joseph Glenmullen shares: I m very concerned about the huge number of children that are being prescribed these antidepressants. This has been described as a national health care crisis. What we are seeing happening to these children is happening across the board. These antidepressants are being vastly over prescribed, while their dangers are ignored. The FDA does actually not approve these antidepressants for depressed children. This information comes from an educated psychiatrist. He also views that there is a large problem with the administration of antidepressants to children as well.
There are many alternatives that would help Doctors and patients work together to create a better understanding of the benefits for the proper use of antidepressants. There have been some recent discoveries on new medication that has been unconstrained an example of this is as follows: There are new medications that are generally as efficacious as the older tricyclic antidepressants such as Prozac and Zoloft, but have safety advantages. They may be more effective and cost-effective than the older drugs because they are more likely to be taken in an adequate dose for long enough to produce remission and prevent relapse. The efficacy of the new antidepressants is similar to that of the older drugs. The new drugs may be more effective as they are more likely to be taken in an effective dose for an adequate time and are less likely to be toxic. The longer a patient is well, the more likely they are to remain well (Prescr 1999). This is an example of another alternative that doctors could consider.
Patients with minor depression will often recover without drug treatment. The physician should sit tight and listen to the patients need and help the patient by talking him or her through the problem without prescribing ant antidepressant until the physician can make an educational decision that the symptoms require drug treatment. An example that the doctor could use to determine when the patient should be prescribed the medication would be the fact that the doctor may want to wait at least two weeks to see if the patients problem persists. The doctor could then make the educational suggestion that drug treatment could be beneficial. If a patient with major depression is unable or unwilling to take higher dosages of a tricyclic antidepressants, switching to a newer drug might ensure that an adequate dose is given where it is really needed (Kendrick 3). Patients could also work together in group sessions with each other to see if they are really in need of medication. This may be an alternative for some people.
Although there are many alternatives for the usage of antidepressants, in order to administer antidepressants.
Doctors should get to know their patients very well by educating themselves about the right dosage they should administer to their patients rather that just prescribing the antidepressants because of family history, feeling unsure about the prescription because the doctor has suspicion that the person may be lying to him or her, researching very well to prescribe medication that is suitable for young children and mostly knowing exactly the right dosage and the amount of other medication they may be prescribing to prevent unhealthy incidents. With the understanding of these concepts, doctors, especially psychiatrists, would help create a downfall to the problem of over administered antidepressants.